NDSS Helpline 1800 637 700

ndss.com.au

Life after
gestational
diabetes

Find this resource at ndss.com.au

 Gestational diabetes – what next? 1
Contents

After gestational diabetes 2

Why is diabetes a problem? 4
Steps to a healthy life 6
Diabetes checks 6
Make healthy food choices 8
Be active every day 15
Aim for a healthy weight 19
Encourage a healthy lifestyle for the whole family 20
Goal setting 22
Planning for another pregnancy 25
What if I develop diabetes before my next pregnancy? 26
Looking after your health into the future 28

If receiving information about pregnancy or gestational diabetes raises personal

concerns for you or causes you any distress, you can opt out from receiving further
communications by visiting our website at ndss.com.au/gdm-update or calling the
NDSS Helpline on 1800 637 700. If you need support, ask your GP or local hospital
maternity service about support services available in your area.

Disclaimer:
This information is intended as a guide only. It should not replace individual medical advice.
If you have any concerns about your health, or further questions, you should contact your
health professional.

Version 10, September 2021. First published July 2009.

NDSSA5B003
Gestational diabetes —
what next?
This booklet is for women who have had a pregnancy with gestational
diabetes. It provides information on looking after your health after
pregnancy and into the future.

This booklet has been sent to you from the National Gestational Diabetes
Register. When you registered on the National Diabetes Services
Scheme (NDSS) with gestational diabetes, you were automatically
included on the National Gestational Diabetes Register.

As part of the Register, you and your GP will be sent reminders

about postnatal follow-up and regular type 2 diabetes checks. This
booklet does not take the place of the valuable advice you receive from
your health professionals.

For more information about the National Gestational

Diabetes Register
» Call the NDSS Helpline on 1800 637 700
» Visit ndss.com.au

Life after gestational diabetes | 1

After gestational diabetes

Gestational diabetes is a form of diabetes that occurs during

pregnancy. For most women, diabetes disappears after pregnancy;
however, there is an increased risk of future diabetes.

As many as 1 in every 2 women who have had gestational diabetes will

develop type 2 diabetes or pre-diabetes within 10–20 years.

Women who have had gestational diabetes are also at higher risk of
developing gestational diabetes again in a future pregnancy.

Pre-diabetes is a condition where the blood glucose levels are

higher than normal but not high enough to be diagnosed with
type 2 diabetes. Having pre-diabetes means that you are at
increased risk of developing type 2 diabetes.

Type 2 diabetes is a form of diabetes that occurs when the

pancreas can’t make enough insulin and the body cells can’t
respond properly to insulin, leading to high blood glucose levels.

2 | Life after gestational diabetes

Risk factors
Gestational diabetes is one risk factor for developing pre-diabetes
or type 2 diabetes. Your risk also increases if you have other risk
factors, including:
» A family history of type 2 diabetes
» Being above the healthy weight range or putting on weight over time
» An inactive lifestyle
» Having an Aboriginal or Torres Strait Islander background
» Being from a Melanesian, Polynesian, Indian subcontinent,
Middle Eastern or Asian background
» Having polycystic ovary syndrome
» Age – your risk increases as you get older
» Taking some types of antipsychotic or steroid medications.

Talk to your doctor about your risk factors for type 2 diabetes.

Life after gestational diabetes | 3

Why is diabetes a problem?
Diabetes can develop at any age. If left undetected or unmanaged,
it may cause damage to the eyes, kidneys, nerves and blood
vessels. The risk of long-term health problems can be reduced if
diabetes is detected early and managed well.

Pre-diabetes
Pre-diabetes is a condition that occurs before type 2 diabetes develops.
It has no signs or symptoms. The only way to diagnose pre-diabetes is
through a blood test. If you have pre-diabetes, it means that you are at
high risk of developing type 2 diabetes.

The good news is that with a healthy lifestyle — including

regular physical activity, making healthy food choices and being
a healthy weight — you can reduce your risk of type 2 diabetes
by almost 60%.

4 | Life after gestational diabetes

Type 2 diabetes
If you develop type 2 diabetes, and it’s detected early and
well-managed, you can continue to lead a healthy life. Type 2 diabetes
is managed with a healthy lifestyle, regular health checks and
medication (as needed).

Type 2 diabetes can sometimes be difficult to detect. Many people don’t

know they have it, which is why regular checks for diabetes are essential.

