From 12 to 18 July, Australians living with diabetes, alongside their carers, researchers, health professionals and clinicians, did something powerful. They said, out loud and without apology, the one thing they have always wished people knew. Under the theme Stronger Together, the Living Out Loud campaign gave 2 million Australians a platform that was entirely their own.  

What made the wall of voices so powerful was not just the number of declarations, but the breadth of who was speaking and who was listening. People living with diabetes used their wishes to speak directly to the community around them, including to friends and family who have never fully understood the daily load, to health professionals who see the clinical picture, to researchers, to the medical industry, to pharmaceutical companies and to the government. These were not just personal statements. They were acts of advocacy, calling for better access, fairer funding, less stigma, and more understanding from the very people with the power to act on them.

What made it even more remarkable was that the conversation ran both ways. Health professionals, clinicians, researchers, and allied health workers stepped up alongside those living with the condition, adding their own wishes to the wall. When organisations beyond the diabetes community, including the neuroendocrine cancer community, spoke up about the unexpected link between their condition and a diabetes diagnosis, it reinforced something this campaign has always believed: diabetes rarely comes alone, and every voice that surrounds it matters.

Together, these declarations did not just raise awareness. They mapped the full, complex, and interconnected reality of living with diabetes in Australia, and sent a clear message to every decision maker who encountered them that this community is organised, informed, and ready for change. Here is a look back at what we achieved together.

600+ wishes and counting

This National Diabetes Week, over 600 Australians completed the sentence “I wish people knew鈥�” and added their voice to the wall.

From people newly diagnosed to those who have lived with diabetes for decades. From carers and parents to researchers and clinicians. From type 1 to type 2 to gestational diabetes and beyond, every type had a voice, and every voice had a place. Here is a selection of the wishes we received:

There is still time to add your voice

The conversation does not stop here. We are still collecting wishes to showcase at the International Diabetes Federation Western Pacific Region (IDF-WPR) Congress in Melbourne, and we want to take as many Australian voices with us as possible.

If you have not yet shared your wish, it is not too late. Complete the sentence “I wish people knew鈥�” and submit it through our online form or share it on social media using #DiabetesOutLoud. Selected wishes will be featured as part of Australia’s presence at the IDF-WPR Congress. Add your wish.

The campaign that reached Australia

Living Out Loud was not just a digital campaign. It reached Australians in their cities, on their drive to work and through their radios.

Out of home

In the media

The campaign made international, national, state and local news throughout the week, with Australians living with diabetes sharing their stories across television, print, digital, and radio, reaching nearly 4 million Australians.

The week was previewed with a story that ran nationally on Win regional TV news with an interview with Perth Diabetes Centre’s Tayla Dyson, who lives with type 1 diabetes, and 芒果直播’s Group CEO Justine Cain.

It was followed on Saturday, 11 July, with an opinion editorial by聽Ms Cain聽in the Weekend Australian Magazine, which also features in the Qantas Magazine.聽Ms Cain聽told readers: 鈥淚 wish people knew that diabetes is a very serious chronic condition that can develop for many different reasons, and that the individuals who live with it are inspiring and resilient.鈥澛�

Lara McSpadden, WNBL champion, Blue Circle Collective Ambassador and type 1 diabetes advocate, headlined the national media launch, describing what it means to represent Australia with diabetes. Ms Cain and the director of Endocrinology and Diabetes at the Melbourne Children’s Hospital, Professor Fergus Cameron, were also interviewed. Lara’s story was broadcast by 9News and 10 News across the nation on afternoon and 6pm news bulletins, reaching thousands of Australians with a message that diabetes never has to be a barrier to success. Lara and Ms Cain were also featured in the Herald Sun.

Monday, 13 July, kicked off from 5am with FM and AM radio news stories across every state and territory on capital city stations and throughout the regions. Throughout the week, 芒果直播’s Ms Cain, Nicole McMahon, Hannah Jackson, Minke Hoekstra and Deanne Minniecon were interviewed for program chats on commercial and ABC stations including Adelaide’s FiveAA, Bathurst, Canberra, Wollongong Wave FM, Sydney, Newcastle, Darwin, Alice Springs, Perth’s 6PR, and West Gippsland. Deanne’s Saturday morning chat on SRN regional radio network was broadcast by 47 stations around Australia.

