Gestational Diabetes – the what, why and how?

What is it?
Gestational diabetes is a form of diabetes and is the most common pregnancy-related complication, often detected early in the third trimester (McIntyre et. Al. 2019). The number of women in Australia being diagnosed with gestational diabetes is increasing. Between 2017-18, 1 in 6 women between the ages of 15-49 were diagnosed, which is triple the number of women diagnosed between 2000-01 (AIHW, 2020). Like type 1 and type 2 diabetes, gestational diabetes sees a rise in blood sugar beyond a healthy level. If you have been diagnosed with gestational diabetes you should seek advice from a medical professional due to possible health risks for your infant. Gestational diabetes usually resolves itself after pregnancy however can increase your risk of developing type 2 diabetes.

How do you get it?
During pregnancy hormone levels increase and fluctuate and these changes can impact a hormone known as insulin. Insulin is responsible for keeping blood sugar levels within a healthy range, and this is especially important after eating a carbohydrate-rich meal that causes blood sugar levels to rise. The action of insulin is reduced during pregnancy which means your body needs to produce more to compensate. If your body is unable to do so, gestational diabetes may develop.

Other possible factors that are commonly associated with an increased likelihood of a gestational diabetes diagnosis include being overweight before pregnancy and gaining too much excess weight during pregnancy. However, it’s important to note that not all women that develop gestational diabetes are overweight. Women are more likely to develop GDM if they have had it previously, if they are over 40 years of age and unfortunately some women simply have a genetic predisposition. No matter what the cause it is important to remove some of the stigma around Gestational diabetes and for women to be open and willing to get help with management.

So, what can you do about it?
There are many strategies you can use to reduce your risk of developing gestational diabetes as well as manage a diagnosis.
1. Healthy eating
o Eating small regular meals throughout the day
o Spread your carbohydrates evenly across meals
o Opt for low GI carbohydrates
o Eat a variety of fresh fruit, vegetables, plant proteins, dairy and meat (your Women’s Nutrition Dietitian Rachel Hazlett can help you with this!)

2. Monitor your carbohydrate portions
o This can be a challenge for a lot of women as the serve sizes of various carbohydrates differ depending on the brand and size and what you eat with it. As a general rule aim for 30-45g (2-3 serves) of carbohydrates at breakfast, lunch, and dinner. For snacks aim for 15-30g (1-2 serves) of carbohydrates at mid-morning, mid-afternoon, and supper

3. Be aware of Glycaemic Index (GI)
o Choose low GI carbohydrates that are more slowly digested by the body.

4. Appropriate weight gain
o Discuss with your dietitian an appropriate weight gain for your pregnancy. Click here for a handy online tool to see how much you should gain.

5. Physical activity
o It’s challenging to fit this one in when you’re feeling exhausted however it is important to try to include more incidental physical activity throughout your day. Start small with things like taking the stairs instead of the lift, parking further away from your destination and household chores.

6. Sugar and artificial sweeteners
o If you’ve got a sweet tooth you could consider using artificial sweeteners to avoid having too much sugar. However there is scarce research around the safety of these during pregnancy so limiting them would be the best option. Try having a small serve of fresh fruit to meet your sugar cravings instead.

7. Monitor blood glucose levels
o A key part of GDM management is monitoring your blood glucose levels so that you can track how your body is reacting to what you eat. By identifying which foods are likely to cause a spike in your sugar levels you can hopefully learn to manage it better. This is a bit complicated though so remember to ask for help. Rachel at Women’s Nutrition loves talking diabetes management with her patients and coming up with simple and practical ways to eat eat yummy food whilst managing your diabetes. There are also specialist nurses called diabetes educators who can help you too.

Quick tips
1. Monitor your diet and make changes when your blood glucose rises too much after a particular meal.
2. Figure out how much weight gain is appropriate for your pregnancy with the help of a Women’s Nutrition dietitian.
3. Try to fit in some light exercise to help manage weight gain

Book in Today for help with your Gestational Diabetes

References
McIntyre, H. D., Catalano, P., Zhang, C., Desoye, G., Mathiesen, E. R., & Damm, P. (2019). Gestational diabetes mellitus (primer). Nature Reviews: Disease Primers, doi:https://doi.org/10.1038/s41572-019-0098-8

Australian Institute of Health and Welfare. (2020). Diabetes. Retrieved from https://www.aihw.gov.au/reports/diabetes/diabetes

For more information take a look at the Australian Dietary Guidelines for pregnancy:

n55h_healthy_eating_during_pregnancy.pdf (eatforhealth.gov.au)