I Have Gestational Diabetes, Now What Do I Do?

AUTHOR: MADELEINE WHITE, RD
Associate Registered Dietitian Nutritionist at Nutrition Instincts – San Diego Nutrition Therapy

Gestational Diabetes (GDM) is diagnosed in pregnant women who have never had type 1 or type 2 diabetes before. Due to its hormonal nature, the diagnosis and management of GDM has been difficult to understand – as no two people maintain the same hormone balance1. What we do know is that during pregnancy, the body undergoes physiological changes that naturally replicate some of those seen in diabetes. For example, cells don’t take up as much glucose, a process called insulin resistance, in order to deliver more of that glucose to the fetus. In addition to these changes, the diagnosis of GDM can also be linked to preconception risk factors – ones we likely don’t even know about!

Gestational diabetes can happen to any pregnant woman. Any pregnant woman living in any body at any size and of any race can be diagnosed with gestational diabetes. That’s why every pregnant woman is required to take the test at 24-28 weeks gestation. I emphasize this because of the shame, guilt, and stigma nearly all women feel after a diagnosis of GDM.

Gestational Diabetes is not your fault, so why do you feel responsible?

Identifying the shame in diagnosis

A Gender Paradigm

The diagnosis of GDM can only be made in, of course, pregnant females. This alone heightens the stigma in and of itself in our gender-biased culture. If half of the population is “safe” from the disease, there is less urgency to spread to awareness regarding its diagnosis and management. Moreover, GDM shares similarities (and the same name) with [Type 2] Diabetes – which is widely misunderstood by the general public, ridiculed for it’s “causes,” and made out to be the “fault” of those who carry the diagnosis. More on that at another time.

A ‘Health’ Paradigm

We live in a society that values health, and where that picture of health is extremely narrowed. The stigma surrounding diabetes can be felt from nearly all angles – media, family, friends, and unfortunately – trusted healthcare providers2. Women often experience scare tactics in an effort to influence them to “better” manage their GDM – yet we rarely hear of the “success” stories where mama and baby go on to live happy and healthy lives2. In a Canadian study, it was found that the three primary themes that arose following in the diagnosis of GDM were concern for the infant, concern for self, and sensing a loss of personal control over [their] health1.  This led to an increase in anxiety, resulted in poorer health perceptions, and made for a less positive pregnancy experience compared to “non-diabetic” controls1. On the other hand, women may feel judgment from healthcare providers or outsiders if they aren’t worried enough about their GDM outcomes. Ultimately, creating a confusing limbo between “You better do XYZ or else” and “Don’t stress though – it’s not good for the baby.” It’s no wonder the combination of depression, anxiety, and stress, or what experts refer to as diabetes distress, remains at an all-time high throughout pregnancy3.

Tips on reducing the shame and guilt in your gestational diabetes diagnosis

Get Non-Shaming, Person-Centered Education on Your Diagnosis

“Education is the foundation for diabetes self-management – it’s important to ensure women feel empowered to make lifestyle changes for the health of themselves and their growing families”1.  Inform yourself (and those of your choosing) of the what, why, and how of your diagnosis. Gestational diabetes does not need to be defended, remember – your diagnosis is not your fault. However, with just 9.2% of pregnancies resulting in GDM, most people just don’t know much about it2!

 Note: it’s easy today to do a quick search on Google and fall down a rabbit hole of misinformation and scare tactics. Go slow – ask your physician for medical resources (these will be reliable and credible) and find yourself in the care of healthcare providers that you feel comfortable with. Tempting as it is because it’s all at your fingertips, skip the Youtube videos and WebMD articles – which will just leave you confused and scared.

Find Support From Trust-Worthy Sources

 In addition to those close to you, find support in therapy, support groups, and other avenues of professional help. A dietitian knowledgeable of managing gestational diabetes can be so helpful in navigating the day-to-day decision making when it comes to meals and snacks, eating out, fueling for physical activity, and so much more. Ask your OBGYN for the support you need if what you’re offered isn’t enough. Make an appointment with a mental health professional, even if you don’t feel like you absolutely need it. It’s easy to feel like the diagnosis of GDM can  swallow you up and take over who you are, but you are not your diagnosis. The more supported and empowered you feel, the easier it becomes to distance yourself from your GDM.

Bring in Some Self-Compassion

There are so many feelings that accompany the diagnosis of GDM, and it’s okay to experience all of them. You’re being asked to pay mind and potentially modify your nutrition and physical activity, improve your sleep quality, manage your stress, poke yourself multiple times a day, possibly begin a medication regimen – all while undergoing the extreme physical changes of pregnancy, maybe caring for other children, working, being a partner/friend/daughter, and continue life as one would normally do. Realize that this is A LOT for one person to juggle and that doing your best is likely enough.

Seek Professional Help

If you’re struggling with managing Gestational Diabetes, let us help. It’s not uncommon to walk away from a doctor’s visit feeling confused about what and how much to eat, whether or not you can eat carbs (hint: you can and your body needs them), or how to manage your blood sugar without restricting food. At Nutrition Instincts, we fit GDM management into your life, not the other way around. Together, we can work towards a more positive pregnancy and GDM experience. To learn more contact us today! 

References:

1. Young, Lesley. “Improvement Needed in Gestational Diabetes Education: Study.” Medical Xpress – Medical Research Advances and Health News, Medical Xpress, 15 Nov. 2018, medicalxpress.com/news/2018-11-gestational-diabetes.html.
2. Llamas, Michelle. “Diabetes – Stigma, Blame and Shame.” Drugwatch.com, 14 May2019, www.drugwatch.com/featured/diabetes-stigma/.
3.     Endocrine Today. (2016, October 24). Diabetes distress, depression affect medication adherence. Retrieved from https://www.healio.com/endocrinology/diabetes/news/in-the-journals/%7Bf9667bec-ba07-40eb-a441-115b1c1e8605%7D/diabetes-distress-depression-affect-medication-adherence

Connect with our Registered Dietitian Nutritionists for Gestational Diabetes Support in San Diego

Looking to remove the guilt and shame around food and your body? Nutrition Instincts is here to help! Our team of specialized Registered Dietitian Nutritionists have expertise in eating disorders, intuitive eating, nutrition counseling for families and individuals struggling with selective eating disorders, ARFID, and picky eating, prenatal and postpartum nutrition support and diabetes therapy in San Diego and online. Learn more about our fees and insurance and answers to common questions on our FAQs page. Connect with us today to discover how to make peace with food and your body!

AUTHOR: MADELEINE WHITE, RD
Associate Registered Dietitian Nutritionist at Nutrition Instincts – San Diego Nutrition Therapy

Maddie White, an eating disorder and diabetes care provider at Nutrition Instincts is passionate about helping others restore their relationships with food, body, and mind. Maddie also works as a clinical dietitian in a local San Diego Acute Care Hospital and previously managed youth programing at the American Diabetes Association for San Diegans living with type 1 diabetes. Maddie believes intuitive eating holds a space for everyone and every body. By taking an individual approach with each client, Maddie walks alongside her clients as they learn the best way to navigate your journey to food and body freedom.   Interested in working with Maddie? Contact us today!