Gestational Diabetes
Gestational Diabetes (GDM) is the most common pregnancy complication. It can lead to excess fetal growth, birth complications/trauma, birth defects, and a higher instance of cesarean deliveries. It can also lead to blood sugar instability for the newborn (which comes with it’s own risks), type 2 diabetes and heart disease in the mother.
Gestational Diabetes is also the most studied pregnancy complication. Even with all the knowledge we have, there is still misinformation and a stigma attached to GDM. Gestational Diabetes effects between 5-10% of the pregnant population in the United States.
What is Gestational Diabetes?
The pregnant body does an amazing job of allowing extra glucose in the blood so that baby never runs out. This happens through a metabolic shift and the hormones produced in the placenta (placental growth hormone and human placenta lactogen), which peaks in the second and third trimesters. Because there is more glucose circulating in the blood, the pancreas continues to produce insulin. With GDM, pregnancy creates insulin resistance, allowing there to be too much sugar in the blood.
GDM Testing and Diagnosis
GDM testing is done between the 24th and 28th weeks of pregnancy. A mother will drink a sugary drink that contains 50 grams of sugar and then her blood sugars are tested an hour later. In a lab, the drink is often Glucola, but other options like the Fresh Test are available.
If blood sugars are above 140 mg (although some care providers use different numbers) a three hour test is typically recommended. For the three hour test, you have to fast, drink 100 grams of sugar, and then have your blood tested at the 1 hour, 2 hour, and 3 hour mark.
Pro tip: make sure you pack a high protein snack for after your blood draw(s) because you may feel shaky or nauseous.
If a mother receives a diagnosis of GDM, the first approach is typically to start with diet and lifestyle changes. She’ll be monitoring her blood sugars at home, first thing in the morning and about an hour after each meal. If diet and lifestyle changes do not help her lower the amount of sugar in the blood, medication is used next.
Lifestyle Changes
There are a lot of factors when it comes to how blood sugar is managed in the body. Lack of sleep/changes in sleep, stress and cortisol, movement, and illnesses all effect blood sugars. Aim for 30 minutes of exercise a day. A simple 10 minute walk, squats, or 5 minutes of calf raises after each meal can really make a difference for your blood sugar numbers. Being consistent with movement is very important for stabilizing blood sugar.
Diet Changes
Diet changes can make a real impact on blood sugar regulation. Underrating, meal composition, meal timing, fasting (even overnight), and hydration all play a key role. Yes, we can cut out added sugar like cookies, candy, and treats, but we also need to check ingredients for hidden sugar. Sauces, dressing, packaged foods like oatmeal, cereal, bars, and even our coffee drinks are major culprits for sugar. With a GDM diagnosis, we need to be very mindful of these things that we may be consuming everyday.
So what can we do past cutting sugar? Here is exactly what you need to nourish:
Eat protein with every meal and snack
Spread out carbs throughout the day (the conventional recommendation is to stay under 175 grams per day)
Don’t fast for over ten hours (this usually means adding a high-protein snack before bed)
Start with a protein heavy breakfast (breakfast is wildly important as blood sugars are most unstable after fasting)
Increase fiber and anti-oxidants with every meal (yes, fruit is awesome for GDM when paired with protein)
Consider supplementing magnesium and vitamin D, as deficiencies in these nutrients are common with GDM
Start with protein, add fat and fiber and then add carbs.
Other evidenced based additions:
Probiotics for 4-8 weeks can lower oxidative stress, inflammation, and insulin sensitivity
Ceylon Cinnamon for 8-12 weeks at 1.2 gram/day (1/2 teaspoon) can stabilize blood sugar
Apple Cider Vinegar 1-2 tablespoons before heavy meal can lower blood sugar by 20% - hello starter salad!
Moving Forward
It feels like a lot to manage a GDM diagnosis. But we can look at what and how we are eating every day and make small changes to make a big impact.
Want more practical nutrition info for pregnancy? Check out the guide here.
