Patient information · Women's health
Gestational diabetes
and the postnatal test almost everyone forgets
Gestational diabetes is high blood glucose that develops in pregnancy. It is manageable, and good control substantially reduces the risks to you and your baby. It is also a warning about your future health — and the follow-up that identifies that is missed in a large proportion of women.
Contact your maternity unit urgently if you have
- reduced or changed fetal movements
- severe headache with visual disturbance, or sudden swelling of the face and hands
- persistent vomiting, or inability to keep fluids down
- very high glucose readings with thirst, drowsiness or abdominal pain
- vaginal bleeding, or abdominal pain
- readings that are persistently above target despite following the plan
Reduced fetal movements always warrant same-day assessment, whatever the reason. Never wait until the next appointment. In an emergency call 999, or contact your maternity unit directly.
Who is screened
Testing is with an oral glucose tolerance test, usually at 24 to 28 weeks, or earlier if you have had gestational diabetes before. You are offered it if you have any of:
- BMI over 30
- a previous baby weighing 4.5kg or more
- previous gestational diabetes — tested early, at booking
- a first-degree relative with diabetes
- a family origin with high diabetes prevalence — South Asian, Black Caribbean, Middle Eastern. This applies to a large proportion of families in East London, and at lower BMI thresholds than in white European women
- polycystic ovary syndrome, or glucose found in the urine at an antenatal visit
The targets
You will be given a meter and asked to test several times a day. Testing is more informative than it feels — it shows which of your meals push you over, which is far more useful than a generic diet sheet.
Diet and activity
Helps
- Lower-glycaemic carbohydrates: basmati rice, wholegrain bread, oats, pulses
- Protein and healthy fat with every carbohydrate portion, which blunts the rise
- Smaller, more frequent meals rather than large ones
- A 10–15 minute walk after eating, which lowers post-meal readings substantially
- Testing to find your own triggers rather than following generic rules
Raises glucose sharply
- Fruit juice, smoothies and sugary drinks
- White rice, white bread, and large portions of any starch
- Breakfast cereals, including many marketed as healthy
- Skipping meals, which causes rebound highs later
- Very low-carbohydrate diets without advice, which risk ketosis
If diet is not enough
- Metformin is usually tried first and is safe in pregnancy.
- Insulin is added or used instead where readings remain above target, or where the baby is measuring large. It is safe, does not cross the placenta, and needing it is not a failure — it reflects the placenta's hormones, not your effort.
- You will have extra growth scans, usually every four weeks from 28 weeks.
Birth and afterwards
- Birth is usually recommended by 40 to 41 weeks, earlier if there are complications or you are on insulin.
- Your baby's blood glucose is checked after birth; early and frequent feeding helps prevent it dropping.
- Diabetes medication is stopped immediately after delivery in most women.
- Breastfeeding lowers your future diabetes risk and helps your baby's glucose.
The follow-up that gets missed
Gestational diabetes means a substantially raised lifetime risk of type 2 diabetes — over half of women develop it within 10 to 15 years. You should have a fasting glucose or HbA1c at 6 to 13 weeks after birth, and then an HbA1c every single year for life. In practice a large proportion of women never have the postnatal test and are never offered the annual one. If nobody has arranged yours, arrange it yourself. Identified early, progression to type 2 diabetes is often preventable.
Why come to us. If your postnatal or annual test has not been arranged, we can do it — HbA1c and fasting glucose taken in-house with results explained the same visit, alongside blood pressure, lipids and weight, and a plan to reduce your risk. We also offer early screening if you have had gestational diabetes before and are pregnant or planning to be. Seven days a week, no referral needed, and many of our clinicians speak the languages of the communities most affected.
The postnatal and annual test, actually done
HbA1c in-house, results the same visit. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.