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Gestational diabetes — which happens in roughly 10 percent of all U.S. pregnancies — is a temporary condition that can develop during pregnancy in women who don’t otherwise have diabetes.
Receiving a diagnosis of Gestational Diabetes can be scary for women, and sometimes women blame themselves for the diagnosis. “One of the most important things we do is provide support and reassurance that we’re here for them throughout the pregnancy. We want women to know they aren’t alone and that this isn’t something they caused. Pregnancy hormones can cause insulin resistance and lead to this diagnosis.” says Erica Hechler, a registered dietitian and certified diabetes educator at AdventHealth.
The good news is that with a nutritious, well-balanced diet and close monitoring, women diagnosed with gestational diabetes can continue to have a healthy and enjoyable pregnancy with few, if any, side effects for mom or baby.
What is Gestational Diabetes?
Gestational diabetes typically develops during a woman’s second or third trimester. The placenta, which supports the baby during pregnancy, secretes estrogen and progesterone. These hormones can cause the body to use insulin less efficiently and lead to insulin resistance.
“Insulin is a hormone that’s released by the pancreas and acts like a lock and key mechanism. Insulin is the key as it allows glucose to enter the cells (the lock), letting circulating glucose that’s in the bloodstream get into the cell,” Hechler says. “If the body isn’t producing enough insulin or the insulin isn’t working efficiently, a woman’s blood glucose can rise above the normal range.”
During pregnancy, insulin requirements increase by about three times, making the need for insulin greater, according to the American Diabetes Association. The problem is further compounded by insulin resistance, which results in elevated levels of glucose in the blood. This is known as “hyperglycemia.” Pregnant women who aren’t treated run the risk during pregnancy of:
- High blood pressure
- Protein in urine
- Swelling in hands, feet and legs
- Urinary tract infections
The extra glucose in a woman’s bloodstream can cause a baby’s developing pancreas to work overtime to produce insulin. Untreated, gestational diabetes can lead to the following risks for the baby:
- Breathing problems
- Diabetes later in life
- High birth weight, increasing the need for cesarean section or causing injury from trying to fit through the birth canal
- Jaundice two to three days after birth
- Low blood sugar at birth
How is Gestational Diabetes Diagnosed?
All women are screened for gestational diabetes between 24 and 32 weeks of pregnancy, but women may be screened earlier in the pregnancy if they have certain risk factors. She’ll be asked to drink a liquid that contains glucose, and then blood will be drawn an hour later to test blood glucose levels. If these levels are out of range when lab results come back, the mom will be referred back to the lab for a longer glucose tolerance test.Blood will be drawn to get a baseline of glucose levels after fasting. Then she’ll drink the glucose solution. Blood will be drawn at one hour, two hour and three-hour intervals.
If two or more values are out of range a woman will be diagnosed with gestational diabetes.
How is Gestational Diabetes Treated?
Women who are diagnosed with gestational diabetes are referred to a registered dietitian at the AdventHealth Diabetes Institute where they will meet with a dietitian to discuss healthy meal planning for pregnancy and glucose control, blood glucose monitoring and managing blood glucose patterns.
“These women can continue to have a healthy pregnancy.” Hechler says. “The way we recommend these women eat is actually the way everyone should eat. We promote a diet with healthy, high-quality carbohydrates, lean proteins, lots of non-starchy vegetables and suggest rounding out the meal with healthy fats.”
To create the meal plans, dietitians look at a woman’s height, weight, weight gained throughout pregnancy, length of pregnancy and activity level. They provide them with a “carbohydrate budget” as well as sample meals and snacks.
Women will also be encouraged to stay active under the guidelines of their care provider. Being active can help women use insulin more efficiently and keep blood glucose more stable.
In most cases, healthy eating and exercising will work well to control blood sugar levels in gestational diabetes. Women will keep a blood glucose log during the day in order to see how they are doing and look for trends if blood glucose is out of range. For those who may need help getting blood glucose down, their provider will prescribe insulin.
“Insulin is very safe and works effectively to reduce blood glucose. It does not cross the placenta and works well at keeping mom and baby’s blood glucose within desired levels,” Hechler said. But for women who are fearful of injecting insulin, some doctors may prescribe oral medication to control blood sugar levels instead.
Here are some of the foods that can be included as part of a healthy diet to stabilize blood glucose during pregnancy:
Healthy Fats (including Omega 3 fats):
- Canola Oil
- Fatty fish
- Mayo, salad dressing
- Nuts and seeds
- Olive Oil
- Legumes (lentils, beans, peas, edamame, hummus)
- Products made of whole wheat
- Sweet potatoes
Lean Proteins (plant or animal):
- Legumes (Lentils, beans, peas, edamame, hummus)
- Nuts and nut spreads
- Soy products
- Green beans
What Happens After My Pregnancy?
Hechler encourages women to be their own best advocates to ensure they repeat their glucose tolerance testing after pregnancy. “There are so many people walking around with diabetes who don’t know it,” Hechler says. “We want to be sure the diabetes has gone away so we encourage follow-up blood glucose testing six to 12 weeks after delivery. Also, women with gestational diabetes have a 50 percent chance of developing Type 2 diabetes in the next five years, so keeping a healthy diet and exercising will help lower the odds,” she says.