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New gestational diabetes mellitus diagnosis guidelines

Did you know that Australia has just updated its guidelines for Gestational Diabetes Mellitus (GDM) diagnosis and management? 🇦🇺
These changes aim to provide even better, more targeted care for women and their babies.
The Australasian Diabetes in Pregnancy Society (ADIPS) released these new recommendations on June 23, 2025, after a decade of research and expert consensus. They “went live” in many services at the beginning of July.

📈 What’s Changed in GDM Diagnosis?

The new ADIPS guidelines introduce slightly higher blood glucose thresholds for diagnosis. This means fewer women at low risk may be diagnosed, allowing healthcare resources to be focused on those who need it most.

New diagnostic criteria (using a 75g 2-hour OGTT):

* Fasting plasma glucose ≥5.3−6.9 mmol/L
* 1-hour plasma glucose ≥10.6 mmol/L
* 2-hour plasma glucose ≥9.0−11.0 mmol/L
These changes aim to strike a better balance, ensuring appropriate care without over-medicalising pregnancies.

 

🤝 Tailored Screening & Collaborative Care

The updated GDM guidelines also emphasise:
* Earlier screening for at-risk women: If you have risk factors (e.g., previous GDM, obesity, family history), your doctor may recommend an HbA1c test in the first trimester.
* Continued routine screening: All women not already diagnosed with diabetes will still undergo a 75g 2-hour OGTT at 24-28 weeks’ gestation.
* A united approach: For the first time, leading Australian experts across various fields have collaborated on these national guidelines, improving consistency and clarity in GDM care.
This means a more individualised and comprehensive approach to managing your pregnancy health.

🎯 Treatment Targets & Ongoing Management

While the diagnostic thresholds have shifted, the treatment targets for managing GDM remain largely consistent to ensure the best outcomes for mum and baby.
General target blood glucose levels for GDM management (as advised by your healthcare team):
* Fasting: <5.3 mmol/L
* 1-hour post-meal: ≤7.4 mmol/L
* 2-hours post-meal: ≤6.7 mmol/L
Remember, the cornerstone management for GDM is healthy eating, regular physical activity, and consistent blood glucose monitoring.

DO YOU NEED MORE HELP?

Our specialist maternal health-GDM dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. Read here to learn more about how we work. If you need support, please make an appointment to help you achieve your goals. 

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Your health after baby: Why your heart and metabolism need love too.

Hello, new mum.

We know that after your beautiful baby arrives, your world shifts entirely to tiny fingers and toes, feeding schedules, and maybe, just maybe, catching a few hours of sleep. It’s completely normal for your own health to take a backseat.

But what if we told you that the time after pregnancy is a super important window for your long-term health, especially for your heart and metabolism?

Think of it this way: pregnancy is a natural “stress test” for your body. It changes so much – your hormones go wild, your blood volume doubles, and your body handles glucose differently. For most, everything bounces back. But for some, pregnancy can gently nudge you towards future health challenges.

What’s the big deal about “cardiometabolic health”?

Simply put, it’s about how well your heart, blood vessels, and your body’s ability to process glucose and fats are doing. During pregnancy, conditions like gestational diabetes mellitus (GDM) (diabetes that develops during pregnancy) and preeclampsia (high blood pressure and protein in the urine during pregnancy) are more than just temporary bumps in the road. They’re like little warning signs from your body:

  • If you had GDM:Your risk of developing Type 2 Diabetes later in life jumps significantly (up to seven times!).
  • If you had preeclampsia:You’re at a higher risk for high blood pressure, heart disease, and even stroke in the future.

Scary? Maybe a little. But here’s the good news: knowing this can empower you to take action.

The postpartum power window: Your golden opportunity

The first few months, and ideally the first year, after giving birth are a crucial time. Your body is generally resetting, and this is your chance to:

  1. Get your baselines checked: Ask your GP to check your blood pressure, blood sugar (fasting glucose), and cholesterol levels. Maybe even how your kidneys are working. These are simple tests that give you a snapshot of your health.
  2. Follow up on pregnancy-related conditions:
    • For GDM mamas: Make sure you get that oral glucose tolerance test (OGTT) around 6-12 weeks postpartum. This checks if your blood glucose has returned to normal. If it hasn’t, your GP (and friendly neighbourhood dietitian and exercise physiologist) can help you with diet and lifestyle changes to prevent Type 2 Diabetes.
    • For Preeclampsia mamas: Keep monitoring your blood pressure and work with your GP to manage any ongoing hypertension.