If you have any symptoms of diabetes, see your doctor promptly for a
health check and remind them that you have had gestational diabetes.

Symptoms of type 2 diabetes can include:

» feeling tired and low on energy
» being thirsty and drinking more than usual
» going to the toilet (to pass urine) more often (especially at night)
» sores or cuts that won’t heal or skin infections
» blurred vision
» pain or tingling in the legs or feet.

Gestational diabetes in future pregnancies

Many women who have gestational diabetes will develop it again in a
future pregnancy. To reduce your chances of getting gestational diabetes
again, BEFORE your next pregnancy:

» Aim to have your weight as close to the healthy range as possible

» Be active for at least 30 minutes each day
» Make healthy food choices
» Ask your doctor for a diabetes check
» Ask your health professionals for advice on healthy weight gain during
pregnancy

See page 25 for more information about planning for another pregnancy.

Life after gestational diabetes | 5

Steps to a healthy life

Step 1 Diabetes checks

Your 6–12 week oral glucose tolerance test (OGTT)

As many as 1 in every 5 women with gestational diabetes will continue
to have high blood glucose levels after their baby is born. For this
reason, it is recommended that you have a follow-up oral glucose
tolerance test (OGTT) 6–12 weeks after your baby is born (or as soon as
possible after this time). This is to check that your blood glucose levels
have returned to the normal range.

After a pregnancy with gestational diabetes, many women find

it hard to make the time to return for their 6–12 week OGTT, or
forget to have this test done. If you haven’t had this test done yet,
it’s not too late — your GP can organise this for you.

6 | Life after gestational diabetes

Follow-up checks for diabetes
Regular diabetes checks are recommended for all women who
have had gestational diabetes.

As a general guide, diabetes checks are recommended:

» Every 1–3 years depending on your risk factors for
type 2 diabetes
» If you are planning another pregnancy

If your results show that you have pre-diabetes, annual blood

glucose checks are recommended.

Your GP will advise you on the type of test and how often you need to
have this done. This will depend on your risk factors for type 2 diabetes,
the results of previous tests and whether you are wanting to have any
more pregnancies (see page 25).

For the majority of women, ongoing type 2 diabetes checks are

usually a simple blood test.

Remember, even if your follow-up checks show that you don’t have
diabetes, remind your GP that you have had gestational diabetes and
have follow-up checks again every one to three years.

People with type 2 diabetes

often feel OK without noticing
symptoms for some years.
That is why it’s important to see
your GP for regular diabetes
checks. Detecting diabetes
early can help you manage the
condition and stay healthy.

Life after gestational diabetes | 7

Steps to a healthy life

Step 2 Make healthy food choices

Healthy eating can help reduce your risk of developing type 2 diabetes.
You don’t need to be on a special diet — making healthy food choices,
being active every day and managing your weight are keys to reducing
your risk.

To get the right balance of healthy foods choose:

» At least 2 serves of fruit and 5 serves of vegetables each day

» High-fibre, wholegrain breads, cereals, and grains
» Lean meats, skinless chicken, eggs, tofu, or fish (aim for 2–3 fish
meals each week)
» Legumes, such as lentils, chick peas or baked beans (aim for
2 legume meals each week)
» Reduced-fat dairy foods (or soy-based alternatives) without added
sugars
» Small amounts of healthy fats and oils, such as avocado, nuts and
seeds, nut butters, and poly or monounsaturated oils/spreads.

8 | Life after gestational diabetes

Putting together healthy meals
Getting the right balance of healthy foods and choosing serving sizes to
suit your needs can help you to reduce your risk of type 2 diabetes and
maintain a healthy weight.

When putting a healthy main meal together:

» Fill half of your plate with a variety of vegetables or salad

(not including potato, corn or sweet potato).
» Fill a quarter of your plate with a lean protein food, such as lean meat
(beef, lamb, pork), skinless chicken, fish/seafood, tofu or eggs.
» Fill a quarter of your plate with a carbohydrate food that has a lower
GI, such as pasta, basmati rice (white/brown), SunRiceTM Low GI rice
(white/brown), wholegrain bread, corn, sweet potato, low-GI noodles
or legumes (such as lentils, chickpeas, kidney beans).

Include healthy fats and oils as part of a balanced meal, such as

olive oil in cooking or as a salad dressing, avocado in a salad or
nuts/seeds in a stir-fry.

See page 13 for an example of a healthy meal plan.

