LIVING
well
PLANNING FOR
PREGNANCY Diabetes probably isn’t front of mind for most women as they start thinking about pregnancy, but it’s important to get tested for gestational diabetes, even if it doesn’t run in your family, writes JANE-ANNE GARDNER. Gestational Diabetes Melitus (GDM) is the fastest growing diabetes in Australia, even though it only affects pregnant women. There are a number of risk factors for GDM, including your ethnic background, having had a large baby previously, being on certain medications, being above the age of 35 and having had GDM during a previous pregnancy. Although many of those risk factors can’t be changed, simple changes to your lifestyle can help prevent or lessen the risk of developing GDM.
into the risk factors above your doctor or midwife should offer you an oral glucose tolerance test (OGTT) early in your pregnancy. If not, you’ll be offered the OGTT at 24-28 weeks. Prior to the test make sure that you are eating your usual diet. Don’t worry about “passing” or “failing” the test – the only people being affected by your blood glucose levels are you and your baby. It’s really important that you have your OGTT as there are risks to you and your baby if your blood glucose is not within the expected range.
Firstly, it’s important to know that GDM is incredibly common, with around 12% of pregnant women within Western Australia being diagnosed with gestational diabetes. That number is pretty staggering when you consider that of all the women who gave birth in WA in 2021 only 0.5% had been living with type 2 diabetes prior to pregnancy and 0.3% of women had been living with type 1 diabetes. If you are diagnosed with GDM, know that you are not alone and you should not feel that you have done something wrong. As we’ve seen, there are many risk factors that simply can’t be altered.
If you are wanting to reduce your risk of GDM, diet and exercise can be of immense benefit.
It’s important to get your blood glucose levels tested during pregnancy. You will be having lots of blood tests, such as checking on things like your iron stores, which help the oxygen be transported around the body and your levels of immunity against bloodborne diseases. If you fall 18
Try eating low fat, high fibre and low GI foods and getting active at least twice a day, by walking or swimming. Swimming can be especially good exercise during pregnancy as swimming or walking in water is a weightless activity and it can help with any ligament pains you might be having. If you have been diagnosed with GDM, it’s important to know that you and your baby are at an increased risk of developing type 2 diabetes in the future. However, if you continue with your lifestyle changes your risk will be reduced, as will your baby's as they will likely model their behaviour on yours. Managing your GDM is essential for the health of your baby. If your blood glucose levels are not managed during pregnancy it can lead to a
miscarriage or even a stillborn baby. Your baby could be at risk of breathing issues or might need to produce more insulin to lower their blood glucose levels – meaning your baby will grow quicker and bigger (insulin is a growth hormone) which could lead to complications and an increased risk of needing interventions during your labour. A big baby doesn’t necessarily mean the baby is healthier than a small baby. Your baby will not have diabetes when they are born but may need to have some blood tests in the first 24 hours to check their blood glucose levels. Do note that this advice only applies to women who are not yet living with diabetes prior to pregnancy. If you have diabetes and are planning to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. Raised blood glucose levels can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby.