Why This Matters for You

It’s not just about avoiding future diseases (though that’s a huge benefit!). It’s about having the energy to chase toddlers, enjoy family walks, and be there for your children for years to come. Chronic conditions can drain your energy, pile on healthcare costs, and simply make life harder. By being proactive, you’re investing in your own well-being and your ability to live a full, vibrant life.

Life as a new mum is hectic – we get it!

Sleep deprivation, stress, and finding time for yourself feel like luxuries. But even small steps make a difference. Talk to your healthcare provider about:

  • Nutrition: What simple changes can you make to eat healthier? Do you need extra help with planning or accountability? Please reach out to us.
  • Movement: How can you incorporate gentle exercise into your day, even with a baby? (Think pram walks or online programs. See this video for excellent, evidence-based advice)
  • Mental Health: Don’t hesitate to seek support for stress or postpartum mood changes.
  • Breastfeeding: If you’re able, know that breastfeeding can also offer some metabolic health benefits for you. (Studies have shown that if you had GDM and can breastfeed for at least 9 months this almost acts as a ‘reset’ for your metabolism – it drops your risk of Type 2 Diabetes to that of someone who didn’t have GDM. Amazing!)

The Bottom Line…

Your health matters. A lot. Pregnancy is a wake-up call, highlighting areas where your body might need a little extra TLC. By paying attention to your cardiometabolic health after baby arrives, you’re not just taking care of yourself, you’re ensuring you have the strength, energy, and longevity to enjoy every precious moment with your growing family. You deserve it.

Dietitians are trained to take a key role in assisting women with achieve cardio-metabolic health after pregnancy. Here at Lifestyle Maternity, specialist women’s health dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. We look forward to supporting you on your journey to better health and quality of life. For further information book an appointment with one of our dietitians today.

 

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PODCAST – Eating for Two? Peak Nutrition for Pregnancy

 Recently, our Director and Principal Dietitian, Dr Shelley Wilkinson spoke with Laureate Professor Clare Collins about pregnancy nutrition.

In this podcast Clare and Shelley cover nutritional needs of pregnancy. Topics they discuss include the importance of a nourishing, high quality diet in pregnancy, food safety, weight gain, and recommended supplements. They back up these facts with the nutrition science that sits behind the recommendations and practical solutions to achieve these goals.

Listen here or through your favourite streaming service.

 

Dr Shelley’s featured recipe on No Money, No Time.

 

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Help! I’ve got gestational diabetes and my blood glucose readings are high.

What is gestational diabetes?

Gestational Diabetes Mellitus (GDM) or gestational diabetes (GD) is a type of diabetes that occurs during pregnancy. It is diagnosed following a 2-hour Oral Glucose Tolerance Test (OGTT) at around 24 to 28 weeks of pregnancy.  

Some women whose health, pregnancy or family history put them at a higher risk will also have this test early in their pregnancy.  

The OGTT is a blood test ordered by your GP, obstetrician, or antenatal clinic. This is considered a ‘universal test’, which means all pregnant women should have this test. 

What happens if my blood glucose levels stay too high in pregnancy?

If high blood glucose levels (BGLs) are not treated you and your baby may experience a number of problems.  Women with sub-optimal BGLs are at much higher risk of developing type 2 diabetes mellitus after pregnancy. This risk increases when women are not supported to follow a healthy lifestyle during and after pregnancy. This risk is exacerbated by postpartum weight retention in the longer term.

A woman with GDM can have a baby that has an unhealthy growth pattern before it is born.  Glucose crosses the placenta into your baby’s bloodstream. If your BGLs are high, your baby will receive high amounts of glucose.  A baby’s insulin still works well meaning, even in utero, it is able to store this extra glucose and will grow faster and fatter.

This means the growing baby can be at risk of:

  • being a very large baby
  • being born early
  • being distressed during birth, and/or
  • having low blood glucose levels at birth.