A member of 芒果直播鈥檚 Health Professional Advisory Council, Dr Konrad Kangru, spoke with ABC regional presenter Susan-Graham-Ryan and later in the week with ABC Tropical North’s Rob Kidd about the importance of recognising even mild symptoms, getting regular health checks, and the possible complications that can develop with diabetes.  

online explored the hidden health challenges Australia’s top athletes manage behind the scenes, shining a light on everyday realities that elite performers navigate alongside their diabetes, including Blue Circle Ambassadors Lara McSpadden and Lachie Kennedy.

In Western Australia, Lucy Woods spoke openly about breaking the stigma of diabetes through social media. Her story featured in as part of a state-based exclusive that put real lived experience at the centre of the conversation.

told the extraordinary story of James Griffiths, a proud Wangaaypuwan man and Blue Circle Collective Community Advocate from Sale, who lost his sight, his kidneys, and the career he was building to type 2 diabetes, before finding a new purpose in archery and setting his sights on the Paralympic Games.  James鈥檚 story resonated with editors around Australia and was published online in the Herald Sun (Melbourne), the Daily Telegraph (Sydney), the Adelaide Advertiser, the Courier Mail (Brisbane), and NT News (Darwin), as well as other regional newspapers. You can read more about James鈥檚 story below.

Ken Johnson and Minke Hoekstra told Hobart’s Mercury newspaper about Ken’s determination to live a healthy life after his type 2 diagnosis and efforts to achieve remission. Ken’s story, “How a type 2 diabetes diagnosis set this 77yo on the path to a marathon” was republished in Melbourne’s Herald Sun, Sydney’s Daily Telegraph, and the Cairns Post.  

The Adelaide Advertiser featured Lara Wilson, a young woman living with type 1 diabetes who channelled her knowledge gained through living with a chronic condition to help children and parents at the Adelaide Women’s and Children’s Hospital school, going on to win the National Trainee of the Year Award in 2024. Now studying to be a teacher, Lara’s message was: “I wish people knew how many extra decisions I make every day because of my diabetes.” Lara coaches tennis and volunteers several times a week at the Flinders Park Tennis Club.

Channel 7’s national health editor interviewed Shalisse Thompson and revealed to a national and international audience for the first time that Shalisse’s Dad, , died eight years ago, aged 40, from diabetic ketoacidosis, caused by dangerously high glucose levels. Lance was diagnosed in his late 20s, and was a respected and popular professional rugby league player for the St George Dragons and later Cronulla.  Shalisse’s wish was simple and devastating: “I wish people knew diabetes can be life threatening.” Her story reached audiences on 7News Australia (online), , the West Australian, and the Daily Mail UK.

Online

Socials were buzzing throughout the week with over 450 people using #DiabetesOutLoud or #NDW2026 on Instagram, Facebook and X. We also saw a further 200+ wishes submitted through the online form, which continues to receive submissions leading into IDF-WPR Congress.

Beyond individual voices, the campaign inspired collective action. There were over 150 downloads of the campaign toolkit assets, showing strong uptake of the resources across the community. Diabetes Credentialled Educators, health practitioners and their clinics built their own physical wall of wishes, inviting patients to write and pin their declarations for all to see. A big shout out to the PDC Health Hub for their standout contribution over the week. 

Last week’s standout wish

Among hundreds of powerful declarations, this one stopped us in our tracks:

James Griffiths, a proud Wangaaypuwan man, Blue Circle Collective Community Advocate and aspiring Paralympic archer, knows better than most what diabetes can take from a person. Diagnosed with type 2 diabetes at just 19, he lost his sight, his kidneys, and the career he was building, all because of a condition he was never warned about. After surviving kidney failure and undergoing a kidney-pancreas transplant, James rebuilt his life with extraordinary determination, finding a new purpose in archery and community advocacy. He has been involved with the Sale to Sea Disability Kayak Challenge, served on advisory boards, and chaired the Wellington Access and Inclusion Advisory Group. Today, he continues to pursue his archery ambitions while using his lived experience to drive change in his community. His wish carries the full weight of a life transformed by diabetes and a determination to ensure the disease does not define his future, or the futures of others.

What the wishes told us

The declarations we received covered every corner of the diabetes experience. They spoke to the daily reality of managing a condition that never switches off, challenged the stigma that too often follows a type 2 diagnosis, celebrated what is possible in sport, leadership, and life with diabetes, and called for better access, improved technology, and more understanding.

