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What is gestational diabetes?

During normal pregnancy, there is a rise in hormones which causes the mother’s body to become relatively insensitive to insulin, the hormone your body produces to lower blood sugar. A woman with gestational diabetes cannot make sufficient insulin to overcome this insensitivity and so develops diabetes, which usually disappears after delivery.

What is the treatment for gestational diabetes?

In many cases, adjusting the diet so as to avoid sugar will be enough. However, if the blood sugars are still too high when measured on home glucose meters, the next step is to start treatment. In the past, treatment was only with insulin injections. Now, there is an alternative to insulin called Metformin.

What is Metformin?

This is a tablet taken by mouth, which works by making the body more sensitive to insulin. It has been used for several years to treat diabetics, but has only been used recently to treat pregnant women with diabetes. It has been found to be as effective as insulin in controlling the blood sugar levels in pregnancy.

Are there any side-effects of Metformin?

Metformin can cause abdominal discomfort, nausea, vomiting, diarrhoea, and disturbed taste. These side-effects are reduced by starting with a low dose and slowly building up. Also side-effects are much less if the drug is taken with food rather than on an empty stomach. Very rarely, it can cause a skin rash, in which we would have to discontinue it.

Are there any side-effects of insulin injections?

Insulin is an injection and cannot be given by mouth. It does not cross over to the baby, so the side-effects only relate to the mother. Obviously, if the dose is too high or the mother didn’t eat enough after her injection, insulin can cause ‘’hypo’s’’ where the blood sugar goes too low. ‘’Hypo’s’’ make patients feel faint and sweaty and need to be treated by taking sugar to bring the blood level back to normal. Another side-effect is weight-gain which is more likely with higher doses.