Many people who experience pregnancy look forward to the standard glucose screening with some amount of dread, simply due to the unpleasant sugary drink and the necessity of having blood drawn. However, this test is vital for the health of the pregnancy. Some people are shocked to find that even though they are fit and healthy and have no unusual symptoms or history of diabetes, they’ve tested positive for gestational diabetes.

According to the Centers for Disease Control and Prevention (CDC), gestational diabetes affects about 10% of pregnancies in the U.S. every year. The great news is that with proper guidance and timely intervention, the condition is manageable. A dietitian specializing in gestational diabetes can provide significant support in guiding your pregnancy to be the healthiest it can be.

This article provides a detailed understanding of gestational diabetes and offers suggestions and tips for managing blood sugar levels through diet and lifestyle changes.

What Is Gestational Diabetes?

Gestational diabetes (GD), or Gestational Diabetes Mellitus (GDM), is a type of diabetes that develops during pregnancy due to high blood sugar (blood glucose) levels, which can lead to pregnancy complications. Gestational diabetes diagnosis usually takes place in the middle of the pregnancy between 24 and 28 weeks. 

There are two types of gestational diabetes:

1. Class 1 GDM can be managed with a balanced diet and regular exercise.
2. Class 2 GDM may require medication in addition to lifestyle changes.

Even if you did not have diabetes before you got pregnant, you can still develop gestational diabetes. This condition is caused by hormonal changes that occur during pregnancy. Blood sugar levels often return to normal after giving birth; however, gestational diabetes may increase the risk of developing type 2 diabetes in the future.

The American Diabetes Association (ADA) recommends that women without a history of diabetes get tested for gestational diabetes between 24 and 28 weeks of pregnancy. Those who develop GDM should be tested between 4 and 12 weeks after birth and get their blood sugar checked every 1 to 3 years to help prevent diabetes in the future.

Symptoms of GDM can be subtle, including thirst, hunger, frequent urination, fatigue, and nausea. These symptoms can overlap with pregnancy symptoms and may go unnoticed. Additional symptoms may appear in some cases, such as rapid breathing, confusion, and blurred vision.

Causes of Gestational Diabetes

The leading cause of gestational diabetes is hormonal changes occurring during pregnancy, which change the way our body uses food to get energy. Insulin is a hormone that takes sugar ( glucose) from the blood and delivers it to our cells, where it’s converted to energy. If, for any reason, insulin does not function properly or is insufficient, blood sugar levels in the blood rise.

During pregnancy, the placenta produces several hormones that facilitate the baby’s growth and development. However, some of these hormones can also prevent insulin from working effectively, leading to insulin resistance. As a result, the body needs even more insulin to perform the same function. If the body fails to produce this extra insulin, it results in high blood sugar levels.

Risk Factors for Gestational Diabetes

To facilitate early recognition and intervention, it’s essential to understand the risk factors associated with gestational diabetes.  Women who are physically inactive, obese or overweight, have polycystic ovary syndrome (PCOS), or have an increased maternal age are at risk for developing GDM. 

Furthermore, having a history of gestational diabetes, prediabetes (higher-than-normal blood sugar levels), type 2 diabetes, high blood pressure, and heart disease also makes women susceptible to developing gestational diabetes.

Individuals of certain origins are also at a higher risk of developing GDM. These include African Americans, Latin Americans, Asian Americans, Native Americans, and Pacific Islanders.

Risks Associated with Gestational Diabetes

High blood sugar due to gestational diabetes can cause complications for both mother and baby, such as an increased risk of C-section or stillbirth, psychological stress, hypertension (high blood pressure), and heart disease. Additionally, people with gestational diabetes are vulnerable to developing type 2 diabetes in the future.

Infants born to women with gestational diabetes have higher chances of developing childhood obesity, type 2 diabetes, and long-term metabolic disturbances. In some cases, birth trauma and developmental effects in the central nervous system can also occur.

What to Eat With Gestational Diabetes

Maintaining a healthy diet and a moderate weight is one of the best ways to reduce the risk of developing gestational diabetes. Eating a balanced diet consisting of natural, whole, and unprocessed foods can help you achieve this goal. These habits promote the health of the mother and baby by maintaining the blood sugar levels.

