While there are well known risk factors for developing diabetes in pregnancy, a recent published study has highlighted a new interesting risk factor - having pre-existing depression, or early antenatal depression. The study (referenced at the end of the article) involving over 127,000 pregnant women revealed that those with a history of depression are 29% more likely to develop GDM compared to those without depression. This highlighted a bidirectional connection between depression and gestational diabetes.

The exact reasons for the connection between depression and gestational diabetes mellitus (GDM) are not fully understood yet, but researchers have identified several potential factors that may contribute to this relationship:

Biological Mechanisms: Depression and GDM share common biological pathways involving inflammation, oxidative stress, and hormonal changes. Chronic stress, often associated with depression, can lead to dysregulation of the body's stress response system, including the hypothalamic-pituitary-adrenal (HPA) axis, which may affect glucose metabolism and insulin sensitivity.

Lifestyle Factors: Individuals with depression may engage in unhealthy behaviours such as poor diet, physical inactivity, and irregular sleep patterns, all of which are known risk factors for GDM. These lifestyle factors can directly influence insulin resistance and glucose levels, increasing the likelihood of developing GDM.

Psychosocial Stress: Depression during pregnancy can lead to increased psychosocial stress, which may further exacerbate physiological responses related to glucose metabolism. Stress hormones such as cortisol, which are elevated during periods of chronic stress, can interfere with insulin function and contribute to insulin resistance.

Medication Use: Some medications used to treat depression, such as certain antidepressants, have been associated with an increased risk of metabolic disturbances, including insulin resistance and weight gain. However, the extent to which medication use contributes to the relationship between depression and GDM remains an area of ongoing research and debate.

Shared Risk Factors: Depression and GDM often coexist with common risk factors such as obesity, sedentary lifestyle, and unhealthy dietary habits. These shared risk factors may contribute independently to the development of both conditions, making it challenging to disentangle their individual effects.

Overall, while researchers have identified potential mechanisms underlying the association between depression and GDM, further studies are needed to fully explore the complex interplay between mental health, physiological processes, and pregnancy outcomes. Understanding these mechanisms is essential for developing effective strategies for the prevention, early detection, and management of both depression and GDM during pregnancy.

It's essential to remember that experiencing depression or developing gestational diabetes is not your fault. Mental health challenges and medical conditions like GDM are complex and multifactorial, influenced by a combination of biological, psychological, and environmental factors. Blaming yourself for these conditions can add unnecessary stress and may hinder your ability to seek help and support.

Instead, it's important to recognise that seeking support and treatment for depression and GDM is a proactive step toward managing your health and well-being during pregnancy. Remember that you are not alone, and there are resources and professionals available to provide support, guidance, and treatment options tailored to your needs and are listed below.

By prioritising self-care, seeking support from healthcare professionals, and accessing available resources, you can navigate these challenges with resilience and compassion for yourself. Remember, you are doing the best you can, and reaching out for help is a courageous and important step toward healing and well-being for both you and your baby.

Perinatal Anxiety & Depression Australia (PANDA)

Helpline: Call 1300 726 306 (Mon to Fri, 9 am - 7.30 pm AEST/AEDT)

Beyond Blue

Helpline: Call 1300 22 4636 (24/7 support)

Gidget Foundation Australia

Helpline: Call 1300 851 758 (Mon to Fri, 9 am - 4 pm AEST)

COPE - Centre of Perinatal Excellence:

Helpline: Call 1300 737 732 (Mon to Fri, 9 am - 7.30 pm AEST)

Parentline

Helpline: Call 1300 30 1300 (24/7 support)

Black Dog Institute

Online resources: https://www.blackdoginstitute.org.au/resources-support

Zhang C, Jing L, Wang J. Does depression increase the risk of gestational diabetes mellitus? A systematic review and meta-analysis. Pak J Med Sci. 2023 Jan-Feb;39(1):285-292. doi: 10.12669/pjms.39.1.6845. PMID: 36694731; PMCID: PMC9843022.