Gestational Diabetes " Stacey is 35-years-old she who has multiple risk factors for developing gestational diabetes"

Case study ( 1441 views as of December 15, 2017 )

Stacey is 35-years-old and was sent to see a Registered Dietitian (RD) for some pre-conception counselling to prevent gestational diabetes (GDM). Stacey has an 18-month-old son who weighed 9 lbs and 2 oz at birth. Stacey denies having been diagnosed with gestational diabetes in her first pregnancy. Her doctor suggested she see the registered dietitian because she has multiple risk factors for developing gestational diabetes and has the opportunity to make lifestyle changes which can help prevent GDM.

At Stacey's first visit with the RD she learns about her multiple risk factors for developing GDM including her age (35 years and older), having a baby born weighing 9 lbs or greater, pre-pregnancy obesity (her current BMI is 30.2 because she had a difficult time losing the weight she gained from her first pregnancy) and a strong family history of Type 2 Diabetes as both her mother and father are living with Type 2 Diabetes. There are other risk factors for developing gestational diabetes that don't apply to Stacey including being part of a high risk ethnic group (such as Asian, South Asian, African, Aboriginal and Hispanic descent), having Polycystic Ovary Syndrome, or being treated with steroid medications.

Stacey and the RD discuss lifestyle changes that she can implement now and through her future pregnancy. This may not prevent gestational diabetes as most of her risk factors are not modifiable but Stacey agrees that healthy lifestyle changes are important to implement. Stacey could also benefit from incorporating some regular activity into her lifestyle, and could consult with an exercise specialist to develop an appropriate program to help her before her next pregnancy, and could start prenatal yoga classes. Since losing weight would help lower her risk of developing gestational diabetes, Stacey's lifestyle efforts should be targeted toward assisting her with reducing her body weight before she conceives again.

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Conversation based on: Gestational Diabetes " Stacey is 35-years-old she who has multiple risk factors for developing gestational diabetes"

Gestational Diabetes " Stacey is 35-years-old she who has multiple risk factors for developing gestational diabetes"

  • The case study mentions that most of Stacey's risk factors are not modifiable, but that it's still important to make lifestyle changes in order to support a healthy pregnancy. Proportion of carbohydrate intake will be important to address too, since this is where excess sugar intake stems from. High blood sugar during pregnancy can lead to health complications in the infant, namely obesity and diabetes as well.
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    • @MIchelleKaarto I know a number of women who were diagnosed with gestational diabetes that continued to follow their "diabetic diet" after giving birth to lose the pregnancy weight
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    • @K.Michael - very good point about the importance of making those lifestyle changes to support a healthy pregnancy. Not only can good lifestyle choices around food and activity help Stacey manage her risk of gestational diabetes, they are also beneficial in controlling pregnancy weight gain, preventing back pain in pregnancy, and support an easier delivery and recovery after having the baby.
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    • Making the healthy lifestyle choices to try and minimize her risk of developing gestational diabetes will help her be a healthier person overall
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  • What does the weight of prior babies have to do with the risk of gestational diabetes ?
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    • A high birth weight is common with gestational diabetes, so if Stacey's first child was relatively heavy at birth it's likely that she had gestational diabetes during that pregnancy. As a result, she is at greater risk for developing diabetes again in her future pregnancy.
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  • Does gestational diabetes during a pregnancy always result in gestational diabetes in subsequent pregnancies? Is it possible that Stacey had gestational diabetes during her first pregnancy and it was undiagnosed? Her first baby was fairly large at birth which is a sign of gestational diabetes.
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