(such as pasta, corn,

low-GI rice, legumes
or sweet potato)

¼ low-GI
carbohydrate
foods
½ vegetables
or salad
¼
lean
protein

(such as lean meat,

skinless chicken, fish,
eggs or tofu)

Life after gestational diabetes | 9

Snack wisely
Whether or not you need to snack
between meals depends on your activity
levels, weight and eating patterns. If you
are breastfeeding, your appetite may be
higher than usual, making snacks important
for your energy and nutrient needs.

Snacking can be a great way to add extra

nutrition to your day. However, some snacks
can be high in kilojoules/calories, saturated
fat and sugar and can make it difficult to
maintain a healthy weight.

If you choose to snack it’s important

to make healthy choices and watch
your portion sizes.

Ideas for healthy snacks

1 serve of fresh whole fruit (e.g. 1 medium apple, 1 small banana)

2 small fruits (e.g. mandarins, plums or kiwi fruit)
1 cup fresh fruit salad or mixed berries (fresh or frozen)
1 cup of reduced-fat milk
1 small tub reduced-fat plain or Greek yoghurt topped with berries/passionfruit
Vegetable sticks — carrots, celery, capsicum, cherry tomato with hommus
1 cup air-popped (not microwave) popcorn
4 VitaweatsTM or VitagrainsTM with sliced avocado and tomato
2 Ryvitas® lightly spread with peanut butter
30g (a handful) of unsalted, mixed nuts
1 small packet of roasted chickpeas (e.g. Happy Snack CompanyTM )
Small can of tuna (90g) or a hard-boiled egg

10 | Life after gestational diabetes

Watch what you drink
What you choose to drink is important for good health.

Drinks for every day:

Water is the best everyday drink, but alternatives include soda water or
sparkling mineral water (you may wish to flavour with sliced lemon/lime/
frozen berries/cucumber/fresh mint). Other suitable choices are tea (black,
green or herbal) or coffee/decaffeinated coffee (black or with skim/reduced
fat milk). As an occasional substitute, diet soft drink or diet cordial may add
variety without extra sugar or kilojoules/calories.

Drinks to limit or avoid:

Soft drinks, energy drinks and cordials are high in sugar and have no
nutritional value. These should be avoided. Other drinks high in kilojoules/
calories such as fruit juice and flavoured milks should be limited and
consumed only in small amounts.

Alcohol is also high in kilojoules/calories which can make it difficult to

manage your weight. If you choose to drink alcohol, current health guidelines
recommend no more than 10 standard drinks in a week and no more
than 4 standard drinks on any one day. One standard drink is equal to:

100ml
60ml
425ml
375ml
285ml

30ml

regular mid-strength low-alcohol fortified regular spirits

beer beer beer wine wine

For breastfeeding women, current guidelines recommend that not

drinking alcohol is the safest option. However, if you choose to drink alcohol
occasionally, no more than 2 standard drinks are advised. Any alcohol you
drink also gets into your breastmilk, so if you decide to drink, you need to
plan ahead. Breastfeed your baby, or express breast milk, before drinking
alcohol. You will also need to wait until your breastmilk is free of alcohol
before breastfeeding again. Ask a health professional for advice or contact
the Australian Breastfeeding Association.

Life after gestational diabetes | 11

Tips for healthy eating

Plan healthy meal and snacks Eat 2 fruit and 5 vegetables everyday

Take care with serve sizes Limit fast foods and takeaways

Avoid foods and drinks high in sugar Choose healthy snacks

Enjoy healthy meals as a family Limit how much alcohol you drink

12 | Life after gestational diabetes

Sample daily meal plan
The following sample meal plans provide a guide to healthy meals and
snacks. The recommended amounts of food are based on the Australian
Guide to Healthy Eating suggested serves. The amounts shown are for
one person and are a guide only. A dietitian can help you with advice on
healthy eating to meet your individual needs and food preferences.

