Frequently Asked Questions

Frequently Asked Questions

Gestational Diabetes FAQ’s

Will my baby get diabetes? The baby will not be born with diabetes.  Because the baby will have inherited the mother’s genes in the longer term when the child grows up they will have an increased risk for diabetes.  Thus both the mother and infant should be sensible about their diet and keep active. Either way we will have much better ways of treating diabetes by then.

Does insulin harm the baby? Insulin does not cross the placenta and thus will not harm the baby. The high glucose if left untreated crosses the placenta and can harm the baby.

What are my chances of getting diabetes in the long term? Because your pancreas was not able to make enough insulin to handle the pregnancy we know it is not perfect. In the long term especially if you gain weight, do not pay attention to diet and exercise the risk of diabetes at fifteen years after the baby was born is as high as 50% in the mother.

Diabetes can cause complications to eyes and kidneys, will I get them? It usually takes long-standing diabetes to get diabetic complications so we would not expect a mother with gestational diabetes to get these problems during the pregnancy.

If I get a low blood sugar, does this harm the baby? Low blood sugars do not seem to harm the baby.  Low sugars in treated gestational diabetes are rare as the mother is so resistant to insulin. Animal studies suggest the hypoglycemia has to be very severe and very prolonged before any harm could come to the baby.

What are the lower limits for my sugars? As a general guide a fasting sugar below 3.5 mmol/l   (63 mgs/dl), a one hour after meal value of 4.5 mmol/l   (81 mgs/dl) or a two hour after meal value of 4.0 mmol/l   (72 mgs/dl) would be considered low and if on therapy would prompt a reduction in the insulin. If you are not on treatment and get low numbers like these then no intervention is required, these values are likely within the normal range albeit at the lower end.

Am I more likely to  have a stillbirth?  Few words are more feared than the word Stillbirth.   It is devastating when it happens.  A review in the Lancet in 2007 by Smith and Fretts indicates that the overall rate of stillbirth is 6-7  per 1,000 deliveries.   An important issue is whether it is more common in GDM.   A study of over 10,000 pregnancies by Karmon reported in 2009, Int J Gyn Obs, showed no increase in stillbirth and the Ohana study from Israel in 2011, J Mat Fet Neo Med, of more than 220,000 births  where there was 1,694 intrauterine deaths showed GDM was not a risk factor.   In a population study from Sweden by Fadl in 2010, Diab Med, there was no difference in the stillbirth rate if one had GDM.  The current  evidence indicates that having GDM does not increases the risk of stillbirth.


Other sites that may be of interest:

http://www.babyandbump.com/gestational-complications

A general forum for chatting and discussion.

http://www.diabetes.ca/diabetes-and-you/healthy-guidelines/protecting-mothers/

CDA website about followup after GDM

 

General Information

Canadian Diabetes Association

http://www.diabetes.ca/

hard to find pregnancy specific information

American Diabetes Association

http://www.diabetes.org/

hard to find pregnancy specific information

 

diabetescarecommunity.ca

A new website from Toronto for general  diabetes

 

http://evidencebasedbirth.com/

A site that looks at how good the evidence for some of the things that have become standard

 

www.exerciseandpregnancy.ca

A site about exercise in pregnancy with advice on safe exercising in pregnancy under the “Resources” heading.