10 Gestational Diabetes Myths Busted

Rebecca McPhee with Credit to Diabetes NSW & ACT


3 Minutes

Common myths around gestational diabetes

There are many myths when it comes to health and it is no different with gestational diabetes. Putting pregnancy and diabetes in the same sentence can bring about daunting feelings and therefore raise many questions. However, pregnancy diabetes, also known as gestational diabetes is more common than you may think. In Australia, one in every seven Australian women has gestational diabetes. In Canberra, the rates are even higher. Don't worry, there is no need to panic as we know t how to prevent and look after gestational diabetes. 

Below, we explore 10 common myths around gestational diabetes and provide you with the real facts.  

 

What is pregnancy diabetes?

Pregnancy diabetes, otherwise known as gestational diabetes, occurs during pregnancy. It happens when hormones produced by the placenta block the action of a women's insulin in regulating blood sugar levels. Increased blood sugar levels can lead to complications including early labour, bigger babies and high blood pressure for mums - among others.  

Gestational diabetes usually goes away when the baby is born; however, research shows that women who have had gestational diabetes are 70% more likely to develop type 2 diabetes later in life. Further, if you have Gestational diabetes in your first pregnancy, you have a 30-69% chance of it recurring in future pregnancies. 

The good news is that gestational diabetes can be managed to ensure a healthy mum and bub. 

 

1. Gestational diabetes harms the baby

It is true that untreated gestational diabetes can cause problems for you and your baby. Women with gestational diabetes are more likely to have a caesarean section, pre-term labour, or induced labour than women without gestational diabetes. However, the good news is that the likelihood of these happening is still relatively small. If managed well and monitored closely, most women will go on to have a pregnancy (and birth) free from complications that can harm the baby. 

 

2. Eating too much sugar causes gestational diabetes 

There is the stigma that eating too much sugar causes gestational diabetes. The fact is, there is no single cause and it cannot always be prevented. Whilst poor diet, being above a healthy weight and inactivity can increase your risk, there are other risk factors that you can't change that can lead to a diagnosis too: 

  • Previous diagnosis of gestational diabetes or high blood sugar levels. 
  • Family history of type 2 diabetes. 
  • Being over the age of 40 
  • Being from specific ethnic backgrounds. 
  • Have gained weight rapidly in the first 20 weeks of pregnancy. 
  • Having polycystic ovarian syndrome. 
  • Taking some types of antipsychotic or steroid medications. 

 

3. I'm free of diabetes once the baby is born  

For most women, gestational diabetes usually goes away after the baby is born. A blood test six to twelve weeks after childbirth can confirm if gestational diabetes has gone away. However, this is not necessarily the end of the diabetes journey.  

In recent years, research has shown that women with gestational diabetes have a higher risk of developing health problems later in life. The risk of type 2 diabetes is 70% higher in women who have had gestational diabetes, and the risk of developing high blood pressure and heart disease is nearly tripled. 

By following a healthy lifestyle, you can help limit your risk of developing these conditions. This might be easier said than done with a young family but there are plenty of small things you can do to stay healthy In the long term. 

 

4. A gestational diabetes diet means cutting out carbs  

You don't have to start ditching the carbs altogether. Pregnancy is not the time for a low or no carbohydrate diet because your baby needs them to grow. Choosing the right type and portion of carbohydrate foods will help manage gestational diabetes.  

Healthier/better carbohydrate choices include: 

  • Oats – a nutritious wholegrain packed with prebiotic fibre. 
  • Quinoa – an ancient seed, rich in protein, fibre, vitamins and minerals. 
  • Sweet potato - so long as you're baking, roasting, grilling or boiling them.  
  • Fruit – go for seasonal fruit and you'll find it not only taste better but will be cheaper. 
  • Dairy – milk and unsweetened plain Greek or Natural yoghurt is high in protein and ultra-versatile.  

It's a good idea to include carbohydrates with each meal and snack as eating large portions in one sitting can cause blood glucose levels to spike. Every woman is different when it comes to their nutritional needs but aiming for a fist-size portion of carbohydrates with each meal is an excellent general rule. Your diabetes educator or dietitian can advise on the exact portion size for you. 

 

5. You can't exercise when you have gestational diabetes 

Exercise is very safe during pregnancy especially if have been diagnosed with gestational diabetes. In fact, research has also shown that doing some exercise after meals can help women with gestational diabetes hit their recommended target blood glucose levels more often. We also know from studies that even before pregnancy, participating in a moderate level of physical activity can lower the risk of gestational diabetes by helping the body become more sensitive to insulin created in the body to regulate blood sugar levels.  

