A Dietitian's Advice For Pregnant Women On Managing Gestational Diabetes

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For many pregnant women, their blood sugar levels elevate during pregnancy causing gestational diabetes. This is diagnosed through blood sugar testing and those with Gestational Diabetes (GD) are at higher risk of developing type 2 diabetes later in life. Managing this condition can be quiet challenging because they have to be mindful of what they consume to make sure that their blood sugar does not increase and this can be difficult at a time when the nutritional needs of mother and baby are paramount but you have to make certain choices given an added condition of GD.

So how can you deal with this apart from the nutritional and medical aspect?

“Just being pregnant seems to invite advice or comments from well-meaning relatives to random strangers”, says Robyn Compton, a gestational diabetes dietitian. “Add in a diagnosis of GD & suddenly there are all these “experts” telling you what you should or shouldn’t be eating”.

Robyn Compton is a dietitian who has a private practice in Melbourne, Australia. She specializes in assisting and supporting women with Gestational Diabetes. More recently she has also worked as a research dietitian with adults with type 1 diabetes.

Getting evidence-based information for women with gestational diabetes is her goal. Follow her on Instagram at Gestationaldiabetes_Dietitian

It is stressful enough to deal with a diagnosis of GD. It’s a big learning curve in terms of understanding the condition, management & eating plan. Then there’s your own worries & feelings about GD, your pregnancy & having to change your diet. The last thing you need is someone commenting on your food choices or giving unsolicited, insensitive & often incorrect dietary advice. Every case of gestational diabetes is different & what works for one woman may not work for another. That fact in itself is often the easiest comeback to any unhelpful advice.

How should a mom-to-be react when they receive a GD diagnosis?

“Being diagnosed with Gestational Diabetes (GD) can come as quite a shock. It can be very upsetting. Many emotions arise. Initially, it can feel quite overwhelming. Guilt & shame are very commonly experienced by women. Unfortunately, diabetes stigma exists due to ignorance about the condition & why it occurs. It is important to know that GD is NOT your fault. You didn’t cause this condition. It is not because you ate too many sweets. The reasons are multi-factorial but mostly a result of hormonal, genetic & cultural influences which are out of your control. It’s normal to feel angry. It’s not how you imagined your pregnancy journey. Understanding more about the condition & its management can clarify questions”.

“Talking about it can help to lift that burden. Distress and anxiety about the impact of GD on your baby, pregnancy & your own health are very understandable. Talking with your doctor & health professionals who specialize in diabetes can answer many questions & offer basic support, as well as talking with supportive family or friends”.

What kind of awareness and support should they look out for?

“You may feel overwhelmed with how you need to manage GD. Being armed with the right GD education, advice & support makes a huge difference. Seeing a diabetes educator and/ or midwife initially is recommended to understand how to monitor your blood glucose levels (BGLS) & learn more about GD management. Seeing a dietitian specializing in GD can help to answer all the practical questions about food, types, amounts, meal planning, pregnancy nutrition & provide ongoing support. Generally, with this assistance, women with GD will manage well but it’s very normal to have good & bad days. It’s ok to acknowledge if you are struggling. For further support speak with your Diabetes Team or health care provider”.

What about women who are asked to take insulin?

“Remember that despite attention to diet & exercise, some women may need to take insulin to assist with optimizing blood glucose levels (BGLs). Genetics & hormones contribute to insulin resistance. This is not your fault. Some women may just need bedtime insulin (long-acting) to control elevated fasting levels. Others may need mealtime insulin (short-acting) at 1, 2, or all 3 meals. Or any combination of the above, based on individual BGLs”.

What kind of postpartum care would you suggest for women with GD?

“If you have just had your baby following a pregnancy with Gestational Diabetes ( GD). Congratulations!! It was a big job managing your GD during pregnancy. Well done to have got through that challenging journey. Now you are at home with your little one, life continues to be busy but in different ways. You are juggling many new roles, with usually much less sleep. Your energy levels need to be supported with adequate nutrition, rest, sleep & self-care. If you are breastfeeding, the energy demands are further increased”.