Women who are not breastfeeding

Breakfast 1½ cups high high-fibre breakfast cereal (e.g. Fibre PlusTM)
+ 1 cup (250ml) reduced-fat milk
Morning snack 1 cup (250ml) reduced-fat milk (can make into coffee)
Lunch 2 slices wholegrain bread
+ 1 boiled egg / small tin (90g) tuna
2 cups salad
OR
2 cups vegetable and lentil soup
+ small wholegrain bread roll
+ 1 cup side salad
Afternoon snack 1 serve of fresh fruit (e.g. an apple or 2 small plums or
1 cup mixed berries or ½ mango)
Dinner Spaghetti Bolognese:
1 cup cooked pasta
+ 1 cup lean mince bolognaise sauce
+ 2 cups salad
OR
Chicken Curry:
1 cup cooked basmati rice (white/brown)
+ 1 cup skinless chicken cooked with spices/
curry paste in a tomato-based sauce
+ 2 cups non-starchy vegetables (e.g. spinach, broccoli,
cauliflower, zucchini)
Use healthy fats and oils in cooking.
Supper 1 serve of fresh fruit (e.g. an apple or 2 small plums or
1 cup mixed berries or ½ mango)
+ small tub (100g) reduced-fat yoghurt
Drinks Water, soda/mineral water, tea/coffee

Life after gestational diabetes | 13

 Women who are exclusively breastfeeding*

Breakfast 1½ cups high-fibre breakfast cereal (e.g. Fibre PlusTM)

+ 1 cup (250ml) reduced-fat milk
+ 1 slice wholegrain toast
+ olive oil-based spread and vegemite

Morning snack 1 cup (250ml) reduced-fat milk (can make into coffee)
+ 4 wholegrain crispbreads (e.g. VitaweatsTM or VitagrainsTM)
+ tomato / avocado

Lunch 2 slices wholegrain bread

+ 1 boiled egg / small tin (90g) tuna
+ 2 cups salad
OR
2 cups vegetable and lentil soup
+ small wholegrain bread roll
+ 1 cup side salad

Afternoon snack Small handful (30g) of unsalted nuts

+ 2-3 small dates
+ carrot/cucumber sticks

Dinner Spaghetti Bolognese:

1½ cups cooked pasta
+ 1 cup lean mince bolognaise sauce
+ 2 cups salad
OR
Chicken Curry:
1½ cups cooked basmati rice (white/brown)
+ 1 cup skinless chicken cooked with spices/curry paste
in a tomato-based sauce
+ 2 cups non-starchy vegetables (e.g. spinach, broccoli,
cauliflower, zucchini)
Use healthy fats and oils in cooking.
Supper 1 serve of fresh fruit (e.g. an apple or 2 small plums or
1 cup mixed berries or ½ mango)
+ small tub (100g) reduced-fat yoghurt
Drinks Water, soda/mineral water, small amount of tea/coffee
*If you are breastfeeding, your energy needs will reduce as the number of breastfeeds each
day slows down. In this case, the meal plan for women who are not breastfeeding can be
used as a base and adjusted, according to your appetite to include more vegetables, fruits,
wholegrain bread and cereals, and reduced fat dairy products as needed.

14 | Life after gestational diabetes

 Steps to a healthy life

Step 3 Be active every day

Being active every day can help you reduce your risk of future type
2 diabetes, as well as the risk of gestational diabetes in another
pregnancy. Physical activity can also improve your general fitness,
energy levels, mood and emotional well-being, and help you maintain a
healthy weight after pregnancy.

Starting out
Talk to your doctor once you are ready to return to being active after your
baby is born. Building up your activity levels gradually is recommended.
Some hospitals run postnatal physical activity programs or provide
physiotherapy services to help new mums get back into regular physical
activity safely.

Being active
As a general guide, aim for at least 30 minutes of moderate physical
activity on most days of the week. This can also be broken up into
shorter periods of at least 10 minutes, three times a day.

‘Moderate physical activity’ means that while being active you will have a
slight but noticeable increase in breathing and heart rate (but you should
still be able to hold a conversation).

Moderate activities include:

» swimming
» brisk walking
» aqua fitness classes
» stationary cycling
» exercise classes or walking
groups (where you can
bring your baby)

Life after gestational diabetes | 15

 Tips for being active:
» Walking with a pram or stroller is a great way to be active and
get out and about with your baby.
» Joining a gym, swim centre or outdoor exercise group that
provides childminding can be a fun and social way to be active.
» Asking friends or your mothers’ group if they want to go
walking or meet up at the pool or gym can be of benefit to
everyone.

Day-to-day activity
You can also increase your day-to-day activity by walking to the shops,
playing with your children at the pool or park and being active around the
house. Fun family activities such as dancing or playing in the backyard
are great ways to be more active. Reducing the amount of time spent
sitting has also been shown to help reduce the risk of type 2 diabetes.

