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?

Highlights

At forty, I am a more confident person now who cannot tolerate people’s bullshit anymore and will call it out if I have to.

From my personal experience, there are a set of life lessons I have learned, some the hard way through trials and tribulations and some through the pure experience of trial and error.

Here are a few things I am unapologetic for in this phase of life and I wish I could tell these to my younger self.

2. Not answering the phone when I can’t or don’t feel like it.

With technology and communication narrowing spaces between people and literally invading each other’s personal lives and spaces, I have learnt how underrated it is to get some peaceful time away from the pings, beeps and rigs of the mobile phone. I don’t pick up calls of people who I know will disturb my mental peace, text me instead, please. And I make sure I keep the ringer on silent and keep it away for a couple of hours if I have to. The world can wait.

10. Unlearning toxic things I learnt when I was younger

There was so much sexism and misogyny I grew up with and very frankly I didn’t realise it until now. It is not until now that I learnt that so many things I learnt were normal were actually not and were wrong on so many levels.

The forties have been a self explorative journey for me. I have become more comfortable in my skin, learnt to embrace my flaws, don’t care about my size, weight or those greys, wear what I like and do what makes me happy. I only feel I could revisit my younger self and tell her these things. But then had I not gone through my life experiences I probably wouldn’t be the confident, unapologetic person that I am today.