Together, they painted a picture of a community that is resilient, determined, and ready to be heard. Not statistics; these were many distinct, powerful, and individual voices.

The next step: Join the Blue Circle Collective

If speaking up felt like the beginning of something, the Blue Circle Collective is your next step.

Our community of Ambassadors, Advocates, and Advisers uses lived experience to influence policy, shape research, and drive real change for the diabetes community across Australia. We are recruiting Advocates now, looking for people who are ready to turn one declaration into lasting advocacy. Express your interest.

Thank you

To everyone who shared a wish, posted a tile, tagged #DiabetesOutLoud, shared the campaign with someone they love, or simply listened; thank you.

To our Blue Circle Collective Ambassadors Lachlan Kennedy, Lara McSpadden, and Warren Bingham, who led the way with courage and generosity; thank you.

A big thank you to the talented photographers Nick James Fraser, Yvette Scott, and 漏 David Kelly/Copyright Agency, 2026.   

To the 2 million Australians living with diabetes every day, this campaign was always for you. We hope last week felt like what it was: a moment where Australia stopped, listened, and heard you.

The voices do not stop here.

#DiabetesOutLoud #NDW2026

Australia’s peak diabetes organisations have welcomed new recommendations from the Australasian Diabetes in Pregnancy Society (ADIPS) that update the way gestational diabetes mellitus (GDM) is diagnosed, saying the changes will help better target care to the women who need it most.

The updated guidelines, published today in the Medical Journal of Australia, recommend higher blood glucose thresholds for diagnosing GDM and introduce more tailored screening for women with known risk factors early in pregnancy. said these evidence-based changes aim to ensure women and their babies receive appropriate care without over-medicalising pregnancies where the risk of complications is low.

芒果直播, the and the joins with ADIPS in supporting the changes, as have other peak health bodies, reflecting broad consensus across diabetes management.聽

For the first time, Australia’s leading experts in GDM including general practitioners, obstetricians, midwives, diabetes clinicians and pathologists, have united behind a national approach to improve the consistency and clarity of GDM diagnosis. This collaboration marks a significant milestone in maternal health and diabetes care.

More than 280,000 women give birth in Australia each year, and GDM affects nearly one in five pregnancies. Appropriate diagnosis and treatment are critical in reducing the risk of complications during pregnancy and birth, and in helping women avoid long-term health issues such as type 2 diabetes.

It’s critically important that every woman who develops GDM is identified and supported with the care she needs. These updated guidelines will facilitate that goal by focusing healthcare resources where they can make the biggest difference on women and babies most at risk.

The recommendations follow a decade of evolving research and reflect the lived experience of women who have had GDM, alongside the clinical insights of the country鈥檚 leading diabetes and maternity care professionals.

Implementation of the new recommendations will be rolled out across hospitals and primary care settings over the coming months.

芒果直播 has joined forces with the peak society for diabetes in pregnancy to forge a stronger alliance to address the diabetes epidemic.

The Australasian Diabetes in Pregnancy Society (ADIPS) has become an Associate Member of 芒果直播 in a move that will strengthen support and advocacy for pregnant women with diabetes.

ADIPS is committed to advancing clinical and scientific knowledge of diabetes in pregnancy and its effect on the child, mother, and wider family. Associate membership of 芒果直播 will significantly contribute to that work.

芒果直播 Group CEO Justine Cain said the partnership will deliver better outcomes for women with diabetes and further demonstrates 芒果直播鈥檚 commitment to provide leadership and support for the diabetes community. 

鈥溍⒐辈� is steadfast in our commitment to leading and implementing strategies that affect change which improve the lives of people living with, and at risk of, diabetes,鈥� Ms Cain said.

鈥淕estational diabetes (GDM) is the fastest growing type of diabetes in Australia, making pregnant women a significant focus of prevention and care work.

鈥淢others have a higher risk of developing type 2 diabetes later in life after experiencing GDM in their pregnancy, and the risk is also higher for the children of those pregnancies.

鈥淏y unifying our efforts with ADIPS, we are creating a stronger voice for pregnant women with diabetes and increasing our ability to support them,鈥� Ms Cain said.

The number of women diagnosed with GDM annually has more than doubled over the past decade. In the 12 months to June 2023, more than 44,700 women were diagnosed with GDM.