Resistance exercise
Light to moderate resistance exercise is also beneficial for muscle
strength and can help with weight loss. Resistance exercise includes
using free weights, machine weights or your own body weight. Talk to
a qualified exercise professional about a resistance program that suits
your needs.

Pelvic floor exercises

High impact activities or those that put pressure on the pelvic floor
should only be started gradually after pregnancy. This will depend
on how well your pelvic floor has recovered and how your baby was
delivered. Learning how to do pelvic floor exercises can help you
strengthen these muscles. A physiotherapist or exercise physiologist
can provide advice on pelvic floor exercises — ask your doctor or local
hospital about services in your area.

16 | Life after gestational diabetes

Physical activity for weight loss
If you are trying to lose weight, aim to increase your daily activity levels
to more than 30 minutes each day to help with weight loss.

Plan to be active
Find out what activities are available in your area through your local
council, community health centre or baby health clinic. Make a plan to
include regular physical activity in your day to help you achieve your
goals.

Monitoring your daily activity by keeping an exercise diary or using a

device such as an activity tracker or app can also encourage you to be
active.

To exercise safely remember to:

» include a 5-10 minute warm up and cool down
» drink plenty of water during and after physical activity
» wear loose, light clothing to avoid overheating
» avoid exercise when you are hungry, unwell or have a high
temperature
» STOP exercising and seek medical advice if you experience
chest pain, dizziness, back pain or pelvic floor weakness.

Life after gestational diabetes | 17

Tips for being active

Be active for at least 30 minutes/day Exercise in a group or with friends

Stay active with your family Try to limit the time spent sitting

Add some resistance exercise Look after your pelvic floor

18 | Life after gestational diabetes

 Steps to a healthy life

Step 4 Aim for a healthy weight

Aiming for a healthy weight after your pregnancy will help reduce your
risk of developing type 2 diabetes in the future.

For most women it will take some months to return to their pre-
pregnancy weight. For the best long-term health outcomes you should
aim to reach your pre-pregnancy weight within 6–12 months after your
baby is born.

If you are still carrying extra weight after your baby turns one year old,
losing as little as 5–10% of your body weight will still reduce your risk of
type 2 diabetes and improve your overall health.

If you are planning another pregnancy, it’s important to aim for a healthy
weight before you fall pregnant. This is one way to help reduce your risk
of getting gestational diabetes again.

Setting realistic goals can help you stay on track. If you need extra
support with managing your weight, see a dietitian for advice.

Benefits of breastfeeding
If you are breastfeeding your
baby, continuing to do so for the
first six months or more may help
you with managing your weight
and reduce your future risk of
type 2 diabetes.

Life after gestational diabetes | 19

Steps to a healthy life

Step 5 Encourage a healthy lifestyle for the

whole family
Encouraging the whole family to eat well and be active can have
benefits for everyone.

Type 2 diabetes tends to run in families, so it’s a good idea to discuss

diabetes with your relatives (parents, grandparents, aunts, uncles). Ask
if they have recently been checked for diabetes and if not, suggest they
visit their GP for a health check.

Children born to mothers who have had gestational diabetes also have
a greater chance of being overweight and developing type 2 diabetes
later in life. For this reason it’s recommended that the whole family eat
well and stay active to reduce the risk.

Children do not need to be routinely checked for type 2 diabetes*.

However, a GP may recommend type 2 diabetes checks for older
children or teenagers if there are additional risk factors such as carrying
too much weight, a strong family history of type 2 diabetes, or in
children from a high-risk cultural background.

* Type 2 diabetes is different to type 1 diabetes (the type more commonly seen in childhood).
Type 1 diabetes is an auto-immune condition that may be suspected in a child who is going to
the toilet excessively to pass urine, very thirsty, losing weight and becoming tired and generally
unwell. Children with these symptoms need urgent medical care. There is no additional risk of
type 1 diabetes in children whose mothers have had gestational diabetes.

20 | Life after gestational diabetes

Tips for healthy families
Once you have introduced a range of solid foods to your child, they can
start to eat the same healthy foods as the rest of the family. For a healthy
family lifestyle:

» Base family meals on fresh foods such as fruits, vegetables, lean

meats, dairy foods and wholegrains (with appropriate types of foods
and textures for children’s ages and stages)
» Stock your fridge and pantry with healthy foods for everyone — try to
avoid having ‘junk’ food in the house
» Pack healthy snacks and lunches for day care, school and work
» Avoid sugary drinks and limit pre-packaged snacks
» Encourage your child/children to always have a water bottle handy
and pack one for yourself too
» As your children get older, try to eat as many meals as you can
together as a family
» Take time to stop and eat during your busy day
» Avoid snacking on children’s leftovers
» Be active as a family — try bike riding, swimming, playing in the
backyard or at the park, bushwalking or walking the dog
» Keep an eye out for new recreational facilities or activity programs in
your neighbourhood.

