Gestational diabetes is a type of diabetes that occurs during pregnancy. According to Diabetes Australia it is said to occur in between 12-14% of pregnancies in Australia. The underlying cause of Gestational Diabetes is Insulin Resistance. This basically means that the body is not able to utilise glucose (sugar) correctly - the glucose gets stuck in your blood instead of being taken up by your body to give you energy. This ofcourse can make you, the mum, feel tired as your body is not using energy correctly. However, the main concern is that continuous elevations of glucose in your blood stream, will directly affect your baby’s blood glucose levels. Babies with high blood glucose levels are at risk of gaining excess body fat (born large because of excess fat) and they are also at risk of having low sugar levels at birth (when the constant stream of high glucose is removed). In the long term, continuous exposure to high glucose levels during gestation can negatively influence life long metabolic health ie risk of diabetes, obesity and heart disease in adult life. This is not meant to scare you if you HAVE been diagnosed with gestational diabetes - this is why there is screening and why your blood glucose levels are monitored and controlled so to avoid these impacts.
All pregnant women become increasingly more insulin resistant from the beginning of the second trimester until birth of their baby and the placenta (it is the placenta hormones that drives insulin resistance during pregnancy). This is basically an evolutionary survival mechanism so fuel was always available for the baby.
A diagnosis of Gestational Diabetes will occur when the pregnant mums blood sugar levels go beyond the safe threshold. That being said even if you aren’t diagnosed with gestational diabetes your blood glucose levels during pregnancy will still have an effect on your babys life long metabolic health - passing the test is not a free pass to just eat whatever you want!
So what places someone at risk of developing a higher level of insulin resistance (aka a diagnosis of gestational diabetes) than others?
There are some risk factors that are out of
our control:
- Certain ethnicities (Asian, Aboriginal, Hispanic, African-American).
- A family history of type 2 diabetes or gestational diabetes (think back to metabolic set up during your gestation).
- Previous history of hormonal imbalances such as PCOS.
- Advanced maternal age (above 40yr old).
There are other things that increase the risk of gestational diabetes which we have more control over:
- Higher fat % pre-pregnancy (not really just BMI as this can be quite a skewed measure of excess body fat). - Excessive pregnancy weight gain (again this needs to be considered with clinical judgement Eg fluid retention, pre-pregnancy weight, multiple births need to be considered.
- Low physical activity levels (this is only one factor, please be guided by your medical team to ensure exercise and exercise levels are safe for your pregnancy).
- Inadequate protein intake during early pregnancy (the protein helps the pancreas grow to handle the increased load during pregnancy).
- Excessive intake of high GI and refined carbohydrates during pregnancy (and before pregnancy as well).
- Nutrient deficiencies such magnesium and vitamin D.
Therefore we CAN modify our RISK of developing Gestational Diabetes however it is not completely in our control. Many women are also diagnosed with Gestational Diabetes without a single risk factor. Sometimes this can be very confronting and upsetting, but on the flip side becoming educated about a healthy lifestyle throughout your pregnancy and being able to monitor your blood glucose levels can have a significant affect on the long term metabolic health of your child and the generations to come!