ADIPS President Professor David Simmons said a stronger partnership with 芒果直播 would further strengthen Australian and New Zealand international leadership in clinical practice, research and advocacy for women with diabetes in pregnancy, their families and care providers.

鈥淎DIPS is passionate about helping ensure that pregnancies complicated by diabetes are safe and happy.  We know how much work this can be for those with diabetes and their partners and are always striving to find ways to improve the experience while reducing the complications,鈥� Professor Simmons said.

鈥淎DIPS is delighted to work closely with 芒果直播, as the leading consumer diabetes organisation in Australia, allowing us to collaborate with our expertise in diabetes in pregnancy, to the wider mission of supporting those with diabetes throughout the life course.鈥�

A first-of-its-kind international study led by Western Sydney University has shown that treatment of gestational diabetes from early pregnancy adds additional protection for babies and mothers from pregnancy complications.

Published in the prestigious New England Journal of Medicine, the new research explored whether treatment of gestational diabetes before 20 weeks鈥� gestation among those already at high risk improves maternal and infant health, finding a reduction in complications.

Through a randomised controlled trial performed at 17 hospitals in Australia, Austria, Sweden and India, the study screened over 43,000 women to recruit 802 women with a diabetes risk factor before 20 weeks鈥� gestation, who had gestational diabetes by the World Health Organization definition.

Lead author Distinguished Professor David Simmons from the University鈥檚 School of Medicine and Translational Health Research Institute said the study provides new evidence for those deemed at higher risk for early testing and treatment of gestational diabetes beyond the current recommended approach of intervening at 24-28 weeks.

鈥淭esting for gestational diabetes is offered routinely later in pregnancy and those at higher risk are also tested early on to exclude undiagnosed type 2 diabetes. If these early glucose values are increased, but below those diagnostic of type 2 diabetes, we feel we should treat but data has been lacking to demonstrate the effects of such treatment on the mother or baby; we have now filled this major knowledge gap likely affecting millions of pregnancies every year,鈥� said Distinguished Professor Simmons.

The study assessed pregnancy outcomes with the initiation of treatment for gestational diabetes before 20 weeks鈥�, compared with no early treatment and subsequent initiation of treatment depending on results of repeat oral glucose tolerance testing (OGTT) at 24-28 weeks鈥� gestation, with significant and unexpected findings relating to respiratory distress in babies.

The First Nations Health Unit delivers programs that are specifically focused on supporting Aboriginal and Torres Strait Islander people and those who are part of the Indigenous Health Workforce. If you鈥檙e reading this article, it is highly likely that you are a member of this Indigenous Health Workforce. Our full suite of offerings is on our website at the link at the end of this article, but right now we鈥檇 like to provide a focus on one program that you and your work colleagues may be interested in. This is the Understanding Diabetes for Aboriginal and Torres Strait Islander Health Workers and Practitioners program.

As the name implies, the program is focused on Health Workers and Practitioners, but all who work with Aboriginal and Torres Strait Islander clients and community are welcome to participate. The program provides foundational information and uses the Feltman and Feltmum education tool which is made by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and Diabetes Victoria.

The program covers the usual topics you might expect in a session such as this and these include:

• what is diabetes;
• the difference between type 1, type 2 and gestational diabetes;
• symptoms;
• complications;
• preventing complications and diabetes management strategies.

In this program though, the topic of diabetes is presented from an Indigenous point of view. The program starts off by examining health before colonisation, then examines the health impacts that arose out of colonisation and concludes with examining the importance of social and emotional health and wellbeing, not merely examining diabetes from only a biomedical point of view.

As we have learnt to pivot and adapt to COVID restrictions over the past two years, we have become quite adept at our skills in online delivery. While our preference is always to deliver programs such as this face-to-face, we understand this is not always possible. We also understand that given the schedules and workloads of the Indigenous Health Workforce, it is not always possible to schedule every possible professional development opportunity into your already busy schedules.

Thus, we have developed this program so that it can be delivered face-to-face or online in a one-to-two-hour period (depending on the amount of conversation generated). While we have a rolling monthly schedule of online deliveries already incorporated into our calendar, the online nature of the program means that we can respond to you and your team at your convenience. Whether its two of you or twenty of you, we can work with you to deliver the program. If that sounds like something that would benefit you and your colleagues, please do not hesitate to contact us via email at firstnationshealth@diabetesqld.org.au.

https://www.diabetesqld.org.au/about-diabetes/first-nations-health-unit/training-for-health-workers/

Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. It affects around 15% of pregnancies in Australia. Due to the significant number of women diagnosed and the possible health impact it can have for both mum and baby, GDM is routinely screened between 24-28 weeks during the pregnancy with an Oral Glucose Tolerance Test (OGTT). This may be completed earlier if there are known

During pregnancy, hormones produced by the placenta can reduce the action of insulin.

