Understanding Diabetes Mellitus
Diabetes mellitus is a chronic condition characterised by elevated blood glucose (sugar) levels. Glucose fuels our cells, but without sufficient insulin, a hormone produced by the pancreas, glucose cannot enter cells efficiently. When insulin production is inadequate or when the body becomes resistant to insulin’s action, blood sugar rises, increasing the risk of serious complications if left unmanaged.1
Main Types of Diabetes
There are three primary types of diabetes:
- Type 1 Diabetes
- Type 2 Diabetes
- Gestational Diabetes
In addition, medical authorities often recognize a fourth category, “other specific types”, which includes monogenic forms (e.g. MODY) and secondary diabetes caused by drugs or other diseases.
Type 1 Diabetes
Definition: An autoimmune disorder in which the pancreas produces little to no insulin.
- Prevalence: Accounts for about 5–10 % of all diabetes cases worldwide.
- Onset: Most commonly diagnosed in children, teens or young adults.
Type 2 Diabetes
Definition: Characterised by insulin resistance and a gradual decline in insulin production.
- Prevalence: Represents approximately 90 % of global diabetes cases.
- Onset: It’s most common in adults and is strongly linked to obesity, inactivity, and family history; it can often be managed initially with lifestyle changes and oral medications.
Risk Factors:
Overweight/obesity, sedentary lifestyle, family history, and advancing
Gestational diabetes mellitus (GDM) develops when hormonal changes in pregnancy interfere with insulin’s effectiveness.2 As placental hormones rise, particularly human placental lactogen and progesterone, they can provoke insulin resistance. To compensate, the pancreas must secrete more insulin; when it cannot, blood glucose levels climb.3
Causes of Gestational Diabetes
Following are 2 major causes of Gestational diabetes:
- Insulin Resistance: Placental hormones block insulin action, demanding higher insulin output.
- Insufficient Compensation: If pancreatic β-cells
Who Is at Higher Risk?
Women who have:4
- Previous GDM: History of gestational diabetes in an earlier pregnancy.
- Maternal Age ≥ 35: Risk rises steadily after age 35.
- Family History: First-degree relative with type 2 diabetes.
- Body Weight: Pre-pregnancy overweight (BMI ≥ 25 kg/m) or excessive early pregnancy weight gain.
- Ethnicity: Women of Indigenous Australian, South Asian, East Asian, Middle Eastern, Afro-Caribbean or Hispanic background.
- Polycystic Ovary Syndrome (PCOS): Associated with insulin resistance.
- Large-for-Gestational-Age Infant: Prior delivery of a baby weighing > 4 kg.
- Medication: Use of corticosteroids or antipsychotic drugs.
Recognizing and Diagnosing GDM
Most women do not notice symptoms. When present, they can include:5
- Increased thirst and dry mouth
- Frequent urination
- Unusual fatigue
Because these overlap normal pregnancy changes, targeted screening is essential. Oral Glucose Tolerance Test (OGTT)
- Fasting Blood Sample: After a 10-hour overnight fast.
- Glucose Drink: Standard 75 g solution.
- 1-Hour & 2-Hour Blood Tests: Measured at 60 min and 120 min.
Diagnostic Thresholds (WHO Criteria):
- Fasting ≥ 5.1 mmol/L
- 1-hour ≥ 10.0 mmol/L
- 2-hour ≥ 8.5 mmol/L
A single elevated value confirms GDM.
Potential Impacts on Mother and Baby
Gestational diabetes can affect both mother and the baby, following are the potential impacts:
Maternal Risks
Mother can face risks like:
- Preeclampsia (pregnancy-induced high blood pressure)
- Increased likelihood of caesarean delivery6
Fetal and Neonatal Risks
Baby can face:
- Macrosomia: Birth weight > 4 kg, raising delivery injury risk.
- Neonatal Hypoglycaemia: Baby’s blood sugar may drop rapidly after birth.
- Preterm birth and breathing difficulties7
Long-Term Concerns
Gestational diabetes not only affects the mother during pregnancy but also affects both mother and baby later in life:
- Mothers face a 35–60 % chance of developing type 2 diabetes within 10–15 years.
- Offspring have higher rates of obesity and glucose intolerance in adolescence or adulthood.8
How To Manage Gestational Diabetes?
There are many ways you can successfully manage gestational diabetes. Once you have been diagnosed, you may be referred to your local diabetes service.9,10
Balanced Nutrition
A balanced diet can have really great impact on reducing sugar levels during pregnancy:
- Spread carbohydrates evenly across meals and snacks
- Choose low-glycaemic foods: whole grains, legumes, fruits and non-starchy vegetables
- Consult an accredited dietitian for a tailored meal plan
Safe Physical Activity
You can also try some light exercises to manage it:
- Aim for 30 minutes of moderate exercise (e.g. brisk walking, swimming) most days
- Avoid high-impact or contact sports, check with your obstetric team first
Monitoring & Treatment
By combining diligent monitoring, tailored nutrition and exercise, and timely pharmacotherapy, you can maintain blood glucose within target ranges, optimizing outcomes for both you and your baby. 1. Blood glucose self-monitoring
- Fasting: 4.0–5.3 mmol/L
- 1 hour post-meal: ≤ 7.8 mmol/L
- 2 hours post-meal: ≤ 6.7 mmol/L
2. Medication
- Metformin if diet and exercise alone are insufficient
- Insulin when targets aren’t met
3. Receive injection -technique training and dose-adjustment support from your pharmacist or diabetes educator
Reducing Future Risk
You can significantly reduce the risk of gestational diabetes in future by observing these practices:11
- Pre-pregnancy: achieve a healthy weight; maintain balanced eating and regular exercise
- During pregnancy: limit total gain to 11–16 kg (for normal-weight women); keep glycaemic targets
- Postpartum: continue healthy habits to lower your risk of type 2 diabetes
When to Contact Your Healthcare Provider?
Must contact your doctor if you notice:
- Persistent high or low glucose readings
- Hypoglycaemia signs: shaking, sweating, dizziness
- Preeclampsia symptoms: severe headache, visual changes, sudden swelling
- Any concerns about fetal movement or wellbeing
- Always attend scheduled antenatal visits and glucose reviews
Where to Find Support?
Your local Cooleman Court pharmacist is available daily to guide you through every step of managing gestational diabetes. You may also register with the National Diabetes Services Scheme (NDSS), which offers subsidised access to essential diabetes supplies. Call the NDSS helpline on 1800 637 700 to speak with a healthcare professional, get advice and find out what gestational diabetes services are available in your area.