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Gestational Diabetes Mellitus

 ------ 95661220Gestational diabetes mellitus (GDM) is one of the most commonly diagnosed conditions in pregnancy and rates are increasing. Uncontrolled GDM (when your blood glucose levels are not well-controlled) can increase the chance of complications in pregnancy and can have long term impacts on both mother and baby. Fortunately, dietary changes and exercise (and sometimes insulin injections) can control your blood glucose levels and your baby will continue to grow and develop normally.

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Causes of Gestational Diabetes

Facts

    • When you eat carbohydrate in foods or drinks it is absorbed as glucose, which is a source of energy for your cells.
    • Insulin is the hormone that allows glucose to enter the cells to be converted into energy and used by the body.
    • Pregnancy is naturally a state of insulin resistance which means your cells are less responsive to your insulin (it is a way that your body puts your baby first and ensures it gets enough glucose, you come second).
    • In pregnancy your body needs to produce more insulin to clear the glucose from your blood and get it into the cells. Gestational diabetes occurs when your cells are more unresponsive to insulin than normal. This is detected by the Glucose Tolerance Test at around 22-26 weeks gestation.

You are at higher risk of developing GDM if you

    • Have had gestational diabetes during a previous pregnancy; and/or
    • Have a family history of type 2 diabetes; and/or
    • Have had polycystic ovarian syndrome; and/or
    • Have had a large baby before; and/or
    • Are overweight; and/or
    • Are from an Aboriginal, Vietnamese, Chinese, Middle Eastern, Polynesian or Melanesian background; and/or
    • Are over 30 years of age.
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How to Prevent or Manage Gestational Diabetes

Some simple changes to the carbohydrate in your diet and daily physical activity can be very effective at preventing GDM, delaying its onset or managing it once it is diagnosed.

Facts

    • The main influence on your blood glucose and insulin response is the carbohydrate load you put on your body at any one time.
    • Carbohydrate load is a combination of the carbohydrate content of the meal and the type of carbohydrate (whether it has a low or high GI glycaemic index (external).
    • Carbohydrate is found in all fruit, milk and yoghurt, starchy vegetables (e.g. potato, parsnip), legumes (e.g. chickpeas, beans), rice, pasta, cereals and foods made from flour, honey or sugar and beverages containing sugar.
    • Glycaemic Index (GI) refers to the time it takes for the carbohydrate in the food you have eaten to be broken down into glucose and absorbed into the blood stream. Foods and drinks with a lower GI provide a slower, sustained release of glucose into your blood. The benefits include feeling less hungry, feeling more energetic and achieving healthier blood glucose levels.

Tips

To reduce the carbohydrate load you put on your body you can:

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    • Reduce the amount of carbohydrate you eat at one sitting, by spreading your carbohydrate intake out over the day. It is recommended that you eat more frequently – three main meals and three snacks that all contain some carbohydrate. To find out more about carbohydrate use the Gestational Diabetes Healthy Eating pamphlet as a guide.
    • Choose lower Glycaemic Index (GI) carbohydrates. There are no simple rules to help guess the GI of foods that contain carbohydrates. A list of common foods and their GI can be found in BLOOM Pack 2 (external link) and Gestational Diabetes Healthy Eating (external link), Use this list to help you choose healthier carbohydrate foods. To search for specific foods that are not included in this list check the GI database (external link). As an example, choosing lower GI foods can mean replacing jasmine rice with basmati rice, white bread or wholemeal bread with multigrain bread, watermelon with peaches. You can also reduce the GI of the carbohydrate food by combining it with other foods containing protein (e.g. multigrain crackers with reduced-fat cheddar cheese or dried fruit with nuts.
    • Reducing the fat content of your meals will make it easier for your insulin to work.  Choose reduced fat dairy products, lean meats and low fat cooking methods like baking and grilling rather than frying.
    • Exercising daily increases your sensitivity to insulin and helps control your weight gain. See the Physical Activity section.

More about Exercise, diabetes and pregnancy (external link)
Diabetes Australia - gestational diabetes
Better health channel - gestational diabetes

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