Insulin is a hormone

Insulin is the hormone needed to move glucose from the bloodstream into the cells in the body to be used for energy after eating food containing carbohydrates. With the action of insulin not working as well, the pancreas has to work harder and may not be able to produce enough insulin. This in turn leads to higher blood glucose levels.

Once diagnosed with GDM, a mother will need to work with her treating team to ensure blood glucose levels stay within a target range. Sometimes this is managed through lifestyle adjustments such as and exercise; however, some women may need some additional help through medication or insulin.

Glucose crosses to the baby

The reason higher blood glucose levels need to be avoided is that the extra glucose in the body can cross via the placenta to the baby and make them grow too big. This can lead to problems before, during and immediately after labour.

Once the baby is delivered the blood glucose levels of the mother usually returns to a normal range, which means they no longer have diabetes. For some woman, however, they may continue to have elevated glucose levels, in which case they now have either or

60% develop type 2 diabetes or pre-diabetes

Importantly, it is now understood that about 60% of woman who had GDM during pregnancy will go on to develop pre-diabetes or type 2 diabetes within 10-20 years. There is also a much higher risk of GDM in future pregnancies.

So after pregnancy, what should a Mum who had GDM know and be aware of?

In the immediate days and weeks after giving birth, life is most likely chaotic as mum and family adjust to their new life with a newborn. Although this can be a stressful period, it is important to ensure the mother remains connected with her health care team and follows some general advice and guidance.

From a food perspective it is important for a new mother to nourish her body with

There is strong evidence of the benefits breastfeeding can have on reducing future type 2 diabetes for both mother and baby. If diagnosed with either pre-diabetes or type 2 diabetes after birth, breastfeeding is also highly effective for helping the mother manage her blood glucose levels.

Here are some general steps for a GDM Mum to follow once her baby is delivered.

1. Ensure regular diabetes checks after birth 鈥� Between 6-12 weeks after delivery, an OGTT is recommended. It is believed 1 in every 5 women post pregnancy will still have higher blood glucose levels. Even if type 2 diabetes is not picked up during the screening it is recommended to repeat this test every 1-3 years depending on the level of risk.
2. Making healthy food choices 鈥� There is no specific diet when preventing or living well with type 2 diabetes. Choose a diet rich in vegetables, wholegrains, and legumes with moderate amounts of fruit, dairy, lean protein sources and healthy fats. Aim to reduce highly processed options and foods high in fat, sugar, energy and salt, which will help reduce insulin resistance and type 2 diabetes risk.
3. Being active every day 鈥� Physical activity helps reduce insulin resistance by making the muscles thirsty for glucose. As a general guide, aiming for 30 minutes of exercise per day will assist in ongoing management of blood glucose levels. Seeking out the support of an Exercise Physiologist can be helpful in the post-partum period.
4. Aiming for a healthy weight 鈥� As a new mum it can be tricky to engage in health-gaining behaviours such as moving more, enjoying healthy food choices and getting sleep when you can etc, which can all result in weight changes. It is important to encourage women to aim as best they can to engage in health-gaining behaviours when and where they can, regardless of weight shifts, as these behaviours may help to reduce the future risk of type 2 diabetes or future GDM pregnancies.

Planning another pregnancy?

• Continue to follow the steps provided above.
• All women need to get tested earlier in the pregnancy, usually before 16 weeks and or when the nausea dies down.
• If you have already been diagnosed with pre-diabetes or type 2 diabetes it is also highly recommended to consider the following:

1. See the Doctor/GP 3-6 months before planning another pregnancy (see booklet page 27 for checklist to assist planning a pregnancy with type 2 diabetes).
2. Once pregnant, be referred to a specialist for close monitoring during the pregnancy.

For more information please refer to the NDSS or call the National Diabetes Services Scheme (NDSS) Helpline on 1800 637 700.

