Not much attention has been paid to gestational diabetes in the past. But recent scientific evidence has shown the importance of monitoring and managing diabetes with increased vigilance at this important time in a woman’s (and her baby’s) life.

New guidelines were introduced in South Africa in 2017 that define what is meant by gestational diabetes and diabetes in pregnancy. Please make sure that if you do have a family history of diabetes that you are pro-active in detecting diabetes during your pregnancy.

Firstly, it is important to set health eating and lifestyle habits PRIOR to conception. It has been shown that optimum weight management and diet at this stage is very important in preventing diabetes occurring. If you already have diabetes before your pregnancy, you want your HbA1c to be as well controlled as possible. Also consider seeing a diabetologist and dietitian whilst planning a pregnancy so that your medication can be reviewed and your diet optimised. Other medications taken for blood pressure or cholesterol control may also need to be altered prior to conception.

During pregnancy, you want to keep your blood glucose levels within a very narrow range. This is to ensure that adverse harm is not done by exposing the fetus to high or low blood glucose levels. Sometimes continuous blood glucose monitoring may be necessary to achieve these targets. Speak to your diabetologist about what type of monitoring may be best for you.

Very often, insulin is necessary during pregnancy although needs may vary during the various trimesters. With good monitoring and regular review, you can adjust your insulin to meet the changing requirements of your body.

Timing of delivery is also vitally important in order to ensure the baby is adequately developed but is not too big. Larger babies may make for a difficult and prolonged labour which may itself result in complications for the mother and baby.

Breastfeeding is a part of pregnancy that is often neglected. Don’t be swayed by pressure to supplement your baby’s feeds with formula just because you are diabetic. The more a baby breastfeeds, the more milk the mother produces. Breastmilk is ideally suited to your baby and provides many, many additional benefits that formula milk is unable to. Seek the advice of a trained professional and with adequate support and encouragement, most mothers should be able to provide enough milk for their newborns.