“However, women who have had GD have usually been advised about their increased risk of Type 2 diabetes in the future. Some women feel the pressure to lose any extra pregnancy weight quickly or feel that they need to follow a restrictive postpartum diet plan. This is what I suggest:

It is not a race. It’s a steady journey back to look after your future health.
Your body has just grown a baby and is nurturing a newborn. It is pretty amazing and should be celebrated & appreciated.
Don’t compare yourself with others. Women’s bodies recover at different rates in their own time. And women have very different experiences with how their baby’s feed and sleep too.
Just focus on you and your baby. Nurture your physical & emotional health with healthy sustainable lifestyle changes.
Hold onto any healthy eating habits which are in your control & you enjoy. Be active when your body is ready & you feel up to it. Take it day by day as you find your new path.
As time progresses, routines generally get more established for your baby, family & you. However, your energy levels still need to be respected.
Reach out for support whether it’s with feeding or sleeping issues for the baby or your own physical & mental health needs.
A healthy lifestyle continues to be important for future health of course but in your individualized realistic framework.
Seeking advice from your dietitian down the track can provide extra support if needed. Postnatal online lifestyle programs are another option some women find helpful when they are ready.

“BOTTOMLINE: Take the pressure off yourself to do everything at once. Enjoy your little one. Remember your self-care needs too”, adds Robyn.

Robyn Compton can be contacted at r ob.compton@bigpond.com

Also Read Why Do We Crave Some Foods During Pregnancy?

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Just like you have your daily CTM skin routine or oiling the hair routine every week, it is also important to take care of your breasts regularly. is important to also take care of your breasts regularly. Breast changes should seek more attention than the notifications on your phone. Regular self-examination of your breasts is the best way to detect breast cancers and catch them early. If breast cancer is caught early is treated more successfully.

Here are 4 easy steps to do a self breast exam

1. Stand in front of a mirror, place your hands on your hips and look at your breasts for their usual size, shape, and color. Look for any uneven shape, visible distortion or swelling. Look out for these:

· Dimpling, puckering, or bulging of the skin

· Nipple has changed position or an inverted nipple (pushed inward instead of sticking out)

· Redness, soreness, rash, or swelling

· Any fluid discharge coming from one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Now, raise your arms and look for the same changes.

2. Using your right hand feel your left breast and then your left hand to feel your right breast. Do this lying down. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Check the entire breast from top to bottom, side to side in a circular motion. Start from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

3. Follow a same pattern throughout. Start at the nipple, moving in larger and larger circles until you reach the outer edge of the breast and then move your fingers up and down vertically, in rows. Feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

4. Now feel your breasts while you are standing or sitting. The easiest way to feel the breasts is when the skin is wet and slippery, so you can do this in the shower. Cover your entire breast, and repeat step 3.

What to do if you find an abnormality?

Do not panic if you think you feel a lump in your breast. Get in touch with your doctor if you’ve noticed a lump or other breast change that is mentioned above. Most women may have some lumps or lumpy areas in their breasts and most turn out to be benign (not breast cancer). Non-cancerous breast lumps may be caused due to hormonal changes, a benign breast condition, or an injury.

Also, there are changes in the breasts throughout the menstrual cycle: breasts may seem to get bigger or more prominent in some way. Menstruators may want to wait until after your period to see if the lump or other breast change disappears on its own before calling your doctor.

The doctor may do a physical exam of the breasts and may ask for breast cancer imaging tests. Both an ultrasound and a mammogram are typically recommended to evaluate a lump in women who are over age 30 and not pregnant or breastfeeding. Further tests may include additional imaging with MRI (magnetic resonance imaging), MBI (molecular breast imaging), and/or a biopsy if required.

It is important to make sure to get an explanation of the cause of the lump or breast change from your doctor, and, if necessary, a plan for monitoring it or treating it. Don’t hesitate to get a second opinion if you are not comfortable or satisfied with the doctor.

How often should one do breast self-exam

Do breast self-examination once a month to familiarize yourself with how your breasts normally look and feel especially after your period ends, when your breasts are least likely to be swollen and tender. If you don’t menstruate, choose a day that’s easy to remember and follow it every month. The upper, outer area around the armpits has the most prominent lumps and bumps.

Record the findings of your breast self-exams in a diary as this may help you remember, every month what is “normal” for your breasts. Lumps may appear at certain times of the month and disappear as your body changes with the menstrual cycle (if you are still menstruating).

Source: breastcancer.org