By Linda Uhr, Diabetes NSW & ACT Accredited Practising Dietitian & Diabetes Educator

Cassie shares her personal account with gestational diabetes. After being diagnosed and feeling upset that there would be complications through her pregnancy, Cassie’s journey includes the changes she and her partner made and the outcomes they experienced.

What was your first reaction to being diagnosed with gestational diabetes? How did you feel right away, and did that change at all as your pregnancy went on?

To be honest I was quite angry and upset when first diagnosed. We had already had difficulties through the pregnancy and I was upset to think there would be more. As I adjusted to the changes though, it became much easier and I realised it wasn’t as restrictive as I had first thought! I actually ended up enjoying it, as I was eating lots of fresh fruit and vegetables (which we didn’t before due to cost).

What worked for you to keep your blood glucose levels in your target range? Did you do exercise, or change some of the foods you ate?

I made a lot of changes to my lifestyle and so did my partner. We had to completely overhaul our sleeping routine, our eating routine and I had to add in exercise. We went from sleeping from 2am to 12pm to 11pm to 7 or 8am. We went from eating 1-2 meals a day and snacking on chips/lollies/chocolate to eating 3 very well-balanced meals and snacks! I added in some exercise (10mins of walking on the spot watching YouTube after meals usually, or housework) and tried to drink plenty of water. I did end up on insulin for fasting numbers, however my meal numbers were always within range.

Where did you get your information from about gestational diabetes?

Most of my information came from the internet to be honest. I did get some basic information from my hospital team however I found much more informative studies etc online. I have always been very good at sourcing information so I enjoyed doing it.

Did your doctor or diabetes educator talk to you about medications like tablets or insulin? If you took them, how did you find it? (About 40% of women with GD take medications for it)

I was able to do an information session on insulin once it was prescribed for me. They explained how to inject, how to store etc. I was given plenty of time to try and help my fasting levels with lifestyle changes first. Next time, I would just take the insulin straight away, as it was much less stressful and for all the effort I put in to change my fasting numbers nothing worked. Honestly, injecting insulin was easier than the finger pricks! It was simple and effective.

Did you find any positives to the diagnosis? Like getting more frequent scans or feeling more motivated to take good care of yourself?

I did lose a lot of weight. At 34 weeks I was under my pre-pregnancy weight! I honestly felt a lot better overall. I also learnt a lot about food, how it works in your system, how its processed. I still look at the carb content for everything I pick up in the supermarket. It鈥檚 fascinating stuff! More frequent scans were also wonderful.

What would you say to another woman who鈥檚 just been diagnosed with gestational diabetes?

It’s not your fault. You didn’t cause this. Doing your best to manage your GD will lower any risk to baby. Don鈥檛 stress about scans, they are often very inaccurate. Follow the diet, but don鈥檛 be too strict on yourself. It’s honestly not as awful as it feels to start with.

My biggest tips would be:

• Always balance your carbs with plenty of protein, good fats, and fibre. These help reign in the carbs.
• Get a good sleep and eating routine worked out.
• Drink plenty of water.
• Exercise for 10 mins after each meal.
• Always wash your hands before testing.
• Track EVERYTHING!

Cassie shares her personal聽gestational diabetes journey. After being diagnosed and feeling upset that there would be complications through her pregnancy, Cassie鈥檚 journey includes the changes she and her partner made and the outcomes they experienced.

What was your first reaction to being diagnosed with gestational diabetes? How did you feel right away, and did that change at all as your pregnancy went on?

To be honest I was quite angry and upset when first diagnosed. We had already had difficulties through the pregnancy and I was upset to think there would be more. As I adjusted to the changes though, it became much easier and I realised it wasn鈥檛 as restrictive as I had first thought! I actually ended up enjoying it, as I was eating lots of fresh fruit and vegetables (which we didn鈥檛 before due to cost).

What worked for you to keep your blood glucose levels in your target range? Did you do exercise, or change some of the foods you ate?

I made a lot of changes to my lifestyle and so did my partner. We had to completely overhaul our sleeping routine, our聽eating routine聽and I had to add in聽exercise. We went from sleeping from 2am to 12pm to 11pm to 7 or 8am. We went from eating 1-2 meals a day and snacking on chips/lollies/chocolate to eating 3 very well-balanced meals and snacks! I added in some exercise (10 minutes of walking on the spot after meals usually, or housework) and tried to drink plenty of water. I did end up on insulin for fasting numbers, however my meal numbers were always within range.