Examples of foods to include:

• Non-starchy vegetables such as asparagus, brussels sprouts, alfalfa sprouts, broccoli, cauliflower, celery, carrots, eggplant, peppers, spinach, and mushrooms.
• Lean protein sources such as chicken, eggs, turkey, salmon, tuna, beans, nuts, and tofu.
• High fiber carbohydrate sources like brown rice, quinoa, oats, sweet potatoes, and fruits.
• Milk and yogurt 
• Pro tip: pairing together a protein, non-starchy vegetable, and high fiber carb source at a meal will prevent your glucose levels from spiking and then quickly crashing later.

Examples of foods to limit or avoid:

• Foods containing refined sugars, like cakes, cookies, candy, desserts, sweet pastries, soda, ice cream, fruit juice, and other sweetened beverages. It can be challenging to avoid sugary treats (especially with pregnancy cravings!), but this is key to helping manage your blood sugar levels.
• Simple carbohydrates, such as white bread, white rice, and white pasta.
• Highly processed foods such as fast food
• Pro tip: if eating these foods, keeping your portion size small can make a major difference in maintaining stable blood sugar levels!

Alongside a balanced diet, including regular physical activity, within your doctor’s recommendations for your pregnancy can help manage blood glucose levels.

Continuous Glucose Monitoring During Pregnancy

Gestational diabetes can have adverse effects in both the short-term and long-term. Because the diagnosis is typically made between 24 and 28 weeks of gestation, it’s essential to start managing the condition right away to prevent negative outcomes.

Some glucose monitoring methods, such as fasting glucose and oral glucose tolerance tests, require blood glucose capture at specific times and can be uncomfortable. The fasting test requires the pregnant person to avoid food for several hours, which can be especially challenging during pregnancy. Drinking the sweet glucose solution during the oral glucose tolerance test can cause nausea or vomiting.

Continuous Glucose Monitors (CGM) are a short-term, wearable sensor inserted under the skin that measures blood sugar levels every few minutes. Therefore, it’s a valuable tool for early detection of gestational diabetes and for controlling blood glucose levels within a target range.

While CGMs are not used for monitoring all cases of gestational diabetes, this method is becoming more common and many pregnant women are choosing it to track their health. One of the best perks of a continuous glucose monitor is providing instant data and trends on how your blood sugar levels respond to specific foods, allowing you to adjust your diet accordingly. 

Medical Nutrition Therapy

The American Diabetes Association recommends consulting a registered dietitian for managing gestational diabetes. Medical Nutrition Therapy (MNT) is the primary approach followed by dietitians, which involves education about GD and guidance on lifestyle and dietary changes, along with regular monitoring. Together with a dietitian, you can plan for alternatives ahead of time and make more informed choices. A dietitian specializing in gestational diabetes will help you create an effective and achievable plan for managing gestational diabetes. 

Key aspects of medical nutrition therapy may include:

• Meals that are designed to meet your nutritional needs, taking into account your pre-pregnancy weight, current weight gain, and blood sugar readings.
• A balanced diet plan is essential for providing adequate nutrition to both the mother and the child, as well as for managing gestational diabetes.
• High-fiber and protein-rich foods to help control carbohydrate intake.
• Foods such as non-starchy vegetables, whole-grain carbohydrates, healthy fats, and lean protein can control the post-meal blood sugar spike.
• Avoiding processed foods such as French fries, candy, soda, added sugars, artificial sweeteners, and saturated fats.
• Guidance on how to pay attention to your hunger signals and eat plenty of healthy meals every day.
• Any form of regular physical activity, including walking or swimming, can help control blood sugar and prevent excessive weight gain.

Working with a Gestational Diabetes Dietitian

All of us at Sarah Lynn Nutrition understand that being diagnosed with gestational diabetes can be both mentally and physically taxing. Our goal is to help guide you through a healthy pregnancy journey in a way that is tailored to your specific needs and lifestyle. 

Our registered dietitians are experienced and skilled in providing comprehensive guidance on gestational diabetes, including medical nutrition therapy, meal planning, dietary changes, portion control, and offering support where you need it most. 

We also provide tips on which foods can adversely affect your blood glucose levels and offer healthy alternatives to help you reach your nutritional goals. With proper knowledge and guidance, you can take control of your health and make informed choices. 

Our services are typically covered by most health insurance plans, allowing you to access care without any stress.