Exercise recommendations for pregnancy are the same for the general population. However, there will be some small changes to make them work for you, depending on the stage of your pregnancy and any pregnancy symptoms you may have.  

It’s recommended to do: 

  • Aerobic exercise like walking, swimming and dancing for about 30 minutes to an hour three to five days per week (at least 150 minutes per week). 
  • Strength exercise like Pilates, using weights or resistance bands two to three days per week (have a day off in between sessions). 

It's important to tell your doctor or midwife that you are planning to become more physically active. They can let you know if what you are planning will be safe for you and your pregnancy. 

 

6. All women with gestational diabetes have big babies 

Statistically, it's true. There are bigger babies among women with gestational diabetes. However, the chances of having a large baby correlate very strongly to blood sugar levels during pregnancy. If your blood sugars are within the target range, then you are no more likely to have a big baby than a female without a diagnosis of gestational diabetes.  

 

7. If I have a family history of diabetes, then I will get gestational diabetes

A family history of diabetes is a risk factor for developing gestational diabetes however it does not guarantee that you will get it. Being aware of your family history can encourage you to follow a healthy lifestyle, even when you are planning a pregnancy. Eating a healthy balanced diet, keeping active and being a healthy body weight can significantly reduce your risk.  

 

8.If you take insulin for gestational diabetes it will harm the baby

Some women feel anxious about needing to use insulin; however, it is good to know that it is perfectly safe. It does not hurt (as much as you think), is easy to use and will ensure your blood sugar levels reach the target range to keep you and your baby healthy. If you have been advised to start using insulin when you are pregnant, you are not alone. In fact, In Canberra, over 40% of women who have gestational diabetes will need insulin.  

 

9. Drinking the glucose drink will cause gestational diabetes

Diagnosis of gestational diabetes typically involves a series of blood tests which take place over several hours and includes an oral glucose tolerance test (OGTT). The OGTT involves drinking a sweet, sugary drink (containing glucose) and testing your blood after one and two hours. The glucose drink will not cause gestational diabetes or harm your baby. The test is observing how well your body processed the glucose over the period when you were sitting in the pathology lab. 

 

10. You only need to test your blood sugar levels if you are taking medication

Monitoring your blood sugar levels on a daily basis is an essential part of managing gestational diabetes. All women with gestational diabetes will need to monitor their blood sugars on a daily basis regardless of whether medication is taken or not. Monitoring your blood sugar levels will help you to understand the effect diet and exercise can play and can reinforce healthy lifestyle choices. Changes in your blood sugar levels will also alert you and your diabetes team about how to best manage your gestational diabetes for a healthy and safe pregnancy. 

 

Summary

  • Gestational diabetes can cause health complications during pregnancy and beyond. In many cases, gestational diabetes can be prevented through maintaining a healthy weight through a healthy diet and regular exercise.  
  • Managing gestational diabetes does not mean cutting out carbs but being 'carb smart'. Sensible portions of low GI carbs will assist with keeping blood sugar levels In range.  
  • The glucose drink given to test for gestational diabetes does not harm the baby and will not cause a diagnosis. 
  • Treatment options such as insulin do not harm the baby 
  • All women with gestational diabetes need to monitor blood sugar levels on a daily basis.   
  • Women who have had gestational diabetes are at higher risk of type 2 diabetes and heart disease later in life.

 

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References

  • O’Sullivan J. Diabetes Mellitus after GDM.  Diabetes 1991; 29 (Suppl.2): 131‐35 
  • Stephanie MacNeill et al. Rates and Risk Factors for Recurrence of Gestational Diabetes. Diabetes Care 2001 Apr; 24(4): 659-662.
  • Moses RG. The recurrence rate of gestational diabetes mellitus in subsequent pregnancies. Diabetes Care 1996; 19: 1348‐1350
  • N Poolsup et al. Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. PLoS One. 2014; 9(3): e92485.
  • Black MH, Sacks DA, Xiang AH, Lawrence JM. The relative contribution of pre-pregnancy overweight and obesity, gestational weight gain, and ADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care. 2013; 36(1):5662.
  • Nankervis A, McIntyre HD, Moses R, Ross GP, Callaway L, Porter C, Jeffries W,  Boorman C, De Vries B, McElduff. ADIPS Consensus Guidelines for the Testing and  Diagnosis of Gestational Diabetes Mellitus in Australia. Australasian Diabetes in Pregnancy  Society 
  • O’Sullivan J. Diabetes Mellitus after GDM.  Diabetes 1991; 29 (Suppl.2): 131‐35 
  • Ferrara A et al. Diabetes Care. 2011 Jul;34(7):1519-25. Pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduce diabetes risk factors: a feasibility randomized control trial.
  • www.diabetesnsw.com.au

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