Ep. 7 The silence of prediabetes & type 2 diabetes

Most mums who've had GDM reach the same conclusion after their baby arrives:

I feel fine, so I probably am.

And honestly? That conclusion makes complete sense — especially when you're sleep-deprived, keeping a small human alive, and no one from the healthcare system is checking in anymore.

But here's what the research tells us: prediabetes and the lead-up to Type 2 diabetes are largely silent. Your glucose levels can be creeping up for years before you feel a thing. Your body works harder and harder to compensate — and you have no idea it's happening.

In this episode, Jaimee breaks down three patterns she sees repeatedly in her clinical work — patterns that map directly onto what the research describes — and explains why feeling fine is not the same as being metabolically well.

She also unpacks why simply telling women the statistics isn't enough, why personalised metabolic data changes everything, and why your health and your child's health are not as separate as they might feel right now.

Because GDM wasn't just a pregnancy complication. It was a metabolic stress test — and what it revealed doesn't disappear when the placenta does.

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General education only — speak with your healthcare provider about what's right for you

Whether you're newly postpartum, years past your GDM diagnosis, or supporting someone who's been through this experience, this podcast is for you. Let's create healthy futures together!

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Links mentioned in this podcast:

Australian National Diabetes Strategy 2021–2030 | Australian Government Department of Health, Disability and Ageing

