Would you believe, here in the Hunter Region alone during 2018, around 13.5% of pregnant women developed gestational diabetes? That’s one in 7.4 women, which is a huge number.1
I’ve been asked many times for my opinion on why this number is so high and I think a big factor is simply that people aren’t aware they may be at risk. So what can you do?
It comes down to planning. Honestly, a small amount of planning can go a long way to help you avoid it. This also gives you the opportunity to prevent even more health issues later for both you and bub.
So let’s bring your knowledge up to scratch on gestational diabetes and prepare you for the exciting path ahead during your pregnancy and life as a mum.
What is gestational diabetes?
Gestational diabetes, or GDM, is defined as “glucose intolerance that begins or is first diagnosed during pregnancy”. It’s a short term type of diabetes which only lasts until the end of the pregnancy.
If you’re diagnosed, you’ll find yourself on a steep learning curve. Then there’s the endless finger pricking to check blood glucose levels. Let’s not forget about the strict diet you need to follow and medications to take daily, which could include insulin injections.
Let’s just say it’s not fun.
Why is knowledge and awareness so important?
We all know that being educated on any subject is the best position to be in, and gestational diabetes is the same.
It’s not just during pregnancy that gestational diabetes an issue. According to J. O’Sullivan, 50% of women who’ve had it go on to develop type 2 diabetes within 10 years after the pregnancy. However, the risks don’t stop there.2 The child is also put at risk of complications which can include:
- Macrosomia (the baby is born significantly larger for its gestational age)
- Growth restriction
- Birth injuries
- Respiratory distress
- Low blood glucose levels (hypoglycaemia) and jaundice
The impact of gestational diabetes is enormous when it can relatively easily be put at bay.
My story
Now, as a dietitian, I can help women recognise risk factors for gestational diabetes but it’s been a long road to this point.
I was diagnosed with type 1 diabetes from the age of 12 years old. Then during pregnancy, the impact was massive and to be honest, I wouldn’t wish it on anyone.
The best situation is to find out sooner than later if you want to best chance of avoiding it. It’s still worth putting in the effort if you’re newly pregnant as well.
Are you or is someone you know at risk?
The logical risk factors that you might expect include:
- family history of type 2 diabetes and GDM
- Being bigger than your best healthy weight
There are a few more surprising ones which include:
- Over 40 years of age, or partner over 40 years of age
- Have had elevated blood glucose levels before
- Are from Aboriginal or Torres Strait Islander background
- From a Melanesian, Polynesian, Chinese, Southeast Asian, Middle Eastern or Indian background
- Do you have Polycystic Ovarian Syndrome
- Or have you previously had a large baby (weighing more than 4.5kg)
- Maybe you gained weight too rapidly in the first half of your pregnancy
This all sounds a bit doom and gloom I know. Well, unfortunately, the facts are the facts; however, there are some really easy changes you can make to improve your chances of avoiding it. These changes are really beneficial for women who’re planning a pregnancy as well.
My 3 top dietary tips
1. Eat more plant-based foods
Try to eat more plant-based foods. This doesn’t mean you need to become vegetarian, but we do have evidence that diets with a higher intake of vegetable protein are independently associated with a lower risk of gestational diabetes. In fact, only substituting 5% of energy from vegetable protein with animal protein is associated with a 29% greater risk of gestational diabetes³.
In other studies, diets with a lower intake of unprocessed and processed meat before pregnancy are strongly associated with a higher risk of gestational diabetes.3
Think about including vegetable proteins such as nuts, legumes (lentils, chickpeas etc) and whole grains instead of the meats a few times a week. There are heaps of delicious ways to enjoy them – just google ‘plant-based recipes’ for some ideas.
2. The Mediterranean diet
The Mediterranean diet has heaps of benefits associated with it related to pregnancy. We have evidence that a “simple, individualised, Mediterranean-style diet in has the potential to reduce gestational weight gain and the risk of gestational diabetes”4
Recent research also shows that “an early MedDiet nutritional intervention reduces GDM incidence and maternal-foetal adverse outcomes and should be universally applied as a 1st line therapy”.5
Yummy, yummy – Mediterranean style diets are the way to go!
2. Nutritious carbs in moderation
Choose nutritious carbs in moderate amounts. A study in the British Journal of Nutrition found that relatively low carb and high fat and protein intake may increase the risk of GDM, whereas higher fibre intake could decrease it. And one in Diabetes Care journal study reported that “diets with low fiber and the glycemic load was associated with an increased risk.” 6
Other lifestyle measures include taking advice to stop smoking, moderate your alcohol intake, exercise regularly and improve your sleep habits.
Next steps
We know that about 50% of pregnancies are unplanned, so it’s even more important to know your risk factor and what you can do to help avoid gestational diabetes.7
If you know someone who is thinking about having a baby or newly pregnant, share your new knowledge of the consequences. Together we can help lower the risk in our region through knowledge and awareness.
If you’re ready to start planning a pregnancy and you’d like to find out more about gestational diabetes and how you can avoid it, then reach out I’m here to help.
We can work together to identify risks, personalise your nutrition program or exercise regime and evaluate how well these are working for you.
Content contributor:
Sally Marchini – Owner
Description: Sally’s an Accredited Practising Dietitian and is personally experienced in diabetes and coeliac disease, and is passionate about helping other women to avoid getting diabetes in pregnancy. She can help all women towards achieving healthy pregnancies and to help give their babies the best start in life. Sally is also great with all types of diabetes, coeliac disease, IBS, PCOS, endometriosis, risk of pre-eclampsia and other medical conditions that can make pregnancies tricky.
Email: sally@marchininutrition.com
W: https://www.marchininutrition.com.au/
F: https://www.facebook.com/MarchiniNutritionAPD/
I: https://www.instagram.com/sally.marchini.apd
References:
- HMRI women’s health event in 2019. Dr Henry Murray, leading obstetrician at the JHH advised me that “Varies in last year 12.2 to 13.6 %. Some will be type 2 but we don’t know that until after preg finished”.
- O’Sullivan. J. Diabetes Mellitus after GDM. Diabetes 1991; 29 (Suppl.2): 131-35.
- Effect of diet composition on insulin sensitivity in humans. María M. Adeva-Andany, et al Clinical Nutrition ESPEN 33 (2019) 29e38.
- Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM). Bassel H. Al Wattar et al. PLOS Medicine 23 July 2019.
- Effectiveness of Following Mediterranean Diet Recommendations in the Real World in the Incidence of GDM and adverse Maternal-Foetal Outcomes. Nuria Garcia del la Torre et al. Nutrients 2019.
- Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing GDM: the Australian longitudinal study on Women’s Health. Moniek Looman et al British Journal of Nutrition (2018)…and…Dietary Fiber Intake, Dietary Glycemic Load, and the Risk for Gestational Diabetes Mellitus. CUILIN ZHANG, et al. DIABETES CARE, VOLUME 29, NUMBER 10, OCTOBER 2006.
- D Mazza, C Harrison, A Taft, B Brijnath, H Britt, M Hobbs, K Stewart, S Hussainy ‘Current contraceptive management in Australian general practice: an analysis of BEACH data’ Medical Journal of Australia 2012; 197 (2): 110-114. Available online at: https://www.mja.com.au/journal/2012/197/2/current-contraceptive-management-australian-general-practice-analysis-beach-data.
