4 Tips to help you manage gestational diabetes after diagnosis
- Jul 10, 2018
- & Amelia
Learn 4 tips to help you understand your diagnosis of Gestational Diabetes GD and how it can be managed more easily in pregnancy)
I have been recently concerned by the significant increase in the number of my clients who are being diagnosed with gestational diabetes and how I can support them better.
Also in the Fb group I run with Jen Hazi and Samantha Gunn we get many women discussing their recent diagnosis and asking for further support. If you haven’t already joined our supportive evidence based group then here ’s the LINK
We have lives every Monday about pregnancy topics and it’s a fun supported space– no question to big or small.
I was worried about the increase in GD diagnosis and wanted to learn more myself so I reached out to Stephanie at Dynamic Performance physio to try and understand what can be done to manage this condition in pregnancy but also why there has been a spike in diagnosis.
Stefanie is an Accredited Practising Dietitian and Nutritionist and has a special interest in supporting women throughout their pregnancy and any of its complications, including gestational diabetes, pre-eclampsia, morning sickness & appropriate weight gain during pregnancy. Contact her here if you need to chat more- she’s more than happy to help.
What is GD?
Gestational diabetes mellitus (or GDM), as the name suggests, is a form of diabetes that occurs during pregnancy. Typically, after the delivery of the placenta, you will no longer have gestational diabetes. Gestational diabetes is caused by the hormones produced by the placenta which block the action of insulin, a hormone produced by your pancreas.
Insulin is a bit like a key, it unlocks the door to your cells, and guides glucose to enter your cells form your blood stream. Glucose is required by every cell in the body for energy. When you become insulin resistant like in GDM, the glucose gets stuck in your bloodstream and therefore leads to higher blood glucose levels, which comes with associated risks.
Whilst it can be daunting to think about the risks to both you and baby from a higher risk of pre-term labour and more complicated deliveries to the looming risk of type 2 diabetes for you later in life. It is important to focus on what you can do about managing gestational diabetes.
Pregnancy is the best time to be thinking about how to be nourishing your body for both you and your little one to ensure that you’re both being supported on this journey!
GDM is a serious but manageable condition, working with your obstetrician, endocrinologist, GP & dietitian to develop a plan that keeps your blood glucose levels in check and to minimise the following risks
Why do I have it?
There are certain factors that increase your risk of developing GDM, which are:
- Aged 40 years or over
- A family history of type 2 diabetes or close relative with GDM
- Above a healthy weight
- Aboriginal or Torres Strait Islander background
- Previous history of gestational diabetes in previous pregnancies
- History of Polycystic Ovary Syndrome
- Gained weight too rapidly during the first half of pregnancy
- Are from a Melanesian, Polynesian, Chinese, Southeast Asian, Middle Eastern or Indian background
- Taking certain medications such as steroids or anti-psychotics
Remember, that you’re not alone! GDM is the fastest growing type of diabetes in Australia, with 12-14% of pregnant women developing gestational diabetes. That’s about 1 in 8 pregnant women!
With the new diagnostic guidelines, that are tighter on blood glucose levels more women than ever are being diagnosed! Now, women with a fasting blood glucose at or above 5.1 mmol/L can be diagnosed with GDM. Previously this value was 5.5 mmol/L, this 0.4 difference has resulted in a big increase in the number of women being diagnosed with gestational diabetes.
What can I do about it?
First thing to do is to check in with your GP, obstetrician and endocrinologist (if you’re seeing one) to help you alongside an Accredited Practising Dietitian to help you manage your blood glucose levels & weight throughout pregnancy.
The aim of the game with managing GDM is to keep blood glucose levels as close to what is “physiologically normal” using a combination of medication (but not always) and lifestyle changes to avoid your baby being exposed to higher glucose levels.
Here’s the best bit, whilst there’s lots you can’t control about having GDM and other aspects of pregnancy, you can definitely take the reigns with many aspects of managing gestational diabetes. Here are some of the top tips to help get you started.
1. Appropriate pregnancy weight gain
Did you know that the amount of weight gain during your pregnancy is determined based upon your pre-pregnancy weight? And women that know how much they’re ideally meant to gain and track this with their health care professional, are more successful at reaching these targets!
Ask your healthcare professional to track your pregnancy weight gain on a chart, it’s important to remember that you’re not in fact eating for two! Even in the third trimester, you only need an extra 2 and half serves of grain foods and one extra protein serve, which can look like a wholegrain sandwich with a couple of tablespoons of peanut butter, and some extra pasta or rice at dinner time.
It’s important during pregnancy to focus on the NUTRIENT density of the foods you’re eating rather than the ENERGY (or calories), alongside your pre-natal supplements, what you eat is providing nourishment for both you and your bub.
2. Looking at Carbohydrates
Carbohydrates have the greatest impact on our blood glucose levels, but that doesn’t mean it’s time to say goodbye to carbs! Instead, we work together to determine the right amounts & types you need to help you match your insulin (if you’re taking it).
Carbohydrate containing foods should not be excluded from the diet, wholegrains and starchy vegetables provide essential nutrients such as B vitamins, dietary fibre (to help you with constipation) along with a host of minerals & antioxidants too!
Work with your dietitian to work out the best spread of carbohydrate throughout the day that matches your needs in terms of the stage of your pregnancy as well as blood glucose levels &
3. Folic Acid
You may already know that before and during the early parts of pregnancy, women require more folic acid, however, women with GDM also have a higher requirement for folate! Check in with your dietitian about your exact needs and to either supplement or modify your diet appropriately to reach your needs in those early stages of pregnancy.
4. Overall Diet Quality
As for any pregnant woman, ensuring she’s getting enough of each nutrient required through her diet and any supplements is critical to help support both mum & bub over the next 9 months. Iron deficiency is common, iron needs sky rocket as you progress throughout pregnancy as your blood volume increases to support your growing baby, get your blood levels checked and seek support so you can get some of your energy back!
There is no one-size-fits-all dietary approach for gestational diabetes, and it does not require any foods such as sweets being “banned” from your diet, work together with your healthcare professional to develop a plan that you’re comfortable with.
Where can I find more help?