Have you recently been diagnosed with Gestational Diabetes and feel overwhelmed and unsure where to look?
Let’s break it down and simplify the process whilst also helping you find a positive trajectory so that you not only enjoy this pregnancy but also thrive.
With all of the information below keep in mind it is important to remember you are still in control. Your birth outcomes are largely dependent on your mentality. If you are diagnosed with GDM it is vital that you are proactive in allocating a multi-disciplinary team. Whilst this team is here to support you it is your responsibility to stay informed and up to date with your appointments and lifestyle changes.
What is Gestational Diabetes?
Gestational Diabetes is a form of diabetes that arises during pregnancy. GDM essentially occurs when your body cannot make enough insulin during your pregnancy. It is diagnosed for most women between 24 and 28 weeks of pregnancy. GDM will usually cause high blood sugar levels which will require regular monitoring initially. The fluctuations of your sugar levels can poorly affect both your baby and your health. Having said that there are a number of elements within your control which can have a positive affect including exercise, diet and medications if needed.
Women who have GDM are still able to have a healthy pregnancy and baby provided their healthcare providers are managing your care effectively. The following information will highlight the diagnostic process, risk factors, treatment, and the effects GDM can have on labour and birth.
Diagnosis
Between 24-28 weeks you will be given a pathology slip to have an oral Glucose Tolerance Test (GTT). This test will identify if you have elevated BSL by identifying how your body responds to the glucose load over a three-hour period.
Prior to diagnosis of gestational diabetes there are a number of risk factors which could predispose you to the condition, such as:
- Obesity / overweight
- Limited / No physical activity
- Race or ethnicity
- Family medical history
- Having polycystic ovary syndrome
- Previous Gestational Diabetes
- Aged over 40years
- Current medication prescription
Usually with the diagnosis of Gestational Diabetes come the terms ‘high risk’, ‘intervention’, ‘additional monitoring’, ‘big baby’, ‘induction’ and ‘caesarean’. Whilst there is a time and place for each individual intervention it is vital that you equip yourself with the tools to promote and healthy pregnancy and positive mindset. Alongside your medical professional can include dietician, chiropractor, naturopath, Chinese medicine practitioner, hypnobirthing practitioner, diabetes educator, mediations and even counselling. Evidence suggests that taking a multi-disciplinary approach can promote positive physical and mental birth outcomes.
According to research these can be some of the complications experienced by your baby.
- Excessive birth weight
- Early (preterm) birth – high BSL can result in early labour
- Breathing difficulties
- Low blood sugar levels shortly after birth
- Serious complications can occur if GD goes undiagnosed
How can we minimise your risk of developing GDM?
There is evidence to suggest that when eating your meals you can stabilise blood sugar levels through the order you eat your food. For example if you eat your protein first, then fibre and carbohydrates last. This will allow your body to prevent a large insulin spike and keep you feeling balanced for longer. Other things to keep in mind that can minimise risk or impact of GDM:
- Eat healthy foods
- Physical activity
- Change lifestyle where possible
- Increase protein intake
| Foods to Encourage
– Protein – Varied vegetables – Fibre with low sugar options – Small regular meals – Increasing water intake
|
Foods to Avoid
– Avoid alcohol, sugar drinks – Highly processed foods – Takeaway foods – Limit coffee and tea – Reduce or remove sweets (cake, biscuits, cereal, slice) |
Management, care and treatment
As identified above changing your lifestyle to promote healthy outcomes will improve the management of GDM. Physical activity and healthy diet will have the most effective impact on glucose levels. Depending on your care provider you may also need to be managed through medications, injections and daily sugar monitoring. Daily sugar level monitoring is a non-invasive finger prick to check your body’s ability to process and use sugar.
Do I need an induction?
You may be encouraged to have an induction or elective caesarean between 36-38 weeks if you are diagnosed with GDM. According to the research there is no evidence that this is entirely beneficial. Please remember that each woman, baby and pregnancy is unique and will have its own set of boundaries and limitations. This is why it is vital that your healthcare professional is familiar with you and has a good understanding of your pregnancy.
As Dr Sarah Wickham states in her book ‘In your own time’ the label of being higher risk isn’t necessarily indicative of intervention. She highlights that the need for intervention should come from a medical complication or concern rather than a risk factor. To reiterate there is no confirmed evidence that women with GDM have better outcomes with inductions of labour between 36-38weeks. This can be said for a number of other conditions experienced in pregnancy, therefore, ensure your healthcare provider is able to advocate for you and your appropriate birthing pathway.
I have been fortunate enough to have supported a close friend who was diagnosed with GDM. This mother was a primip with no family history of diabetes. Her pregnancy was non complicated with no other risk factors or complications that presented. The mother went on to deliver a healthy baby girl at 39+4 weeks. She went into spontaneous labour followed by a normal vaginal delivery in the birthing pool at the local hospital. She experienced first degree tear with delayed cord clamping. Her baby girl was 7pound 6 and had immediate skin to skin with nil issues attaching and breastfeeding. This was an incredible experience for this first-time mother and me – allowing a lot of the GDM roadblocks to be debunked for us both.
For further information follow this link to stay informed with up to date with guidelines.
Gestational Diabetes | Diabetes Australia
Gestational diabetes | The Royal Women’s Hospital (thewomens.org.au)
Induction for gestational diabetes: what’s the evidence? – Dr Sara Wickham
My Name is Teghan Gregg, and I am a Birthworker who is undertaking extensive training at the Doula Training Academy with Vicki Hobbs. If you would like to talk more about my offerings, please contact me:
Business Name:
Awaken Birth with Teghan
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