Gestational Diabetes and labour.

I failed my 1hr GLT yesterday, and my midwife has told me I have about a 50/50 chance of having gestational diabetes based on the outcome of that test. So I have to go back and do the big 3hr test to be sure.
I know a fair bit about management and treatment of diabetes. But I don't know a great deal specifically about gestational diabetes. In particular I would like information about any genuine increase risks during birth for bubs or myself.

I know that a big baby is a risk, but I have had a 10lb bub before (without gestational diabetes) so I'm not concerned about my bodies ability to birth a big baby at all, so wouldn't be going along with induction or any intervention for reason of size alone.

I just want to educate myself, so I'm not caught completely off guard IF this next test does come back positive an I have to start discussing 'options' with my midwife (and likely a hospital appointed ob if it turns out I do have GD). I want to be educated, not just reliant on what I am being told.

I had GD with my last baby (born 9 weeks ago), I found out at 26 weeks and I was only slightly over the allowed BSL for my hospital. I needed to attend GD clinic fortnightly, do BSL 2 hours after each major meal and keep a log of BSL and food diary.

I wasn't told any big risks are fair as labour/birth went other then she would be monitored closely for 48 hours, heel pr!ck blood sugars every 3-4 hours in the first 12-24 hours, they may push for formula top ups (which they didn't :)).

I had 2 extra scans, one at 28 weeks and another at 34 weeks

They may want to induce you early because of it, but there is no real evidence to support this other than trying to avoid a larger baby. You will not be 'allowed' to birth at a birth centre or similar because you will immediately be classed as high risk. There is a really good article on here by Henci Goer about gestational diabetes being a diagnosis in search of a disease and it's really good. Michael Odent has written about it too.

Depending on the severity of the GD, you may be hooked up to an insulin/glucose drip during labour to keep your BSLs steady. Ignoring the big baby scenario (which should only occur if the BSL's are not controlled), the main issue is that BSL's can rise quite high during labour which results in the baby producing extra insulin to metabolise the sugar from the mother, then after the birth the sugar source is removed but they still have excess insulin and can then suffer from hypoglycaemia.

My BSL's were rising rapidly during labour despite having nothing to eat so I had the drip. My levels were checked every hour and maintained at a steady rate. After the birth, DS had his BSL's checked hourly until he returned three normal levels. It also helps to BF them as soon as possible to prevent any lows.

Basically all the GD data is extrapolated from those with Type 1 or preexisting Type 2 which is not really indicative of GD because the babies are often exposed to high BSL during the entire pregnancy rather than just the last trimester. I don't believe that the data is appropriate for those that can control with diet. However, for those that have to take insulin to maintain a reasonable BSL then extra scans are important and early delivery may be advised as insulin can cause the placenta to reduce function toward the end of the pregnancy.

'They' also most likely won't let you birth in water :(

Thank you so much everyone.
I have the 3hr test first thing Monday morning, so FX that comes back in the clear and I don't have to worry about any of this. But at least I have a better idea now of some of the possibilities.

I wasn't going to be allowed to go past 38 weeks and couldn't be induced as I had a c section with my first other than having my waters broken. I went into labour at 37 weeks, I had my waters broken and dd was monitored with her bsl and admitted to the scn as I had insulin in the beginning before managing it with diet.

I highly was insulin dependent and had to start monitoring and scans for fluid levels twice weekly at 33 weeks.

Apparently in my case there were increased risks on still birth and my fluids were getting very low so I was induced at 38 weeks, I could have argued the point but I was over spending (what was every second day in the end) my time waiting in uncomfortable hospital waiting rooms.

I was stuck on monitors at ALL times, I tried using a fit ball but it was just impossible with all those wires. I had no checks on my blood sugars during labour.

DS spent a day and a half in scn with borderline low sugar levels til he got them up higher.

Good luck and I hope you can manage it with diet but better still pass the longer test

Just thought I would update.
I had the test yesterday and left feeling so sure it was going to come back saying I was diabetic. I felt horrid through it (and apparently looked it too). I also found out that I'd scored a BSL of 10 on the previous 1hr test (which is high).
Well my midwife rang a couple of hours later to let me know I was fine and I didn't have diabetes after all! What a relief!!! I couldn't believe it!

No idea why my BSL were so high with the first test. At best guess my body might have been fighting an infection I wasn't aware of (infections can cause raised BSL).

Great news!