Life after gestational diabetes | 21

Goal setting
Setting goals can help you stay motivated and focused on achieving
good health. Setting a few smaller goals is more likely to lead to success
than having one big goal that is hard to reach. Thinking of one or two
things you are ready, willing, and able to change to improve your health,
is a great place to start. SMART goals are those which are:

S
Specific – make goals that clearly describe what
you want to do.
For example, rather than a goal ‘I will get fit’ a specific goal
would be ‘I will take the dog for a walk’

M
Measurable – you need to be able to measure whether
or not have achieved your goals.
A measurable goal would be, ‘I will take the dog for a half
an hour walk at least 3 mornings a week’

Achievable – setting small goals and building on them

A
is better than setting a large goal that will be difficult to
achieve.
For example, the goal ‘I will walk every morning’ may not be
achievable but ‘I will walk three mornings a week’ may be.

R
Relevant – goals need to be important to you and fit into
your life.
For example, the goal ‘I will walk at 5am every day’ may not
fit into your life if you are not getting much sleep or there is
no-one to look after your child at that time.

T Timely – set a date for starting your goal and for

achieving it.
For example, ‘I will walk on Mondays, Wednesdays and
Fridays starting next week’.

22 | Life after gestational diabetes

Setting yourself up for success
Once you have decided on your goals, planning ahead can help you
achieve them. Make a list of what you need to do to get started, for
example:
» Making sure you have the right footwear
» Checking your calendar for what is happening next week
» Making sure your alarm is set to wake up
» Putting it in your electronic diary or calendar as an appointment
» Getting your walking clothes out and ready to put on
» Having the dog lead somewhere handy.

Barriers
Often things can get in the way of you achieving your goals. Thinking
about these things in advance means you are more likely to avoid or
overcome them. These may include things such as the weather, work or
family schedules or poor sleep patterns.

Life after gestational diabetes | 23

Checking your progress
Checking your progress from time to time can help you stay on track.
Depending on your goal you could do this by keeping a food or exercise
diary or a physical activity tracker.

If you haven’t achieved your goals, don’t be discouraged. Review any

goals you are finding difficult and think about what you can do differently.
Sometimes you may need to change something about your goals to help
keep you on track. For example, arranging to meet a friend for a walk or
joining an exercise class may be an alternative to walking the dog that
still achieves the same results.

Sharing your goals

Sharing your goals with family and friends can help to motivate you,
as they may want to support you to achieve your goals or join you.
Discussing your goals with your health professionals and monitoring
your progress can also help keep you ‘on track’.

Reward yourself
It’s a great idea to reward
yourself when you achieve
your goals. A new outfit,
massage or book can help
motivate you to keep up the
good work.

Goals may be challenging at

first, but with time and effort,
your health goals can become
part of your everyday life.

24 | Life after gestational diabetes

Planning for another pregnancy

Before your next baby

If you are planning for another pregnancy, it’s important to:

1. See your GP for a diabetes check

If you are planning for another pregnancy it’s recommended that you
see your GP to discuss pre-pregnancy planning and care. Remind them
that you have had gestational diabetes. This should include a check for
type 2 diabetes (usually an oral glucose tolerance test) before trying for
another baby.

2. Eat well, be active and aim for a healthy weight

A healthy lifestyle and aiming for a healthy weight before trying for
another baby can help reduce the risk of getting gestational diabetes in
another pregnancy.

3. Get tested for gestational diabetes early in pregnancy

If you have had gestational diabetes you are at risk of getting it again in
another pregnancy. It’s recommended that you get tested for gestational
diabetes earlier in all future pregnancies. Ask your health professionals
for advice on early testing.

Life after gestational diabetes | 25

What if I develop diabetes before
my next pregnancy?

If you are diagnosed with pre-diabetes or type 2 diabetes, it’s

important to plan and prepare for pregnancy before you start trying
for another baby.

