Why me, why now?

At this point you may or may not have been told by your healthcare provider that you have gestational diabetes. You are probably wondering why me?

The short answer is that it can happen to any woman and gestational diabetes is different from regular diabetes in that it simply means your body is having trouble managing your blood sugar levels during your pregnancy.

Gestational diabetes mellitus (GDM) means having higher than normal blood sugar levels during pregnancy.

This is different than both type 1 or type 2 diabetes that already exist before pregnancy. For women who have a diagnosis of type 1 or type 2 diabetes before pregnancy, it is considered to be “pre-existing diabetes”, which is different than gestational diabetes.

Gestational diabetes develops in women because the pancreas is unable to produce enough insulin to counteract the higher blood sugars from the hormones of pregnancy.

The pancreas is an important organ in our bodies that produces insulin when we eat food, especially foods that contain carbohydrates (e.g. bread, pasta, rice, potatoes, fruits, sweets). Carbohydrates are broken down into sugars, which are used for energy. It is important to avoid eating processed foods high in sugar, salt, and additives and to choose real foods (e.g. whole vegetables, fruits, nuts, legumes, meats, whole grains) since they provide important nutrition that is necessary for both your health and the health of your baby. When sugars are released from food into our blood, our pancreas works to make just the right amount of insulin. If your pregnancy hormones are high, your pancreas may not make enough insulin and blood sugars will be high.

Insulin acts like a key that unlocks the door to allow sugar to move from our bloodstream into our muscles and organs where it is used for energy or stored for later use. All forms of diabetes result from blood sugar levels that are too high.

You can help your pancreas by eating nutritious foods and partaking in physical activity (e.g. walking 15-30 minutes after a meal), if your health care team feels that exercise is safe for you. Some conditions prevent moms from getting exercise and you should always listen to your obstetrical team if they ask you to reduce your physical activity levels. If you can’t get your blood sugar into the right range with healthy eating and exercise, then medications such as insulin may be added to help. You can find out more about healthy eating and how to control your blood sugar levels in your gestational diabetes class or from your health care provider.

“Hang on a minute, I’ve already attended my gestational diabetes class!”

Great! That means that you have been given the tools and advice that you need to manage your gestational diabetes. It is important that you follow your health care providers’ recommendations which may include recording what you eat, when you exercise, and what your blood sugar levels are. We know that for many of you this may feel like a lot of work, while some of you may find that you are already eating healthy with the right amount of activity. In any case, keeping records, testing blood sugar levels, and preparing healthy meals may take some getting used to. Be sure to call your health care team if you are unsure about your choices or the recommendations.

The Hard Truths: GDM Risk Factors

Age:
As women get older, the risk of GDM increases. Being over 35 increases your risk.

Ethnicity:
Women who are Indigenous, Asian, Hispanic, and others are at higher risk for developing gestational diabetes.

Weight: Being overweight before you become pregnant and/or excess weight gain during pregnancy can increase your risk for developing gestational diabetes. Your health care provider can give you some guidance on how much weight you should be gaining for your pregnancy. Learn more.

Previous pregnancies with gestational diabetes:
If you had gestational diabetes in a previous pregnancy, you are more likely to develop it in a later pregnancy. If you previously had a large-at-birth baby, this can also be a clue you’re at risk of developing gestational diabetes.

But wait – I don’t have any of these risk factors! Could my health care team be wrong?

Unfortunately, many women without any known risk factors develop gestational diabetes. This is why Diabetes Canada (and most Diabetes guidelines world-wide) recommend that all women should be screened for gestational diabetes no later than 28 weeks’ gestation in their first pregnancy, and earlier in subsequent pregnancies if they had GDM before.