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Gestational Diabetes and Poor Mental Health are Linked. How?

Poor mental health (usually diagnosed as depression) and Gestational Diabetes (GD) are linked, somehow. Studies repeatedly show this association but it’s unclear which comes first, since the mental health assessments for these studies tend to be done at the time the GD is diagnosed i.e. between 24 and 28 weeks’ gestation.


Perhaps they’re both caused by a third common factor.


Worryingly, the depression doesn’t appear to be limited to the 40 weeks of pregnancy either. A study in 2016 in Canada found ongoing depression 11 years later.


Of course, genes may well play a role for some women, making her susceptible to both poorer mental health and GD.


What else might explain the association?


Something physiological maybe? Inflammation, for example, is involved in both depression and diabetes. Inflammation is triggered by, amongst other things, stress, diet and lifestyle.


What else? One study found the association between depression and GD to be higher in those on a low income and from ethnic minorities. With our increasing awareness of health inequalities, we can fairly confidently assume that stress, diet and lifestyle play a major role here too.


How about our gut microbes? It’s highly likely that they are involved. The two-way communication between our gut and our brain is proven but how are our gut microbes involved in diabetes?


It turns out, according to a recent study into Type 2 Diabetes, that it may be down to

having a less diverse range of microbes living in our gut. The mechanism for Type 2 diabetes and Gestational Diabetes is similar and we know that having GD places us at greater risk of Type 2 Diabetes in the future. Perhaps researchers will be asking women with GD for stool samples soon to test the theory!


In order to cultivate a varied range of gut microbes, we need a varied diet with plenty of fruit and vegetables - foods which tend to be relatively expensive and not as freely accessible to those living in lower socio-economic areas. Our gut microbes also flourish in a low stress environment.


All of this, to me, simply adds to the evidence that the health of many women (and men) are victims of the intrinsic socio-economic and political inequalities worldwide.


What if the Gestational Diabetes comes first?


There’s another crucial factor to take into account. Something which none of the studies seem to consider. Could the experience of having GD be damaging to mental health?

I’m referring to the emotional burden they carry. Having worked with many women with GD in UK, I have witnessed the mixture of fear, guilt and confusion that they experience and the massive emphasis placed on their weight as a likely cause of GD and hence a risk to their baby’s health. Imagine how that must feel!


Here’s where we health professionals come in. We may not be able to change the world order, improve a woman’s financial or social situation or change her genes but we can acknowledge her concerns, provide her with evidence-based information and support her in her choices, however limited they may be. We can stop talking about body size and instead see the lifetime of experiences beneath and empower her to manage her GD to the best of her potential with non-judgmental kindness.


For news about upcoming e-courses on gestational diabetes, sign up to my mailing list here. https://mailchi.mp/ea0ae6b25d33/uncgacmhxt


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