Screen early, screen often, stay healthy!
And other tips for detecting / managing diabetes, including gestational diabetes
A message from Dr. Shannon McDonald, FNHA Deputy Chief Medical Officer
November is National Diabetes Awareness Month, and today, November 14, is World Diabetes Day, so it's a good time to talk about diabetes, which is a group of metabolic disorders where there are high blood sugar levels for a prolonged duration.
This is an important conversation to have, because diabetes continues to disproportionately impact the lives of Indigenous people. In fact, there is a very high chance that you or someone you love is dealing with this disease and doing what they can to manage their blood sugar levels. Health issues can result when blood sugar levels become too high. In diabetes, this happens because either the body is unable to make enough of a hormone called insulin or the insulin it has isn't working properly.
As Dr. Evan Adams, FNHA Chief Medical Officer, shared in a previous message, one of the best things we can do for our health and our family's health is to reduce the added sugar and increase the fiber in our diets. Dr. Adams also shared his personal strategies for making this and other lifestyle changes to prevent diabetes. I encourage you to read or reread his message and incorporate the strategies that would work best for you.
Following is some brief information on the main types of diabetes, with a separate focus on gestational diabetes.
Diabetes: main types and basic definitions
The main forms of diabetes are type 1, type 2, and – the focus of my message today – gestational diabetes.
Type 1 diabetes occurs when your pancreas stops producing insulin. If you have type 1 diabetes, you will need to take insulin, which acts as a "key" to allow sugar in your system to enter cells and provide the needed fuel to function properly.
Type 2 diabetes occurs when your body does not respond properly to the insulin it produces – when the "key" fails to work. Cells are starved for energy, but the sugar in the system cannot get to where it is needed. Treatment includes medication and lifestyle changes to your diet and exercise routine. Type 2 diabetes is most common with 90% of all diabetes worldwide being type 2.
Gestational diabetes may occur during pregnancy, when hormone levels surge and increase the demand for insulin, causing blood glucose to rise. This can cause problems for you and your baby, so getting screened for diabetes during pregnancy is important. If diagnosed, speak to a trusted care provider about controlling blood sugar levels with treatment and a healthy lifestyle to minimize risks. To learn more about healthy eating with gestational diabetes, see HealthLinkBC's Healthy Eating Guidelines for Women with Gestational Diabetes.
Gestational diabetes: some basic information
Because gestational diabetes may not cause obvious symptoms, Diabetes Canada recommends that all women who are not already diagnosed with diabetes be tested for gestational diabetes between the 24th and 28th weeks of pregnancy using the oral glucose tolerance test. We also recommend that women get tested early (preferably before conception or at their first prenatal visit) to check for undiagnosed diabetes. If you have diabetes and become pregnant or want to become pregnant, speak with a health care provider about your treatment plan during pregnancy.
If you have known risk factors, you may want to take the test a little earlier and not wait for the 28th week. Also, if the nearest nursing station is not close to you, let your community health nurse know if it will be a problem for you to do the two-part test, which requires you to return another day (for example if you live in a rural/remote area and do not have regular transportation). He or she may be able to use a one-step test in this case.For more information about diabetic screening when pregnant, ask your community health nurse and also check out this BC Women's Hospital – Diabetes and Pregnancy link.
Women who have had gestational diabetes are more likely than other women to develop type 2 diabetes later on: after 16 years, as many as 40% of women who have had gestational diabetes will develop type 2 diabetes. So, regular and timely screening for type 2 diabetes is essential for women who have had gestational diabetes. This information and much more is available here. You can also read about screening for diabetes in general and facts about diabetes in one of our previous messages.
We will post a comprehensive message on gestational diabetes in the near future. In the meantime, please check out the links we've provided in this message to learn more.