Where did you get your information from about gestational diabetes?

Most of my information came from the internet to be honest. I did get some basic information from my hospital team however I found much more informative studies etc online. I have always been very good at sourcing information so I enjoyed doing it.

Did your doctor or diabetes educator talk to you about medications like tablets or insulin? If you took them, how did you find it? (About 40% of women with GD take medications for it)

I was able to do an information session on insulin once it was prescribed for me. They explained how to inject, how to store etc. I was given plenty of time to try and help my fasting levels with lifestyle changes first. Next time, I would just take the insulin straight away, as it was much less stressful and for all the effort I put in to change my fasting numbers nothing worked. Honestly, injecting insulin was easier than the finger pricks! It was simple and effective.

Did you find any positives to the diagnosis? Like getting more frequent scans or feeling more motivated to take good care of yourself?

I did lose a lot of weight. At 34 weeks I was under my pre-pregnancy weight! I honestly felt a lot better overall. I also learnt a lot about food, how it works in your system, how it’s processed. I still look at the carb content for everything I pick up in the supermarket. It鈥檚 fascinating stuff! More frequent scans were also wonderful.

What would you say to another woman who鈥檚 just been diagnosed?

It鈥檚 not your fault. You didn鈥檛 cause this. Doing your best to manage your GD will lower any risk to baby. Don鈥檛 stress about scans, they are often very inaccurate. Follow the diet, but don鈥檛 be too strict on yourself. It鈥檚 honestly not as awful as it feels to start with.

My biggest tips would be:

• Always balance your carbs with plenty of protein, good fats, and fibre. These help reign in the carbs.
• Get a good sleep and eating routine worked out.
• Drink plenty of water.
• Exercise for 10 mins after each meal.
• Always wash your hands before testing.
• Track EVERYTHING!

Women and type 2 diabetes, is there a risk after GDM? Scientists have identified metabolites in the blood that accurately predict whether a woman will develop type 2 diabetes after experiencing gestational diabetes during pregnancy.

This discovery could lead to a test that would help doctors identify patients at greatest risk and help them potentially avert the condition through interventions including diet and exercise.

Michael Wheeler, Senior scientist at Toronto General Hospital Institute said, 鈥淭here is a metabolic dysregulation that occurs in the group of women that will go on to develop type 2 diabetes that is present in the early postpartum period. This suggests there is an underlying problem that exists already and we can detect it.鈥�

The identified metabolic signature can predict with over 85% accuracy if a woman will develop type 2 diabetes, as described in a study published in the journal聽

Gestational diabetes

In America, 1 in 10 women will develop聽gestational diabetes聽during pregnancy. In Australia the figure 1 in 7. This puts these women at higher risk of developing type 2 diabetes.聽 Between 30 to 50% will develop type 2 diabetes within 10 years after delivery.

聽diabetes hampers the body鈥檚 ability to regulate blood glucose levels and can lead to serious聽complications聽including vision loss, neurological problems, as well as heart and kidney disease.

Women with gestational diabetes聽are recommended to have an annual oral glucose tolerance test after delivery, which measures the body鈥檚 ability to remove glucose from the bloodstream. Fewer than half of all women follow through with it.

鈥淚f you鈥檝e got a newborn at home one of the last things you are thinking about or have time for is your own health,鈥� says Wheeler. 鈥淭his is one of the main reasons why we performed this study, to potentially develop a simple blood test reducing the number of hospital visits.鈥�

About the research

Wheeler and Gunderson first uncovered metabolic signatures predictive of type 2 diabetes in their 2016 SWIFT pilot study of 1033 women. All of the women delivered their babies between 2008 and 2011.

The new study builds on this prior research, following the same cohort of women over a longer time period during which more women developed type 2 diabetes.

Baseline blood samples were collected between six and nine weeks after birth and then twice over two years. The women鈥檚 health was followed through their electronic medical records for up to 8 years. During this time, 173 women developed type 2 diabetes and their blood samples were compared to 485 women enrolled in the study, matched for weight, age, race and ethnicity, who had not developed the disease.

鈥淭his study is unique as we are not simply comparing healthy people to people with advanced disease,鈥� says R枚st, who led the statistical data analysis. 鈥淚nstead, we are comparing women who are clinically the same鈥搕hey all had gestational diabetes but are back to living without diabetes after the birth of their child.

