Ep. 8 - Introduction to Gestational Diabetes conversations (with Jaimee)

Jaimee (CDE) briefly explains what GDM is & why we feel it is important to talk about this. From the risks during pregnancy, to things you have some control over to reduce risks, & how the diagnosis can impact your journey. Hayley will share her personal experience in the next episode & we will talk more about the emotional & psychological side of the journey. Unfortunately, a diagnosis of GDM can result in a lot of guilt, stress and an overall negative aspect to pregnancy, impacting on the enjoyment of this precious time. To help improve how women are treated at the time of diagnosis, during pregnancy, and after pregnancy, we hope women feel comfortable to share how their experience could be improved.

Some useful links:
Gestational diabetes – NDSS

ADIPS - Information forConsumers

Transcript

Jaimee 0:10

Hello everyone and welcome back to another episode of Diabetes in the Roar. You've got Jamie here on my own today and it's just gonna be a short one with a bit of an introduction into our next episode, and we are finally doing gestational diabetes possibly with a little bit of type two diabetes in there as well. And one of the things that Haley and I want to focus on in that podcast when we both join you is just how, your experiences might have. Been on your journey if you have been through gestational diabetes or currently going through gestational diabetes, or possibly the diagnosis of type two or maybe just the risk factors that you've been told in regards to type two A after having gestational diabetes.

0:54

One of the reasons that I want to talk more about this and just get some more conversation going is because that it's expected that over the next decade, more than 500,000 women in Australia are expected to develop gestational diabetes, and it does create an intergenerational diabetes epidemic. When we've got mothers who have diabetes in pregnancy who. May have children who are at increased risk of diabetes and therefore there's a flow on effect where it's affecting our children and our grandchildren. Which potentially isn't something that women will, will be told about during their pregnancy, and there's good reason for that. I don't think you need any added guilt or Or blame, and it's certainly not my intention in this episode to create any of that. It's more just putting some information out there, creating some awareness, and I guess letting women do some more research and getting some more support around how they can reduce their risks and their children's risks moving forward. So it's always a good time to review lifestyle. It's always a good time to consider how you would like to raise your child. So just hope in this episode. informs you a little bit about, you know, what you can do, what factors you can't change, and allow you to get some more information and support if you need to.

