October 12, 2021 Staying informed to stay healthy

When Sharan Sandhu of Surrey, B.C., developed gestational diabetes (or GD) during her second pregnancy with her son Agad, eight years ago, she blamed herself. “I didn’t know the first thing about GD and I was really worried,” she says. “I thought I’d have diabetes forever and have to go on insulin for sure.”

What is gestational diabetes?

Fortunately, Sharan met Rema Sanghera, a former registered dietitian and certified diabetes educator at BC Women’s Hospital in Vancouver. Rema worked with Sharan and other pregnant patients diagnosed with gestational diabetes (GD), which occurs in some pregnancies. While age and genetic factors—including being from a high-risk group (Indigenous, Asian, Hispanic, or African descent)—play a role in the development of GD, many women often believe they have done something to cause the condition and worry about harmful effects on their baby, especially if they have to take insulin as a result of the diagnosis, which about 30 per cent of Rema’s patients do. “I let them know that it’s a temporary condition and, in the vast majority of cases, it goes away when the baby is born. The most important thing is to keep blood sugar levels well controlled so that the baby isn’t affected,” says Rema.

Getting a handle on her health

The support Sharan received from Rema helped calm her anxieties. Sharan did not have to take insulin, but she needed to take charge of her health and manage her diabetes through lifestyle changes that ranged from what and when to eat, to being more active in ways that worked for her and her family. Sharan began eating breakfast each morning and dinner at a regular time, snacking frequently, cutting back on sugar and exercising for 20 minutes after dinner, either going for a stroll with her husband or doing chores around the house. “I got fitter, didn’t gain a lot of pregnancy weight and followed every rule. And I felt great. I realized I could eat just about anything—chicken, eggs, fish, vegetables—as long as it was healthy food,” she says. Today, her son, Agad, is a healthy seven-year-old.

When Sharan was diagnosed with GD again during her third pregnancy in 2017, she says, “I felt like I could handle things better.” She used the tools she’d learned the last time around, and her whole family got involved in keeping her on track. “We all embraced healthy living,” she says, adding,

Due to the extraordinary care I received from my medical team, this pregnancy was a breeze.  All the dietary lessons I learned from my second pregnancy easily carried over. I am still dutiful of what and how I eat.

Sharan’s message to women with gestational diabetes: “Don’t blame yourself. I didn’t even know it existed until I was diagnosed. The support I received working with my diabetes educator and her team was a lifesaver. If it hadn’t been for them I would have been so lost and confused.”

Ways to take charge of diabetes

Between three and 20 per cent of pregnant women develop gestational diabetes (GD), depending on their risk factors, and all pregnant women should be screened for this condition between the 24th and 28th week of pregnancy. Women who have developed GD are at greater risk for the condition in their next pregnancy and for developing type 2 diabetes in the future. There is no doubt that living with diabetes can be stressful. Rema Sanghera offers the following advice on how not to feel overwhelmed:

Have an action plan What do you need to work on: adjusting your medication? Finding a fitness routine that works for you? Having more downtime? When you are feeling overwhelmed, it helps to figure out your key goals.

Do not blame yourself Remember that gestational diabetes may be connected to hormonal and genetic risk factors as well as behavioural issues. If your diabetes care team suggests that you make lifestyle changes to manage your gestational diabetes, focus on taking those positive steps forward rather than feeling guilt or shame.

Share your worries “It’s easy to worry when you have diabetes, but you don’t have to worry on your own,” says Rema. “If you have concerns, reach out to your diabetes educator. Calling with any specific concerns between regularly scheduled visits will do a lot to calm you.”

Ask for help if you are struggling Sometimes you may be dealing with stresses that go beyond having diabetes, such as depression, financial problems, family violence, or having a child with health issues. “Many people may not have the adequate supports they need and a diabetes educator can point you toward resources that can help, such as the services of a social worker.”

This story originally appeared in Diabetes Dialogue, Autumn 2017.
 

Did you know?

2021 marks the 100th anniversary of the discovery of insulin. Today, more Canadians have diabetes than ever before. Diabetes or prediabetes affects one in three Canadians. One in two young adults will develop diabetes in their remaining lifetime. We cannot wait another 100 years to End Diabetes. Visit 100 Years of Insulin to learn more, including how you can support those living with or at risk for the disease.