Worried about gestational diabetes? #PCOS

It's a fair call to be concerned that you might be one of the 10-14% of Australian pregnancies that are diagnosed with gestational diabetes, but there's no need to worry as there's lots you can do to minimise your risk. The sooner you start, the better your outcomes will be.

How do you know if you're at risk?

Perhaps you've had it before, or your sister has had it, or you're a little older than you hoped you'd be when planning a pregnancy, or that it's common in your ethnicity, or even that you might think that you could be in better shape... The fact is there's a long list of documented risk factors for gestational diabetes that include these and several others, many of which are actually able to be modified.

How does it even happen?

I just love this graph because if you understand that insulin is a hormone that is produced by your body (unless you have type 1 diabetes) then you can see that as we progress through pregnancy more and more of it is required. Quite dramatically more in fact, and some people's body's just can't keep up with it so they are diagnosed with gestational diabetes, or GDM (gestational diabetes mellitus). At delivery, the requirement for extra insulin just goes away and everything (usually) returns to normal, but there may be major consequences later on.

Image credit: Gestational diabetes mellitus: taking it to heart.Jessica A. Marcinkevage, Kabayam M Venkat NarayanPublished in Primary care diabetes 2011 Figure 1.

Is it worth the effort trying to avoid it?

The sort answer is most definitely YES, and as soon as you can start working towards that goal, the better. Ideally we'd like to see women start this planning a year before they start trying for pregnancy, but if you're already past that point you can still make a big impact.

Three Top Reasons to Try

Yes, for your own comfort and less worry during your pregnancy. If you suddenly have to start taking medications, potentially having to inject insulin as well as watching your diet and checking your blood glucose levels every day, it's going to be a relatively stressful time.

Yes, because if you don't manage it well any extra glucose in your blood can cross the placenta so your baby's pancreas (the organ that produces insulin) will make extra insulin to deal with the extra glucose. The extra insulin causes the baby to grow bigger and fatter. The result of this may be a large baby that may need to be delivered early but may not be mature enough. This also puts the baby at high risk of developing metabolic syndrome symptoms later in their own life.

And Yes, because women who have had gestational diabetes increase their risk of developing type 2 diabetes later in life giving you a 50% chance of developing it within 10 years after your pregnancy! Then you're dealing with it for the rest of your life.

Diet and Lifestyle

We have good evidence to show that following a Mediterranean style diet high in extra virgin olive oil, nuts and oily fish can make a big impact. There's some interesting research on the quality of the gut microbiome and the impact of the right pre- and pro-biotics. And of course physical activity matters too! A specialist dietitian can help you to navigate through what will be best for you and your baby.

One recent review (Donzar-Ezcurra et. at. 2017) identified that it's what we do prior to falling pregnant that has the biggest impact on reducing our risk of developing it. The sooner you start, the better your outcomes will be. So, are you ready?

Join the Discussion!

I've recently started a new closed Facebook group for discussion on this topic. We'd love you to join in. Just click on this link and request to join (and answer a few short questions).

Call us to chat on 0249710770, remembering that we can arrange TeleHealth consults if you're too busy or live too far away. Accredited Practising Dietitian Sally Marchini at Marchini Nutrition is one of the specialist dietitians from the Australia-wide network Nutrition Plus who offer more than just nutrition advice - they offer experience, problem solving, understanding and most importantly compassion to assist you on your health journey in preconception, pregnancy, postnatally and for specific health concerns. Sally can be contacted via her website www.marchininutrition.com, the Nutrition Plus website www.nutritionplus.com.au, by telephone on 02-4971-0770, or by email at sally@marchininutrition.com