Gestational Diabetes

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1 Gestational Diabetes

2 What is Gestational Diabetes? Gestational Diabetes occurs during pregnancy and usually it goes away when your baby is born. In most cases you will have a blood test around 28 weeks of pregnancy to test for it. Gestational Diabetes means that your body is not able to keep the amount of sugar in your blood at a normal level during your pregnancy. When the mother has high levels of sugar in her blood, the sugar is passed through the placenta to the baby. It is important to understand that the baby DOES NOT HAVE diabetes. Gestational Diabetes can be controlled, but it will mean that you need to take extra care of yourself. You can have a healthy pregnancy and a healthy baby. Monitoring your Diabetes You will need to test your blood sugar several times per day with the glucometer (blood sugar testing machine). It is important to test your blood sugar BEFORE BREAKFAST and ONE hour after your meals. If you finish eating at 8:15, do your blood sugar test at 9:15. Before breakfast your blood sugar should be between 4.0 and 5.2. After meals your blood sugar should be between 5.0 and 7.7. Please bring your glucometer to the clinic each visit. You should store your machine and testing strips in a normal temperature setting. These strips must remain in the original bottle with the cap on until you use them. The used lancets (needles) should be thrown away in a tightly closed container as they are dirty with blood. When the container is full, you may throw the closed container in the garbage. Please be sure to keep clean and dirty lancets away from other family members and children. Please write down your blood sugar results on a paper and bring it to the clinic for each visit so it can be reviewed. 1

3 Gestational Diabetes and Your Baby When the sugar passes to the baby, this may cause the baby to grow bigger. A big baby may have problems passing through the birth canal and may need to be born by cesarean section. If your blood sugar is not well controlled, your baby may also go through sugar withdrawal at birth because it is used to high blood sugar levels. The baby s blood sugar may drop too low, and the baby may need special care in the Neonatal Intensive Care Unit (NICU). Appointments at the Perinatal Centre You should usually visit the clinic once a week. At these visits, you will meet with different team members in the clinic. You will meet with the dietician to create a meal plan. This plan will help you control your blood sugar. You should start eating 3 meals and 3 snacks every day. The dietician will decide how much food (calories) you need. He/she is available to answer questions about your meal plan during the course of your pregnancy. Exercise helps to lower your blood sugar, and walking after a meal is suggested. Exercising too hard is not recommended during pregnancy, so you should speak with your doctor before starting any exercise program. Tests That You Will Be Receiving Non Stress Test (NST) You will start having NSTs between weeks of pregnancy. An NST is a simple test that takes at least 20 minutes, and will not hurt you or your baby. You will have two belts placed around your belly and you will be connected to a monitor. The monitor records your baby s heart and movements. This test will start at 32 weeks if: You have Type I or Type II diabetes; You have Gestational Diabetes and need insulin (a medication to help control your blood sugar); Your blood sugar is not well controlled. You must eat a meal before your NST. The baby will be more active after you eat. 2

4 Ultrasound All mothers with Gestational Diabetes must have an ultrasound between weeks. Please make an appointment with the ultrasound department at ext Your health care professional will tell you when to make the appointment. During your ultrasound, it may show that you have an ANTERIOR PLACENTA. This means that your placenta is in front of your baby. Movements of your baby may not be easily felt as the placenta acts as a cushion to decrease your sensation of the movement. Your Baby s Movements If there is a change in your baby s normal activity Every baby is different and there will be times in the day when a baby is more active and times when he or she is less active. You will become used to the way your own baby moves during your pregnancy. After 28 weeks of pregnancy, if you notice a change in your baby s regular activity pattern, you may count his/her movements. A movement may be a kick, a turn, a flip or a rub. Have something to eat, and rest by lying on your left side; and Try to relax and focus on your baby s movements. If in 2 hours, you have not counted 6 movements, please call and then come to the Family Birthing Centre (Pav. B, 5 th floor) right away. Urgent Situations: You should also IMMEDIATELY go to the hospital IF: You feel NO baby movements in 8 hours, OR You FALL, OR You are involved in a CAR ACCIDENT, OR You are HIT in the belly. DO NOT WAIT UNTIL THE NEXT DAY. YOUR BABY S WELL BEING COULD DEPEND ON IT. 3

5 In Hospital Care of the Diabetic Mother If you are taking insulin for your diabetes, do not take your morning dose before coming in for a booked induction or a planned c-section. Your blood sugar will be checked often during your labour, delivery and postpartum hospital stay. If you have gestational diabetes and are taking insulin, after delivery you will not need to take your insulin any more. Follow-up Care of the Diabetic Mother You will need to have a blood glucose test 6-8 weeks after your baby is born to make sure that the diabetes is gone. Your nurse will give you a lab test request form for this test. Take the request form to the Test Center (Pavilion E, Room 102) on a day of your choice. DO NOT EAT OR DRINK anything other than water for the 6 hours before the test. You will have a fasting blood test (a blood test taken after you have not eaten for 6 hours), and then return for a second test. The second test is done two hours after drinking the glucose drink. You may call the Perinatal Centre the next day for your results. Please note, if you had gestational diabetes you are likely to have it again in your next pregnancy. You should visit this clinic around the 10 th week of your next pregnancy so that your blood sugar levels can be checked early. Research shows that you have an increased chance of developing diabetes in the next 10 years. You are more likely to develop diabetes if you are overweight, or have a history of diabetes in your family. It is important to maintain a healthy lifestyle with healthy eating and regular exercise. You should have a diabetes test every year, even if the gestational diabetes has gone away after your baby is born. 4

6 Please remember, you may call the Perinatal Centre if you have any questions or concerns. The clinic is open Monday to Friday 07h30 15h30. If you are not sure if you should come to the hospital or if you have any worries about your health or the health of your baby you can call the Family Birthing Centre at any time, day or night at and ask to speak to a nurse. PERINATAL CENTre Room H ext Prepared by: The Perinatal Centre Health Care Team SMBD Jewish General Hospial 3755 Chemin de la Côte-Ste-Catherine Montreal, QC H3T 1E2 Reviewed by: Dr. Louise Miner jgh.ca 2014 This information should not be considered as medical advice. It is not to be used in place of a visit with a doctor, nurse or other healthcare professional. If you have questions about your individual medical situation, please consult with your healthcare professional. 5

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