Jaimee 2:14

So we're both passionate about this because, one, I work in the area and feel like there's things that could be done better. One of those things is definitely just how we communicate, how we educate. and I guess the focus around, you know, taking the way, taking the blame away from women with gestational diabetes, but also empowering them to change what they can to reduce their risks and babies as well as their risks and babies after gestational diabetes as well. So I thought, Little episode, I would just quickly touch on what gestational diabetes is, so we don't have to go over that in the next episode. For people that already know that um, it's basically diabetes caused by pregnancy hormones. So the hormones during pregnancy create insulin resistance, and that basically means it's blocking your own insulin from working as effectively as it normally would. Now that results in high glucose levels or higher than ideal glucose levels. And that can in, in turn, have an impact on baby's growth and development. And that can then also have an ongoing effect throughout pregnancy, which can lead to increased risks for mom at delivery as well. So I won't elaborate hugely on it, but it's important to understand why the testing is in place. I think it gets a bit of a bad wrap in terms of everyone these days is diagnosed with gdm. I've heard some, some Gps and I guess social media is another way that women learn about this. So we just wanted to, you know, jump on in the next episode. We would love for women to. Get in touch with us and share their experiences. We hope to get at least one, if not two or more women on, and literally talk about their experiences as well. Because that's what this is all about. It's not just about us talking at you. It's more, it's more about sharing. With each other as well. So some of the risk factors for gestational diabetes are having a high b m I. We've gotta be careful talking about people's weight these days. You know, it's always a touchy subject, I think, and that is fair enough, but we also need to acknowledge that it is an additional risk factor to gestational diabetes. So it's not that there should be a lot of judgment or anything around it, but it's one of those risk factors that you can modify. Which means you have some control over that. And I'm not saying that's easy and that's another whole podcast episode in itself, but it's just something that we do have some control over. And if anyone's listening to this pre-pregnancy and they hear that, then it might be something that they work on with their healthcare team prior to falling I pregnant to reduce their risk of developing gestational diabetes. That's not taken away from the fact that it is not just related to weight and lifestyle. And that's the stigma we are trying to get away from with gestational diabetes and type two diabetes is that, you know, we can't put the blame on people. It's not purely lifestyle, but there is lifestyle factors and that is something we have control over and it's something that is becoming more of a risk. As time passes. So that's why I guess I'm passionate about just making sure women realize that so that they can choose to work with their healthcare team to reduce that side of things if possible. Ethnicity is obviously something we can't. Change history of previous G D M. Yes, it increases your risk if you've had gestational diabetes before. But if you have lost weight since the previous pregnancy or if there's been other changes, it's not necessarily going to lead to gestational diabetes in subsequent pregnancies, but it is an additional risk factor. Previous elevated blood glucose levels. So if you have been identified as having pre-diabetes or insulin resistance, Past then that will increase your risk of gestational diabetes and might lead to earlier testing, maternal age of above 40 years. A family history of diabetes or a first degree relative, such as a sister or mother previous macrosomia. So that's the large baby's above four and a half kilo or the 90th percentile at birth. And then we've got polycystic ovarian syndrome and multiple pregnancies such as twins. There's also an increased. Even other medications such as steroids and antipsychotics as well. So they're just some of the risk factors that I wanted to mention in this episode. For those who might be interested before listening to the next one, as we talk more about the personal side of things and how we might be able to improve on that. And I think if women are willing to share their journeys, which a lot of people do these days, then, then that's going to help healthcare professionals potentially. How they do things. And I put myself under that category as well. And it's definitely something I'm passionate about, which is why I'd love to, you know, allow women to get on here and be a voice to help with that. So in terms of type two diabetes, there is an increased risk of developing type two for both mum and baby after gestational diabetes as well. Again, that's not. Create any more guilt or pressure or anything. It's more about empowering and letting women know what they can do to reduce those risks. And that might be things like breastfeeding. And breastfeeding is not something that every woman, you know. Wants to do or can do necessarily, but if you're aware that that can help reduce the risk of type two diabetes and reduce your child's risk of type two diabetes later in life, it might be something that you educate yourself more about and potentially get some more help as well, you know, in the lead up to birth and after delivery as. And the other thing is it's important that we follow up on an oral glucose tolerance test or further glucose monitoring after pregnancy, ideally six to 12 weeks after if you have had gestational diabetes to ensure that glucose levels have gone back to, you know, the normal range. To make sure that you don't have type two diabetes after pregnancy. So sometimes we find that women have never been tested for diabetes and during pregnancy they get this glucose tolerance test done or do some self-monitoring at home, and their glucose levels are quite high. We can't diagnose type two diabetes during pregnancy, The only way we can follow up on whether you have type two diabetes is to get tested after baby's been born. And your hormone levels have sort of gone back to Yeah, pre-pregnancy levels. So that would be lifelong screening probably at least every three years, if not more frequently, depending on your risk factors. So it's these things that we just wanted to, I guess, just put out there prior to our next episode. we will definitely do a bit more on, or a lot more on type two in other episodes as well. Very important that we don't. Put blame on people and create a stigma around this, but it's also important that we acknowledge that there's risk factors that can be changed. And that's sort of where my passion lies as well, because I feel like if we don't be honest and let people know that, then they feel disempowered and they're likely just to accept that this is. This is their journey. And you see a lot of families where diabetes has, has caused lots of negative negative health problems, including things like amputation and loss of. Kidney function and eyesight and these things aren't inevitable. That is a result of high glucose levels for, for many, many years. So I guess we want people to not be frightened of getting tested. Something I always like to. remind women of in, you know, towards the end of their pregnancy if they've had gestational diabetes, is that if they've been on insulin during the pregnancy to keep their glucose levels in range, that doesn't necessarily mean that you'll have to be on insulin or any medication, even if you do go on to be diagnosed with type two diabetes, because the target glucose levels during pregnancy are much tighter while you're growing your little person. And it's also. That you've got those pregnancy hormones on board making you more resistant to insulin during pregnancy. So while your glucose levels might still be elevated enough to result in the diagnosis of type two, you might be able to manage that with lifestyle. And there's nothing to say. That, you know, with the right support from a team and friends and family that you can't manage for many, many years without medication at all. So education is key. Empowerment is key, and that's what we hope to get out of the next episode about. Primarily gestational diabetes, and then future episodes about type two diabetes as well. This little episode is really just an introduction and it's a bit of a call out to please let us know about your journey. We're really interested in your experience with the diagnosis of gestational. Because there have been many instances where women have been told they don't have gestational diabetes by their gp, when actually it's quite clear that their glucose levels are elevated and it is consistent with the positive gestational diabetes test. So I guess it's clarifying that and. We just need to get this information out there because there's many healthcare professionals that don't fully understand this. I'm fortunate enough to work in this area as one of my primary areas, which is why I've, you know, over the last few years, been able to develop a better understanding. But yeah, there's always research going on as well, and so there is some considerations about, you know, the testing levels, the target levels. How beneficial is it to mom and baby? I think information is key if you have contact with a diabetes educator or a team that suggests that you should be monitoring your levels during pregnancy, it's important to understand why they recommend that, and that gives you the choice to make the decision as to whether, you know, you want to follow up with their advice. Of course, the ultimate decision's going to lie with you. And healthcare professionals should be including you in those decisions. So I hope this has been a little intro and a little bit informative to lead into our next episode on gestational diabetes. As always, thank you for listening. Please do share. We would love people who have been through gestational diabetes. To to start following and get in touch. And you can share anonymously. We promise we won't name anyone. If you'd like to just share your story and we can just say, you know, put, put a pretend name up, or whatever it might be. Our little, our little tribe is growing. And I know we, we have had a few people reach out and it does help, it helps each other when you are able to share your stories and support each other as well. So the other thing you can do to help spread the word about the podcast is rate us on your favorite app. There should be a link below the episode where you can do that. So appreciate everything you guys do thanks for listening, and we'll look forward to the next episode on gestational diabetes.