Babies born to mums who have had sub-optimal BGLs are also more likely to be overweight or obese into their adult lives, and have diabetes themselves.

What do I do if I have a high BGL reading?

If you have a high BGL it is important to work out why so you can minimise the chance of it happening again. Ask yourself the following questions to help work out why your level might be high.

Did you eat a larger meal than usual (e.g. eating out)?

Check your serve sizes against the portions list and sample meal plan provided by your dietitian.

Did you eat too much carbohydrate?

Take care with large serves of bread, pasta, noodles and rice – these can increase your BGLs.

Try to choose slow release (low GI) carbohydrate e.g. grain bread in place of white, high fibre cereal rather than low fibre and fresh fruit rather than juice. Make sure you choose ‘slow’ rather than ‘no’ carbs.

Did you wait long enough after eating before your BGL test?

Always wait for a full hour after starting to eat a meal before testing and delay snacks until after you test.

Were your hands clean?

Always wash your hands prior to testing, dirty hands can affect your BGL reading.

Have you been taking your diabetes medication as prescribed?

If you have been prescribed insulin or other medication to manage your gestational diabetes missing this medication will cause a high BGL reading.

Were you active after your meal?

Sitting down immediately after your meal can cause a higher BGL reading than if you do some activity such as a short walk or some housework.  Exercise can help to lower your BGL after a meal.

Do you need more help?

Our specialist maternal health-GDM dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. If you need support, please make an appointment to help you achieve your goals. 

 

 

 

IMAGE CREDIT: Unsplash Rima Kruciene

IMAGE DESCRIPTION: Six people doing yoga on a porch in the one leg up from downward dog pose

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What to eat before and after the gestational diabetes test

What is gestational diabetes?

Gestational Diabetes Mellitus or GDM is a type of diabetes that occurs during pregnancy. It is diagnosed using a 2-hour Oral Glucose Tolerance Test (OGTT) at around 26 to 28 weeks of pregnancy*.

The OGTT is a blood test ordered by your GP, obstetrician, or antenatal clinic. This is a ‘universal test’, which means all pregnant women should have this test.

How do I prepare for my OGTT?

Discuss any medication, both prescription and non-prescription, with your doctor or midwife. You may need to stop medications before the test. The OGTT is a fasting test, so have nothing to eat from 9pm the night before the test. Water is permitted in small amounts. You will need to avoid strenuous exercise and smoking for 8 hours before the test. During the test you will need to sit for the two hours. Even walking around the shops can interfere with the test results.

Does my diet affect the outcome of the test?

Some written information provided to women can be a little misleading or hard to understand.

Some examples of (confusing) advice we have seen include…

“Continue to eat your normal balanced diet making sure you include at least 150 grams per day of carbohydrate for at least 3 days prior to the test. You diet should include cereals, grains, rice,  pasta, fruits, crackers and starchy vegetables such as potatoes, beans and corn”

and

 “..consume at least 10 serves of carbohydrate each day”

We get lots of questions from concerned women that “this seems to recommend a lot of carbohydrate!”. Many ask,

“Is this ON TOP of what I usually eat?”

and

“What happens if I don’t eat this?”

To make sense of this it helps to know how much carbohydrate is in food and how much most Australians eat.

First of all, the ‘minimum of 150g per day’ is easily consumed by most people. Serves of carbohydrate can be quantified in 15g serves and usually equates to a ‘serve’ of food. For example, a slice of bread, half a cup of pasta, a glass of milk, a tub of yoghurt, a medium potato, or an apple, orange or banana each contain about 15g of carbohydrate.

So, by having cereal and milk or toast for breakfast, a sandwich, bread roll or wrap at lunch, and meat with vegies (including a potato, sweet potato, or corn) or a stir fry with some noodles or rice at dinner, plus snacks through the day of fruit and yoghurt, or even plain biscuits, you will easily consume the minimum 150g of carbohydrate per day required.

Some studies have shown that not eating ENOUGH carbohydrate before your test might give a ‘false positive’ result – it might look like you have GDM when you do not (eek!).

To ensure you get the correct result following your OGTT we advise women to continue to eat a healthy balanced diet that includes foods from all the food groups in the days leading up to their test. Use the above examples as a guide to what you might eat throughout the day.

What happens after an OGTT?

