Preventing type 2 diabetes after gestational diabetes
Written by Natasha Leader, Accredited Practising Dietitian & Credentialled Diabetes Educator
Having gestational diabetes (GDM) means you automatically have a very high risk of developing diabetes within a decade of your pregnancy. Although further pregnancies, genetic and ethnic factors can increase your risk of developing diabetes, studies show that a healthy lifestyle can reduce that risk by almost 60%. We’ve outlined 3 areas to focus on around diet, exercise and glucose level management. Involving and educating your family about these healthy lifestyle choices from early on is a great way to set them up for a healthy life as well.
Eat well (and possibly less)
You needn’t stick to the rigid diet you did when you were pregnant but it’s still a good idea to keep up the quality in your diet. Fatty or sugary ‘treats’ should be occasional so get the good stuff in first. Think about the foods and nutrients your body needs and work on counting that up, not focusing on all you ‘can’t’ have. Be inspired by good food and keep using GestationalDiabetesRecipes.com for ideas and current information.
– Choose wholegrain and high fibre carbohydrates – this means fibre of (greater than) >3g per serve for breads, breakfast cereals etc. and grainy/wholemeal for crackers etc. (The nutritional panel on the packet will give you this information.)
– Choose less processed products wherever possible. It’s likely these items will also be; much lower in salt/ sodium, contain way less additives, cost less and be more filling. Not only this but they’re also great for heart health and keeping your digestive system in peak order.
– Fill up on vegetables. Add them cooked or as a salad with lunch, dinner, as a side at breakfast or as a snack. Veggies are your only truly ‘free’ food.
– Steer clear of saturated fats. Fatty meats, full fat dairy products, pastries, commercial biscuits/snacks and fried take-away foods are all full of fats that contribute to cholesterol and heart problems. These fats can also increase your risk of diabetes so be sure to stick to lean and trimmed meats, low fat dairy and minimise commercial snacks and fried foods. For cooking use canola or olive oils and if you’re going to use a spread for bread choose a margarine rather than butter.
– Downsize your portions. Eating too much of practically anything has the potential to put weight on or stop you from losing weight. Even high fibre, wholegrain products, low fat dairy or fruit consumed in excessive amounts can provide too many calories for your needs so make sure you consider how much you are eating.
Current guidelines recommend aiming for 3-4 hours of moderate intensity exercise each week, preferably spread over most days of the week. A small amount of activity every day can help motivate you and make training feel less daunting. And here’s the inside scoop! Activities like walking to the shops, taking the stairs or parking further away all count.
However for weight management you’re better off targeting cardio workouts like walking, running, gym classes, cycling or swimming. A combination of moderate intensity cardio activities plus some resistance/weights sessions will really keep you in good shape. Have a think about when and what will work best for you. Do you have any friends you can set regular exercise dates with?
Keep tabs on your glucose tolerance
Ignorance is bliss or so they say, but it’s important to know your glucose tolerance status especially if you’re planning future pregnancies. Undiagnosed diabetes prior to pregnancy can carry a very high risk (miscarriage and congenital abnormalities such as problems with the baby’s heart, kidneys, brain). If you haven’t had a recent glucose tolerance test (within the last year) you should schedule one before you start trying for a pregnancy. And even if you don’t plan on further pregnancies, regular glucose tolerance tests (every 2-3 years) are the best way of assessing your current situation and being able to manage your health.
A fasting glucose, random glucose test or HbA1c level alone is not considered enough in most cases so you will need to undertake a 2 hour glucose tolerance test. If you’ve previously had an abnormal result (i.e. Impaired Glucose Tolerance) you should have your glucose status checked again in a year’s time.
If you’ve had GDM before, in future pregnancies your glucose tolerance should be assessed earlier initially (at 18-20 weeks) and if this is normal repeated at 28 weeks. Further glucose tolerance testing may also be indicated and your doctor may discuss this with you.
2 hour Glucose Tolerance Testing (GTT) at a glance:
|Trying to fall pregnant & had GDM previously
||Schedule a test before you start trying for pregnancy if you haven’t had a GTT in the last 12 months|
|Pregnant & previously
|Test for GDM at 18 -20 weeks and if normal test again at 28 weeks. Further GTT at 32 weeks may also be done. Random glucose test in early pregnancy may also be of value.|
|Not planning any more pregnancies||Get tested every 2 – 3 years|
|Already have Impaired Glucose Tolerance (IGT)||Repeat GTT each year|
Last updated February 2012.