Gestational Diabetes: A Window into Your Future Health and How to Make Healthy Changes

There are two major life transitions I love talking about with patients: becoming a mother and the transition to/ through menopause. These are 2 life altering and pivotal transitions, there is so much happening during these times, so much to consider and so much to plan for. When these two transitions intersect, this is where things get especially fascinating. Today, I’d like to zero in on a specific conditions that many women (15% of pregnancies worldwide) are diagnosed with during pregnancy (Griffiths et al, 2020))—gestational diabetes—and how it can be more than a temporary diagnosis. It can be a powerful glimpse into your future health.

I've been practicing as a naturopathic doctor in Edmonton for 15 years, and what I’ve noticed—over and over again—is how quickly attention shifts to baby after birth. This is completely understandable, but this blog post is about you. It’s about what your pregnancy can tell you about your body, your health, and the choices ahead. Let’s start with a bit more understanding about the condition.

What Is Gestational Diabetes?

Gestational diabetes (GDM) occurs when your body struggles to manage blood sugar during pregnancy. It is often symptomless at first, which is why screening is critical. In Canada, we typically test for GDM between 24 and 28 weeks or pregnancy using the oral glucose tolerance test (OGTT) (Diabetes Canada | Clinical Practice Guidelines) . You know the one—where you drink that syrupy orange beverage that’s... let’s just say, unforgettable; then you need to wait around for 2 hrs before your blood is drawn. You may be wondering why we can’t just use the same simple blood tests (HbA1c) we use when you weren’t pregnant? During pregnancy your total blood volume increases a lot to support baby; this causes what is called “hemodilution of pregnancy”. Essentially, this extra blood volume “dilutes” your blood making these blood tests inaccurate beginning in the 2nd trimester until 6 months postpartum (Edelson et al. 2020) . Taking HbA1c levels during this period could underestimate your results (Edelson et al. 2020).

Why It Matters After Baby Arrives

Here’s the part that often gets overlooked: gestational diabetes isn’t just a pregnancy issue. It’s a signal. A red flag. A crystal ball showing what may be in your future. Research shows that women who experience GDM are:

• 30–84% more likely to develop GDM in future pregnancies (Diabetes Canada | Clinical Practice Guidelines) .

• 3 to 10 times more likely to develop type 2 diabetes later in life ((Kaufmann et al. 1995; Kim et al. 2002; Lauenborg et al. 2005; Feig et al. 2008; Bellamy et al. 2009; Kugishima et al. 2018; Valizadeh et al. 2018; Li et al. 2020; Vounzoulaki et al. 2020; You et al. 2021; Juan et al. 2022; Wambua et al. 2024) 

• Twice as likely to experience cardiovascular events within 10 years postpartum (Kramer et al. 2019; Sun et al. 2021) .

• At increased risk for fatty liver and serious liver disease, especially if they go on to develop type 2 diabetes (Retnakaran and Shah 2009; Ajmera et al. 2016; Donnelly et al. 2019; Lavrentaki et al. 2019) .

• At increased risk for chronic kidney disease and diabetic retinopathy, particularly if they go on to develop type 2 diabetes (Bomback et al. 2010; Beharier et al. 2015, 2017; Dehmer et al. 2018; Rawal et al. 2018; Barrett et al. 2020).

  
  

Even more concerning? These risks persist even if your blood sugar returns to normal after delivery!

If you are thinking, “I had no idea”, you are not alone, studies show that the message about the importance of follow up or the risks is not getting through. (Smirnakis et al 2005; Clark et al 2003, Morrison et al 2010). Further, studies show that only 14-50% of moms return for their postpartum testing (Morrison et al. 2010, Kerimoglu et al 2006, Russell et al 2006). I feel that there is an opportunity to do better here and while we are waiting on better systems from a public health standpoint, I don’t want you to fall through the cracks. Being proactive about your health care is so important ALWAYS and if you have had gestational diabetes there are some simple things that can make a real difference in your long-term health.

So, What Can You Do?

Let’s shift from worry to action. Here’s how you can take charge:

1. Postpartum Screening

In Canada, it’s recommended to have a 75-gram OGTT between 6 weeks and 6 months postpartum (Diabetes Canada | Clinical Practice Guidelines). After that, continue screening every 1 to 3 years (Diabetes Canada | Clinical Practice Guidelines). If you’re planning another pregnancy, get screened beforehand (Diabetes Canada | Clinical Practice Guidelines).

TIP: Mark it in your calendar AND make it a recurring event. Your future self will thank you.

2. Breastfeeding

Breastfeeding isn’t just beneficial for baby—it can reduce your risk of developing type 2 diabetes (Ziegler et al. 2012). Aim for exclusive breastfeeding for about 6 months, and continue as appropriate for up to 24 months or longer (Breastfeeding your baby - Canada.ca).

It is common to struggle with nursing. You might see others nursing without issue, chances are they had help! Nursing does not fall naturally into place for most and is a misconception I feel strongly that we need to put to rest. If you and your little one are having trouble reach out to a lactation consultant and/or your healthcare provider. The earlier that your reach out for support the better for you and baby. This is not a time to wait or try to figure it out on your own, delays in finding supports can affect your milk supply.

3. Lifestyle Adjustments

Diet, exercise, sleep—we know these are pillars of good health. Yes, we hear this all the time! I won’t go into detail on this as there is more information about all of these items on our blog and I am sure that you have been told far too many times to “eat well”, “exercise often” and “sleep enough”. So, instead I would like to focus on consistency; this is the key to success in all of these areas.

TIP: Create a plan that includes:

• Accountability: Partner with a friend, join a group, or schedule regular check-ins with a healthcare provider.

• Realistic Goals: Start small and build up. Sustainable changes trump drastic overhauls.

• Milestones: Look backwards from your final goal and set smaller milestone goals that show you that you are making progress.

• Rewards: Treat yourself to a flowers, a date with a friend, spa time when you reach small milestone goals along the way.

• Support: Don’t go it alone. Engage with professionals who can guide and motivate you.

  
  

4. Build Your Healthcare Team

It is difficult to get all of your health care needs met by a single person. Even when they are all delivering the same or a similar message, hearing it multiple time and/ or in different ways can increases the likelihood that you will be able to assimilate the information in a meaningful way.

Consider assembling a team that includes:

• Family Doctor: For regular check-ups, screenings and prescriptions as needed.

• Naturopathic Doctor: For regular check ups and screening, personalized lifestyle and nutritional guidance, supplement prescriptions, detailed and personalized explanations of your health concerns/ conditions and treatments.

• Registered Dietitian: To fine-tune your diet and meal planning, and to help you find specific strategies, recipes, and plans that help you reach your nutrition goals.

• Lactation Consultant: To help you navigate any challenges you may be facing with nursing your child.

• Personal Trainer: To develop a safe and effective exercise regimen to help you achieve your fitness goals.

Final Thoughts

Even if you follow every recommendation, there's still a chance that complications may arise. This isn't a reflection of your effort or worth. Remember, taking proactive steps puts you in a better position than ignoring the risks, regardless of a future diagnosis. Our aim is progress, not perfection!

You deserve care, attention, and support—not just during pregnancy, but after and well beyond.

*Disclaimer: The information contained within this post is for general educational and information purposes only; no doctor-patient relationship is formed. It is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. If you have any concerns or questions about your health, always seek the advice of a qualified healthcare professional.

References:

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