Gestational Diabetes, or GDM for short, has been defined as “a carbohydrate intolerance of variable severity with the first onset or diagnosis during the current pregnancy”1 and is usually and traditionally diagnosed through an oral glucose tolerance test.
Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity, poor obstetric history (in other words: a history of miscarriages, ectopic pregnancy or abortions), polycystic ovarian syndrome (PCOS) and certain ethnic groups. It is estimated that between 5.5 and 8.8% of pregnant women in Australia will develop GDM.
Women with GDM will be prescribed a diet with restricted carbohydrate intake. It is generally recommended to have more frequent, smaller portions spread out across the day to help maintain glucose levels. Mostly women are asked to have a smaller breakfast, lunch and dinner and to include some morning tea, afternoon tea and supper.
They are also asked to do regular physical activity, to help burn off excess sugar. Guidelines may vary slightly from one area to another, but mostly women are asked to do 150 minutes per week (or 30 minutes daily) of moderate intensity physical activity. For most women, this means going for a daily walk in addition to their regular daily activities.
Good glycaemic (blood sugar) control is crucial for the foetus as high blood glucose levels can cause complications in the new born baby. These complications can include jaundice (a yellowing of the skin due to a struggling liver, requiring phototherapy), hypoglycaemia (a low blood glucose level), shoulder dystocia (dislocation) and macrosomia (big baby).
Women with gestational diabetes are asked to check their blood glucose levels regularly so that their progress can be reviewed.
In approximately one third of patients, diet and exercise alone is not enough to maintain good blood glucose control and hence insulin treatment may be required. In Australia tablets are generally not used in pregnancy as most tablets would cross the placenta and they are often not strong enough to provide the required level of glucose control. Insulin is a much safer option as insulin will not cross the placenta and side-effects are minimal.
While the carbohydrate intolerance mostly returns to normal after the birth, the mother has a significant risk of developing type 2 diabetes later in life, while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in its life. Self-care and dietary changes are essential in the prevention of diabetes down the track for both mother and child.
To find out more about GDM talk to Carolien. She has helped women with GDM for over 20 years and she understands the concerns you may have. In a consultation with Carolien you can discuss how GDM might impact you or your baby, what you can do to minimise risks, learn more about carbohydrates and how they affect blood glucose levels and what type of physical activity may be beneficial for you. She can also provide you with a free blood glucose monitor.
And if you want to find out more, whilst you are waiting to see Carolien, then the National Diabetes Services Scheme has a fabulous website with loads of useful information: https://www.ndss.com.au/gestational-diabetes