Are you at risk of Gestational Diabetes?

Pregnancy is a journey that’s full of surprises ― from feeling your baby’s first kick to discovering your little one’s gender. But when the “surprise” is gestational diabetes, how can you ensure a healthy pregnancy for you and your baby?

What is gestational diabetes and how common is it for expectant mothers?

Gestational diabetes is a condition in which high blood glucose (sugar) develops during pregnancy when that person didn’t have pre-existing diabetes. It can happen at any stage of pregnancy but is more common in the second or third trimesters. In Singapore, gestational diabetes affects almost 1 in 4 pregnancies.

While most pregnant women with gestational diabetes go on to deliver healthy babies, the condition can cause complications for the mother and child if it isn’t managed properly:

For the mother:

  • Pre-eclampsia: This condition causes high blood pressure during pregnancy and can lead to pregnancy complications for both mum and baby if it isn’t treated.
  • May require a C-section delivery because her baby is too big (macrosomia ― baby weighs more than 4kg at birth).
  • Risk of developing Type 2 diabetes in the future.

For the baby:

  • Macrosomia: The baby grows excessively.
  • Premature birth.
  • Breathing difficulties.
  • Risk of developing low blood sugar or jaundice (yellowing of the skin and eyes) after birth, which may require treatment in hospital.

Risk factors for gestational diabetes

Any woman can develop gestational diabetes during pregnancy, but some may be at an increased risk, for example, if they:

  • Have family members (that is, parents or siblings) with diabetes.
  • Are overweight or obese before pregnancy.
  • Are 40 years and older.
  • Had a child who weighed more than 4kg at birth.
  • Had a history of gestational diabetes in a previous pregnancy.

Screening for gestational diabetes

In Singapore, unless they have pre-diabetes or pre-existing diabetes, all women who are 24 to 28 weeks pregnant are advised to be screened for gestational diabetes.

If you are at high risk of undiagnosed pre-existing diabetes (such as if you have a history of gestational diabetes, have delivered a baby 4kg and heavier, or are obese), you may be screened for diabetes in the first trimester of your pregnancy. If the reading is normal, you will be checked again for gestational diabetes at 24 to 28 weeks of pregnancy.

The Oral Glucose Tolerance Test (OGTT) screens for gestational diabetes. After an overnight fast of 8 to 10 hours, you will undergo a blood test in the morning to check your glucose level. You will then be given a glucose drink. Blood samples will be taken at one- and two-hour intervals to assess how your body is dealing with the glucose. Gestational diabetes is diagnosed if your fasting blood sugar is 5.1 mmol/L or greater, your 1-hour reading is 10 mmol/L or greater, or your 2-hour reading is 8.5 mmol/L or greater.

Keeping gestational diabetes under control

To reduce their risk of developing gestational diabetes, Ms Ruth Ho, a senior dietitian at NOVI Health, advises expectant women to observe the following practices before they get pregnant and in early pregnancy.

  • Adopt a healthy diet with a good balance of vegetables, fruits, lean protein and high-fibre carbohydrate foods (such as brown rice, wholegrain bread, wholemeal pasta, oats)
  • Cut down your intake of sugary drinks, desserts and snacks.
  • Practise portion control ― large portions of carbohydrates will increase your blood glucose levels.
  • Stay active and exercise regularly before and during your pregnancy. Ideally, pregnant women should get at least 150 minutes of light to moderate-intensity physical activity every week to improve their overall fitness and reduce the risk of gestational diabetes.

If gestational diabetes is detected, expectant mothers can better manage their condition at Thomson Medical Centre’s Holistic Personalized (HOPE) Program for Gestational Diabetes, with the support of an experienced team of diabetes nurse educators, dietitians and medical specialists. This programme, run in partnership with NOVI Health, consists of a full-day session and two weeks of digital health coaching through the NOVI app. The aim is to equip expectant mums with important nutrition and lifestyle management information, as well as practical skills in glucose monitoring, so as to put their pregnancy on the right path.

Those who require continued support can sign up for NOVI’s HOPE Plus Program. In this 6 month-long structured programme that follows the HOPE Program, the mothers-to-be will obtain diabetes care support for the rest of their pregnancies and into the post-partum period.