鈥淭his is the holy grail of personalized medicine to find molecular differences in seemingly healthy people and predict which ones will develop a disease,鈥� says R枚st.

R枚st said that, unsurprisingly, sugar molecules feature prominently among the identified compounds. But amino-acids and lipid molecules are also present, indicating underlying issues in protein and fat metabolism, respectively. In fact, the predictive power of the test dropped if amino-acids and lipids were excluded, suggesting that processes beyond sugar metabolism may occur very early in the development of the disease. The finding may help explain why complications occur in type 2 diabetes patients even when聽聽is tightly controlled with medications.

What鈥檚 next for women and type 2 diabetes after GDM?

The researchers hope to turn their discovery into a simple blood test that women could take soon after delivery, perhaps during an early visit to the doctor with their baby.

The women from the SWIFT study are being invited back for a 10-year follow-up visit, where they will be tested for type 2 diabetes. 鈥淭he information we glean from this study will bring us even closer to our goal of developing this blood test,鈥� says Gunderson. 鈥淚t will also help us to identify metabolic differences among race and ethnic groups that this test will need to take into account. The test is intended to help obstetricians and primary care providers identify the women with recent gestational diabetes who are most at risk for developing type 2 diabetes and to support them with breastfeeding and other healthful lifestyle habits during the first year postpartum that may reduce their risk.鈥�

Crystal’s story on how she discovered and managed her gestational diabetes.

It was my first pregnancy and due to my age (over 35 years) and high BMI I was booked in to have a glucose test at 15 weeks. Everything was fine at my first test but when I went in for the 28 week test I was 0.1 over. I was so mad because I had been really careful about what I was eating. I was convinced the only reason I was over was because I鈥檇 eaten a grape that morning. I had such bad morning sickness before the test that I just had to eat something, so I ate one grape. And then my result was over.

I was really upset and emotional after I got the result, so much so that when I jumped into my car I accidently drove into a pole! In shock I quickly reversed鈥� and hit another one. I burst into tears and had to phone my husband to drive over from work and get me. I hadn鈥檛 even told him about the diagnosis at this point because it was all such a mess. When we got home I burst into tears again. I was just devastated.

At first I blamed myself and didn鈥檛 want to tell anyone. I felt really embarrassed, upset and emotional. I started going to the health education sessions and was taught how to test and was told I had to monitor my blood four times a day. I was overwhelmed by the amount of information we received. A lot of it seemed alarmist and I came away feeling more scared than supported.

Even a visit to an endocrinologist didn鈥檛 put my mind at rest because he told me to take Metformin but also said the drug could cross the placenta and possibly cause issues with the baby. I came away confused and slightly annoyed that I鈥檇 paid all that money to a specialist but ended up with more questions than answers.

I decided not to take the tablets and to try and manage through exercise and diet. I was 32 weeks by this time.

The health educators actually frightened us quite a bit by saying if we had readings that were over our targets more than three times in a row we had to ring them or come in. At the time I was in a high stress job as an HR Manager, working long hours, five days a week. I couldn鈥檛 just nip out of meetings to test and rush off to the hospital if my readings weren鈥檛 quite right. It was a stressful time because I was so busy at work and so overwhelmed with doctor鈥檚 appointments. I was also told my baby might have to be taken away immediately after birth and that I would need to express colostrum prior to the birth so they could test it. I was really scared by this threat and said to my husband we might never see our baby. I didn鈥檛 feel supported at all, just anxious.

I managed perfectly well with monitoring myself through food and exercise but a month before my due date my waters broke and I had to go into hospital. I was given a steroid for the baby which affected my glucose levels and meant I had to go onto insulin for the last couple of weeks. I was in hospital for a week but when I got home I found I had an infection because my waters had broken, so I went back in again and was told I had to give birth right away. I was induced and he was 3.1kg at birth. So had I gone full term he could have been quite a big baby. Thankfully he wasn鈥檛 taken away from me after the birth and my glucose levels returned to normal straight away. My gorgeous little boy is now a healthy, happy 18-month-old.

My advice to women going through it is to attend all the education sessions so you understand what to eat and drink to keep your glucose levels consistent. Keep a record of what you eat and how it affects your readings. You might be surprised about what foods make your readings high and what doesn鈥檛. You may need to tell your manager at work so they understand that additional appointments are required. Try not to worry too much. You鈥檙e doing a great job.