If your results are normal you can continue with your usual antenatal care. If your blood glucose levels are raised you have GDM.  It is best practice for you to see an range of specialists including an endocrinologist, diabetes educator and a maternal health specialist dietitian to assist you in the management of GDM.

What changes do I need to make?

A healthy lifestyle incorporating diet and exercise is the starting point to best manage GDM.  Regular meals incorporating slow acting carbohydrates, reducing saturated fats and added sugars/ultra-processed foods and including regular walks and other physical activity will help manage GDM.

A dietitian is the best person to help you build your knowledge, skills and confidence to make these and many more changes to optimise your health with GDM.

Current research shows us that women with GDM who attend regular appointments with a dietitian during their pregnancy have a greater chance of managing their GDM and weight gain. This in turn helps baby to have good outcomes and reduces your risk of developing diabetes in the future.

So, how often should I see the dietitian?

All studies point to the benefits of ongoing contact and support from an expert maternal health dietitian when managing your GDM. Studies testing the effectiveness of GDM nutrition guidelines have shown improved pregnancy outcomes (less need for insulin and better control of blood glucose levels) when women saw a specialist maternal health/GDM dietitian a minimum of three times during their pregnancy + a postnatal review.

Our Director and Principal Dietitian, Dr Shelley Wilkinson, has applied these findings in health services she has worked in and collaborated with and now brings them to Lifestyle Maternity.

Our specialist maternal health-GDM dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. If you need support, please make an appointment to help you achieve your goals. At these appointments a dietitian can assist you to adjust your individual meal plan timing and the content of your diet to optimise your BGLs.

Practical suggestions to help you balance your dietary goals for GDM, manage your weight gain to your individual needs, and develop the healthiest baby possible will be negotiated and matched to your needs.

What does the Lifestyle Maternity GDM service offer?

We would love you to learn to manage your blood glucose levels while still meeting your pregnancy nutrition needs through participating in our innovative gestational diabetes mellitus (GDM) model of care.

 Once you book your GDM package with Lifestyle Maternity you will be sent:

  1. a one-page sheet that summarises your NEED-TO-KNOW dietary modifications. This will help you get your head around and changes you may need to make,
  2. an introductory video to support your first week after diagnosis. It’s a GDM explainer plus more in depth dietary information,
  3. a diary to start keeping a WEEK LONG food and blood glucose record. This will allow your Lifestyle Maternity dietitian to review your progress BEFORE your SECOND appointment with us.

Your individual consult will involve a thorough assessment of your dietary and lifestyle patterns with a personalised action plan being developed in collaboration with the dietitian. This will involve tailoring best practice nutrition guidelines to your personal circumstances and preferences to optimise your health once bub arrives.

The cost of the GDM package (your individual assessment and plan PLUS being sent the starter information sheet, PLUS video link and food and blood glucose diary paperwork, PLUS the review and assessment of this diary by an expert maternity dietitian) is $185. Current Lifestyle Maternity clients will received reduced rates for this appointment ($140).

Each subsequent “review” appointment costs $105. This includes out-of-appointment review of your BGLs and diary prior to each appointment. At your third appointment (your second ‘review’) you will receive a PeNut + Lifestyle Maternity GDM Cookbook (RRP $49). This will help give you extra meal time inspo and includes 30 dietitian-designed, low GI recipes (10 breakfasts, 10 lunch/dinners, and 10 snacks).

 

Don’t have GDM but still need general nutrition help?

We offer individual consultations and self-paced online courses as we know you all have different learning styles and budgets. Attending an individual session OR online course with a Lifestyle Maternity dietitian will allow you to assess your diet against recommended guidelines and identify changes that can be tailored to your lifestyle and dietary preferences.

In our self-paced online course you will be encouraged and guided to assess your own health habits against pregnancy recommendations, participate in activities around setting health goals for optimal nutrition and learn how to adapt your routines with confidence to achieve these goals to make them stick. More information here.

An individual consult involves a more thorough assessment of your dietary and lifestyle patterns with a personalised action plan being developed in collaboration with the dietitian. If you would like further information book an appointment  now.

* People from the groups below are those who would be considered at higher risk of GDM and should be tested for GDM in EARLY PREGNANCY.