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Transcript

0:02

Welcome back to another Healthy Futures After GDM episode. I'm so glad you're here, and if you're a new listener, welcome. I'm Jamie, credentialed diabetes educator and registered nurse. Almost finished my nurse practitioner studies, counting down the months. I work with women with gestational diabetes a few times a week, and this podcast exists because the gap in care after gestational diabetes is real. It's documented, and it's just something that needs more work. I am one person, but I do have a dietitian diabetes educator who works with me, and she's as passionate as I am. So in the last episode, I talked about abandonment, the word women themselves use to describe how it feels when the healthcare system's attention shifts away from them to their baby after baby is born, which is very natural and understandable. But if you haven't listened to that one, go back, have a listen, and it sort of sets everything up for what I'm about to talk about today. When there's no follow-up, no ongoing conversation, no one checking in, women are left to form their own conclusions about their health, and the conclusion most women reach is that, "I feel fine, so I probably am." That's not uncommon with pre-diabetes or even the lead-up to Type 2 diabetes for anyone. So today we're talking about what happens and what the research tells us about it, and why it's one of the most important things we need to shift if we're going to prevent Type 2 diabetes in women after gestational diabetes. The research on perceived risk of gestational diabetes is consistent, and it is confronting. So study after study across multiple countries shows that a significant proportion of women who have had gestational diabetes do not feel personally at risk for developing Type 2. Even when they've been told the statistics, which we consistently hear is around fifty percent of women within five to ten years. Some research suggests it's even higher. But you can do something about it, and that is not inevitable. And what I want to be really clear about is it's not about intelligence. This is not about women not caring about their health. This is about something deeply human, and that is we process risk on how we feel. So in my clinical work, I see three patterns repeatedly, and they map directly onto what the research describes. The first is, "I feel healthy, so I must be okay." This one is so understandable. If you're not experiencing symptoms, if you're getting through your day, if your energy is reasonable as a mum, you're going to feel tired anyway, and nothing feels obviously wrong, why would you feel at risk? The problem with type 2 diabetes and insulin resistance is that they are largely silent in the early stages, and even in the lead-up to the prediabetes and the type 2, you may feel normal. Your glucose levels can be creeping up for years before you feel anything. Your body can be working harder and harder to compensate, and then you've, you've had no idea that this is happening. So your glucose tolerance test and your fasting glucose levels, even that HbA1c might be fine, it might be normal. You may not know what it is. Often you're just told it's normal. But is it increasing? You do wanna know that. So feeling fine is not the same as being metabolically well, and that distinction is one of the most important things I want to try and help women understand. Now, the second pattern is that gestational diabetes was a pregnancy thing, and it's over now. My glucose levels are back to normal after I delivered. You might have even heard that. I hear this constantly, and again, it makes complete sense as a conclusion to reach, especially if no one has explicitly told you otherwise. But GDM is not just a pregnancy complication. It is a metabolic stress test, and it's a window into your potential future health. So it revealed that under conditions of metabolic demand, which was your pregnancy hormones, your insulin response wasn't sufficient. That doesn't disappear when your placenta does as such. Your underlying metabolic vulnerability can remain, and the pregnancy just made it visible. Now, the third pattern is one that's close to my heart, and that is women after GDM are so focused on their baby that thinking about their own future health feels almost indulgent. You're sleep-deprived, you're feeding, you're keeping a small human alive. Your health feels like it can wait. And I get it, I really do. But here's the thing, your health and your child's health are not separate. The lifestyle habits that you build now, the metabolic health you protect now directly influences your energy, your longevity, and the environment your children or your child grows up in. So taking care of yourself is not separate from taking care of your family. It is part of it. Now, here's where I want to bring in something that really matters. The research shows that perceived personal risk is one of the strongest predictors of whether women will engage in prevention behaviours or programs. In other words, if you don't feel at risk, you're less likely to act. Which means that simply giving women statistics isn't enough. Telling someone that they have a fifty percent lifetime risk of type 2 diabetes doesn't automatically make them feel, that they are at risk personally, especially in the fog of new motherhood, especially when you feel well, and especially when the healthcare system has already moved on and no one's truly following up. This is exactly why I believe so strongly in personalised metabolic data. This is why I'm studying my nurse practitioner, so I can actually take more accountability for being able to help people, women who have had gestational diabetes, women like my sister. When I speak to you, I feel like I'm speaking to my sister as well, so it is deeply personal. And understanding your own glucose response, your own insulin-resistant markers, your own numbers, because the abstract risk statistics don't shift behavior the way personal data does. If you see what your body is doing, you're more likely to act. So when you see your own body's response in real time, risk stops being a statistic, and it starts being real. When you understand your blood test results have increased over the last one, two, three years or more, you understand your risk is going up. That's important. So I've lived with type 1 diabetes for over thirty years. I do repeat this, but I just want to reiterate that I understand the challenges of motherhood, along with trying to manage a health condition. It is very hard. I've not had the luxury of not thinking about my glucose levels and my health, and I understand how hard it is to get to appointments, to get the blood test done, to try and eat healthy all the time, ensure that you're getting some strength training in, some cardio exercise. But I can also tell you that there's something profound about understanding your own body's signals. It changes how you make decisions, not from a place of fear, but from a place of knowledge and understanding, and that's what I want for every woman after gestational diabetes. So if you've ever caught yourself thinking, "I feel fine, it was just a pregnancy thing, I'll worry about it later," I want you to know that this is completely normal, completely understandable, and also worth gently challenging. You don't have to overhaul your whole life overnight, but you do deserve accurate information about your own body, your own risk, and someone in your corner or a team in your corner helping you make sense of it all, and helping to motivate and empower you to be the best you can for you and your children and your family. So if you want that, come and join us in our free private Facebook group. I've created that so it's a more private, um, environment where we can have open and honest conversations in a supportive nature. The link is in the show notes, and it's also in my Instagram and Facebook page account. If this episode resonated with you or if you've heard something that felt true to your experience, can I ask a favour? Can you hit follow on your podcast app right now? If you're driving, please wait. Uh, leave a review if you have a couple of minutes to do that, and share this with a friend who's had GDM. Every follow, every share, every new listener helps us reach more and more women. In the next episode, I am going to talk about the real barriers that get in the way of women after gestational diabetes and what you can do about it. It's not just willpower and motivation. Motherhood barriers are real, and they are different from other stages of life. Thank you so much for listening. Do please follow us and give a review if you've got time. Just remember, you matter, not just as a mum, but as a person. See you in the next episode.