Type 1 / Type 2 Diabetes Mellitus (T1DM/T2DM)
Continuous glucose monitoring
Sick day management
Ketone testing
Carbohydrate (CHO)
- Cyber Carbs – online carbohydrate counting course designed by the Family Centre
- Carb counting (NDSS)
Planning for pregnancy and pregnancy with pre-existing diabetes
Driving/travelling with Diabetes
Pre-procedure management of diabetes
Sodium Glucose Co-transporter 2 (SGLT2) inhibitors
Mature Onset Diabetes of the Young (MODY)
MODY is a rare form of diabetes which is distinctly different from both Type 1 and Type 2 diabetes, and runs strongly in families. MODY is caused by a mutation (or change) in a single gene. Visit this resource to learn more.
Gestational Diabetes Mellitus (GDM)
What causes Gestational Diabetes?
Gestational Diabetes is the result of hormonal changes that occur in all women during pregnancy. Increased levels of certain hormones made in the placenta interfere with the ability of insulin to manage glucose. This is called ‘insulin resistance’. As the placenta grows larger during pregnancy, it produces more hormones and increases insulin resistance.
Usually, the mother’s pancreas is able to produce more insulin (about 3 times the normal amount) but if this does not happen, sugar levels will rise and gestational diabetes occurs. We expect blood glucose levels will return to normal after the delivery of the baby.
Risk factors for gestational diabetes
- Being overweight prior to becoming pregnant
- Family history of diabetes
- Being over 35 years of age
- History of large birth weight babies
- Having gestational diabetes in previous pregnancy
- Certain ethnic groups for example Asian, Indian, Middle Eastern
How is it diagnosed?
Diagnosis is made between the 24th and 28th week of pregnancy, based on a 75g Oral Glucose Tolerance Test (OGTT).
If you have had previous gestational diabetes, the OGTT may be performed earlier.
Gestational Diabetes is diagnosed when:
- Fasting ≥5.1mmol/L
- 1 Hour ≥10.0mmol/L
- 2 Hour ≥8.5mmol/L
How is it managed?
- Monitoring your blood glucose levels as recommended by your Diabetes Nurse Educator
- Following specific dietary guidelines as recommended by the dietitian. Good nutrition is recommended in pregnancy.
- Control your weight gain
- 30 minutes of physical exercise is recommended per day, since both insulin and exercise lower blood glucose
- Insulin injections may be required to achieve good control
Blood Glucose Monitoring
Testing blood glucose levels at certain times of the day will help determine if your exercise and eating pattern changes are keeping your levels under control.
- It is important to keep an accurate record
- Testing times: test before breakfast and 2 hours after meals
- Bring record book/sheet and blood glucose meter to each clinic visit
Home Blood Glucose Monitoring
Target:
- Less 5.5mmol/L before breakfast
- Less 7.0mmol/L 2 hours after meals
(These targets may be adjusted by your treating team)
Remember to test blood glucose levels:
- Daily before Breakfast
- 2 hours from start of each meal; breakfast, lunch and dinner
Do l need to take insulin?
Insulin is a hormone that controls blood glucose levels.
Based on your blood glucose monitoring results, the Diabetes team will advise if you need to have insulin injections during pregnancy.
If insulin is needed, the Diabetes Nurse Educator will teach you how to give your injections.
As your pregnancy progresses, the placenta will make more pregnancy hormones and you may need a larger dose of insulin to control your blood glucose level.
Higher blood glucose levels can affect your baby
As insulin resistance does not develop until around the 24th week of pregnancy, birth defects are not a common complication.
Labour and delivery are generally not affected by gestational diabetes, however if the baby has grown too large, induction before your due date or a caesarean delivery may be necessary.
If the blood glucose levels are too high, your baby may:
- Grow too large (over 4kg or 9lb)
- Be delivered earlier than expected
- Have low blood glucose levels after delivery
- Have difficulty breathing
Gestational diabetes will not cause your baby to be born with diabetes.
Labour and delivery
Careful control of your blood glucose levels remains important during labour to avoid a drop in the baby’s blood sugar after birth. If this happens, your baby may require observation in the Special Care Nursery.
Test blood glucose levels 2 hourly when in labour.
Care after delivery
Usually, blood glucose levels return to normal after delivery.
You will need to visit your GP 6 weeks after your baby is born to have an OGTT done.
If the result is normal, you should have a repeat test every 2 years. If the result is not normal, your doctor will advise you what needs to happen.
Women who have had gestational diabetes have an increased risk of developing Type 2 diabetes later in life. To help reduce your risk, continue a healthy lifestyle, control your weight, eat healthy meals, do regular exercise and don’t smoke.
See our doctor for at least annual routine medical checks.
If you had gestational diabetes and plan another pregnancy, talk to your doctor so you can make the necessary lifestyle changes before your next pregnancy. You should also be tested earlier in your next pregnancy.