Diabetes in Pregnancy

You are receiving this pack as you have been diagnosed with Gestational Diabetes in a previous pregnancy.

What you need to know

When you have had Gestational Diabetes in a previous pregnancy, you have a 40-80% chance of developing it again in a subsequent pregnancy. For this reason we recommend commencing blood glucose monitoring earlier this pregnancy. The aim is to detect gestational diabetes earlier in this pregnancy and if required commence management earlier.

You do not need to change your diet when you start monitoring your blood glucose levels. The diabetes team will monitor your blood glucose levels virtually every 2-3 weeks and keep you updated, via telephone or text message (via GDM health app).

 You will be diagnosed with gestational diabetes again if;

  • >10% of your blood glucose levels are out of target range OR
  • You have had to make dietary adjustments to keep your blood glucose levels within target range

 The link below will take you to a short video with a step by step guide on how to do your blood sugar levels as a reminder.

Should you be diagnosed again there is also information on how to best manage diabetes in pregnancy.

For further information you can also visit: 

Blood glucose monitoring in pregnancy

Due to your risk of diabetes in this pregnancy we would like you to start blood glucose monitoring from 16 weeks of pregnancy. We recommend continuing to monitor throughout your pregnancy and until your baby is born.

Please check your blood glucose levels 4 times a day; first thing in the morning before eating or drinking anything (fasting) and 1 hour after finishing your breakfast, lunch and evening meal.

We recommend this testing frequency on a daily basis as we are reliant on identifying patterns rather than looking at individual readings. Please help us to help you by recording 4 times daily.

Your target blood glucose levels are as follows:-

Fasting/Before Breakfast:       3.5 to 5.2mmol/l

1 hour after meals:                  3.5 to 7.7mmol/l

At Chelsea and Westminster Hospital, we use a blood glucose meter that links to an app (GDM Health app). Providing you are testing your glucose levels using the app, the diabetes team will be able to review your levels virtually. This means that if you have any concerning readings we can be proactive in helping you manage these between your face to face appointments. 

In target readings will record as green on the app, above target readings will record red and below target readings blue.

It is important to add information of your dietary intake, including snacks and drinks plus also any exercise that you do onto the GDM-Health app.

If you experience more than 3 out of target range blood glucose levels then please email our team email address on; Chelwest.obstetric.diabeticteam@nhs.net

How to link my blood glucose meter to the GDM-Health app

You will find a written step by step guide in this information pack. Please follow these instructions. You will receive an activation code by text. Please let us know if you do not receive this via our email address.

What happens if I am diagnosed with Gestational Diabetes again?

If your blood glucose monitoring is detected to be abnormal, the diabetes team will contact you via telephone to inform you that you have developed Gestational diabetes.

You will be advised to make dietary and lifestyle changes to help manage your blood glucose control. You should watch the remainder of the video links mentioned previously to remind yourself of these changes.

If your blood glucose levels do not remain in target range with dietary and lifestyle changes alone, the team will make contact with you to advise you of the next recommended steps. This will be management with medication.

You will be referred to have growth scans for your baby at 28, 32 and 36 weeks. The diabetes team will also offer you face to face appointments at the same timings to review your blood glucose levels.

Rest assured, if you have any concerning readings between your appointments, your name will flag on the app and alert the diabetes team who will be in contact.

Contacting the antenatal diabetes team

Our team email address is: Chelwest.obstetric.diabeticteam@nhs.net

This email address is for non-urgent diabetes queries or concerns. We will usually respond to you within 72 working hours. Please do not request a call back via the app as we have no way of identifying what problem or query you may have.

Can we please ask that within the subject heading of the email section you include the reason for your email, for instance:-

  • FAO: Consultant/Dietician/ Midwife/ Nurse
  • Dietary problems
  • App queries or problems
  • Diabetes appointment issues
  • Prescription issues - please contact us in advance before you run out of medicines, if you need a repeat hospital prescription.
  • Prescription issues for needles or testing strips need to be addressed by your GP as we do not stock these items in our hospital pharmacy

If you are concerned about your diabetes management there is further information which is regularly updated on our Trust website, this can be found at; www.chelwest.nhs.uk/services/medicine/diabetes  

If you have any urgent concerns, please contact the Maternity Assessment Suite as detailed on the inside cover of your main maternity notes (0203 315 6000).

Diabetes prescriptions

In your pack we have included a copy of the GP letter that you need to hand in to your GP Surgery as soon as possible to receive a repeat prescription.

This will be for your blood testing strips, lancets and a sharps disposal box.

 Please add your personal ID sticker onto the letter provided and hand this in to your GP practice. All your repeat prescriptions for the meter come from your GP Surgery.

Please ensure to order from your GP a couple of weeks before you are expected to run out of supplies to avoid running out.

If you have any prescription issues with your GP please do not hesitate to contact us on Chelwest.obstetric.diabeticteam@nhs.net and specify the exact issue.

Antenatal colostrum harvesting

In your pack you will find a colostrum harvesting pack which you can start using from 36 weeks onwards.

Antenatal colostrum harvesting has a number of benefits for you and the baby. For more information please visit: https://padlet.com/infantfeedingchelwest/s2ya0c4wo21l


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