  • Previous hyperglycaemia in pregnancy
  • Previously elevated blood glucose level
  • Maternal age ≥40 years
  • Ethnicity: Asian, Indian subcontinent, Aboriginal and Torres Strait Islander, Pacific Islander, Maori, Middle Eastern, non-white African
  • Family history of diabetes mellitus (first degree relative with diabetes or a sister with gestational diabetes mellitus)
  • Pre-pregnancy body mass index >30 kg/m2
  • Previous macrosomia (baby with birth weight >4500 g or >90th centile)
  • Polycystic ovary syndrome
  • Medications: corticosteroids, antipsychotics

IMAGE CREDIT: Richard Jaimes/Unsplash

IMAGE DESCRIPTION: Pregnancy woman with young boy kissing her pregnant belly and looking at the camera

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Making sense of gestational diabetes – diagnosis and diet

What is gestational diabetes? 

Gestational Diabetes Mellitus (GDM) or gestational diabetes (GD) is a type of diabetes that occurs during pregnancy. It is diagnosed following a 2-hour Oral Glucose Tolerance Test (OGTT) at around 24 to 28 weeks of pregnancy.  

Some women whose health, pregnancy or family history put them at a higher risk will also have this test early in their pregnancy.  

The OGTT is a blood test ordered by your GP, obstetrician, or antenatal clinic. This is considered a ‘universal test’, which means all pregnant women should have this test. 

Why do some women get GDM? 

GDM occurs as a result of changes in hormone levels as pregnancy progresses. These changes  can interfere with how some women’s insulin works. Insulin usually helps process glucose from the blood into the muscles (for energy) and liver (for storage and energy).  

What happens if my blood glucose levels stay too high in late pregnancy? 

If high blood glucose levels (BGLs) are not treated, a number of problems can be seen in a pregnant woman or her baby.   

Women with poorly-controlled BGLs are at much higher risk of developing type 2 diabetes mellitus after pregnancy. This risk increases when women are not supported to follow a healthy lifestyle or to healthily lose their pregnancy weight.  

A woman with GDM can have a baby that has an unhealthy growth pattern before it is born.  A baby’s insulin still works well so, even in utero (in the womb), it is able to store extra glucose and will grow faster and fatter. This means the growing baby can be at risk of: 

  • being a very large baby,  
  • having early delivery, 
  • being distressed during birth, and/or
  • having low blood glucose levels at birth.  

Babies born to mums whose BGLs have been higher than ideal, without good support for BGL management, are also more likely to be overweight or obese into their adult lives and have diabetes themselves.   

So, do I have to cut all sugar out of my diet to control my blood glucose levels? 

No. Although some foods we eat (carbohydrates) put glucose into our blood stream, cutting these foods out completely means we cut out all the nutritious goodness we need for a healthy pregnancy and a growing and developing baby. We also need carbohydrates to run our body – without them it is like a car running out of fuel. 

GDM is primarily managed by following a healthy well-balanced eating plan, taking into consideration carbohydrate intake and physical activity. If women’s BGLs are unable to be managed with diet and activity alone, medication such as insulin (injections) or metformin (tablets) are sometimes needed.   

Ongoing, regular contact with Diabetes Educators, Dietitians, and medical specialists during pregnancy is important for good BGLs and best outcomes for mother and baby.  

How many visits should I have with a dietitian? 

All studies point to the benefits of ongoing contact and support from an expert maternal health dietitian when managing your GDM. Studies testing the effectiveness of GDM nutrition guidelines have shown improved pregnancy outcomes (less need for insulin and better control of blood glucose levels) when women saw a specialist maternal health/GDM dietitian a minimum of three times during their pregnancy and a postnatal review.  

Our Director and Principal Dietitian, Dr Shelley Wilkinson, has applied these findings in health services she has worked in and collaborated with and now brings them to Lifestyle Maternity. Our specialist maternal health-GDM dietitians are able to tailor a program to support you to adapt guideline recommendations to your lifestyle and preferences. If you need support, please make an appointment to help you achieve your goals. 

 

IMAGE CREDIT: Unsplash, Paul Lin 

IMAGE DESCRIPTION: Pregnant woman standing outside, side on, looking down at an orange gerbera  

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