Pre-diabetes
If you have been diagnosed with pre-diabetes, you should see your
doctor before you start trying for another baby. Your doctor is likely
to recommend an oral glucose tolerance test (OGTT) before your next
pregnancy to check that your pre-diabetes hasn’t progressed to type 2
diabetes. Your doctor will decide whether or not you need to have this
done depending on how long it has been since your last OGTT.

Women with pre-diabetes

will usually be referred to
specialist services early in their
pregnancy and monitored closely
throughout pregnancy. You may
be advised to start management
for gestational diabetes straight
away without another OGTT until
after that pregnancy. Or you may
be advised to have an OGTT
early in your pregnancy (usually
before 16 weeks).

26 | Life after gestational diabetes

Type 2 diabetes
Women with known diabetes before pregnancy can have a healthy baby,
but there are extra risks during pregnancy, including an increased risk of
birth defects and miscarriage. The risks are higher when blood glucose
levels before and during early pregnancy have not been within the target
range. There is also an increased risk of other complications during
pregnancy, such as developing high blood pressure and pre-eclampsia,
as well as having a large baby. Careful planning and support from a team
of health professionals will help reduce these risks. It’s recommended to
have a review of your diabetes and general health at least 3-6 months
before you start trying for a baby.

The following checklist can help women with type 2 diabetes plan for
pregnancy:

Use contraception until you are ready to start trying for a baby (ask your
doctor which contraception is the most reliable and suitable for you)

Talk to your doctor for general pregnancy planning advice and referral
before pregnancy to specialist services for diabetes in pregnancy

Make an appointment with health professionals who specialise in

pregnancy and diabetes

Aim to keep blood glucose levels in the target range and an HbA1c
(average blood glucose levels) of 6.5% (48mmol/mol) or less

Review your diabetes management with your diabetes health

professionals

Have all of your medications checked to see if they are safe to take
during pregnancy

Start taking a high-dose (2.5mg–5mg) folic acid supplement each day

Have a full diabetes complications screening and your blood pressure

checked

Aim to have your weight as close as possible to the healthy weight

range before you fall pregnant.

Use this checklist as a guide to discuss with your health professionals.

For more information go to: ndss.com.au

Life after gestational diabetes | 27

Looking after your health into the future

When you registered on the NDSS with gestational diabetes you were
automatically included on the National Gestational Diabetes Register.
The Register aims to help women with gestational diabetes manage their
health during pregnancy and into the future. As part of the Register,
both you and your doctor will be sent ongoing reminders about regular
type 2 diabetes checks.

If you need more information or support after gestational diabetes,

talk to your local health professionals. They can recommend services
available in your area. Many state health departments also offer healthy
lifestyle coaching services — ask your GP for more information.
You can also call the NDSS Helpline on 1800 637 700 to talk to a
diabetes health professional for advice about reducing your risk of
future type 2 diabetes.

Baby Steps
Reduce your risk of developing type 2 diabetes
with the Baby Steps program. The Baby Steps
web-based program includes short videos,
learning sessions and interactive activities on
health, food choices and physical activity to work
through on your computer, tablet or smartphone
in your own time and at your own pace.

To join the program, go to ndss.com.au/baby-steps

If you would like more information about the National Gestational

Diabetes Register or to update your details, call the NDSS Helpline
or go to ndss.com.au

28 | Life after gestational diabetes

Acknowledgments:
The Australian Government and Diabetes Australia wish to acknowledge the
valuable contribution and support of the National Diabetes Services Scheme
(NDSS) Diabetes in Pregnancy Expert Reference Group (ERG) who provided
content expertise in the update of this publication. 2019 ERG members
include – Associate Professor Glynis Ross (chair), Associate Professor
Alison Nankervis, Associate Professor Ralph Audehm, Dr Christel Hendrieckx,
Alison Barry, Dr Cindy Porter, Dr Melinda Morrison and Renza Scibilia.

Diabetes Australia is grateful for the assistance of consumers and health

professionals who provided feedback and suggestions during the review
and update of this booklet, as well as the NDSS National Evaluation Team
who facilitated the consumer evaluation process.

The input of the dietitians who provided expertise in the update of the nutrition
content of this booklet is acknowledged and appreciated. Thank you to Julia Zinga,
Effie Houvardas, Minke Hoekstra and members of the National Diabetes Australia
Dietitians group.

For further information regarding this publication, its development

or availability call the NDSS Helpline on 1800 637 700 or email
[email protected]

Life after gestational diabetes | 29

NDSS Helpline 1800 637 700
ndss.com.au