Gestational diabetes – a growing concern
We spoke to dietitian Kaye Foster-Powell about the growing numbers of women being diagnosed with gestational diabetes. ‘I had nine new patients with gestational diabetes this week alone,’ said Kaye. ‘Even two years ago I would have averaged one or two new patients per week. I see them briefly at their routine antenatal clinic visit and will see them all again next week plus any others referred from private practitioners for education and management. That will make at least ten women next Monday morning. The explosion in numbers is just amazing, although universal screening in Australia at 28 weeks may account for some of the increase in the numbers of women I am seeing, it doesn’t tell the whole story. Many are overweight.’
‘If a pregnant woman has gestational diabetes, her blood glucose levels will usually return to normal after the birth and the gestational diabetes disappears. But, the risk of developing type 2 diabetes later in life remains. She has a risk factor. That’s why it’s vital that she make some lifestyle changes including eating well, watching her weight and exercising to reduce her risk of developing type 2 diabetes later in life. She should also have regular blood checks for diabetes as it can develop "silently". As Claire and Rachel say in Success Stories this month, it’s a wake-up call.’
What is it?
Gestational diabetes is the type of diabetes that women can develop during pregnancy. In any pregnancy, some insulin resistance develops as a pregnant woman’s insulin needs are 2–3 times her normal needs. But, if you are overweight at the same time, it’s worse. And if your body can’t produce enough insulin to overcome the insulin resistance, your blood glucose levels increase above normal. If your gestational diabetes is undetected and untreated, your baby is at risk of growing too big in the womb, which can make the birth difficult. Your beautiful baby is also at risk of other complications and is more likely to be overweight as a child and develop health problems such as high blood pressure, heart disease and diabetes later in life.
Who gets it?
About 5 per cent, or one in every twenty pregnant women, develop gestational diabetes, and those numbers are increasing. It is more common in women of African American, Asian American, Australian Aboriginal, Carribbean, Hispanic, Indian, Mediterranean, Native American and Pacific Islander descent. It is also more likely in women over 30, with multiple pregnancies, in overweight women, and in those who have a family history of diabetes or previous gestational diabetes.
How is it managed?
Most women can manage their gestational diabetes with healthy eating, exercise and regular blood glucose monitoring. Some may need insulin injections. Studies show that insulin does not cross the placenta and will not harm the baby.
The good news
- Your baby will not be born with diabetes.
- If you manage your blood glucose levels you can safely have a full term pregnancy and a normal delivery.
You do need a special diet to help you manage gestational diabetes. It’s one that will help you manage your blood glucose levels while meeting your and your baby’s nutrient needs during pregnancy.
- Eat regular meals and mid-meal snacks, and avoid getting overly hungry.
- Limit sugary foods and drinks including soft drinks, cordials, confectionery and desserts.
- Limit fatty foods, especially foods high in saturated fats such as crisps, pastries, take-aways, butter and cream, biscuits and cakes.
- Include low GI (slow release) carbohydrate foods at each meal and snack.
- Eat a wide variety of nutritious foods
Source: Kaye Foster-Powell and The Diabetes and Pre-diabetes Handbook.