To give some context to this article, it’s important to understand what gestational diabetes is. Gestational diabetes is a type of diabetes that is discovered later in pregnancy close to 24-28 weeks. Gestational means “in pregnancy,” and diabetes means “elevated blood sugar.”

Gestational diabetes may sound scary but it is entirely manageable! GDM is one of the most common complications during pregnancy, affecting up to 18% of pregnancies (Coustan, Donald R et al, 2010). Out of 100 women, about 7 of them will have gestational diabetes.

However, with the right guidance, you can effectively make changes to your diet and have a healthy pregnancy. There are a lot of concerns about diabetes and pregnancy risks. So, read on to learn what causes gestational diabetes and how you can manage your health.

Diabetes and Pregnancy Risk

Diabetes and pregnancy risks often go hand in hand, particularly when blood sugar levels are not well managed. The potential risks to both the mother and baby increase when diabetes is present before or during pregnancy. These risks include:

• Preterm birth: Babies may be delivered earlier than full term if complications arise.
• Excessive birth weight: High blood sugar can cause the baby to grow larger than average. It can lead to potential delivery complications.
• Preeclampsia: This condition is characterized by high blood pressure. It can develop in mothers with gestational diabetes.
• Stillbirth: Poorly controlled diabetes increases the risk of stillbirth. Proper management can significantly reduce this risk.
• Type 2 Diabetes in the Future: Gestational diabetes increases the likelihood of developing type 2 diabetes later in life, for both mother and child.

The good news is that with proper monitoring and a healthy lifestyle, these risks can be minimized for both a healthy pregnancy and delivery.

What Are the Different Types of Diabetes?

When it comes to diabetes and pregnancy risks, it’s essential to differentiate between the types of diabetes:

• Type 1 Diabetes: This is an autoimmune condition where the body does not produce insulin. Individuals with type 1 diabetes need insulin therapy.
• Type 2 Diabetes: This is the most common type, where the body either doesn’t use insulin well or doesn’t make enough. Type 2 diabetes can often be managed through diet, exercise, and medication.
• Gestational Diabetes: This type develops during pregnancy and usually disappears after giving birth. However, it increases the risk of developing type 2 diabetes later in life.

How Common Is Diabetes During Pregnancy?

Gestational diabetes is the most common form of diabetes during pregnancy. Women with a history of type 1 or type 2 diabetes also need to take extra precautions, as pregnancy can make managing blood sugar levels more challenging.

Causes of Gestational Diabetes

So, why does the blood sugar get high enough to cause gestational diabetes? There are five main reasons:

• Your body either doesn’t produce enough insulin or isn’t using it effectively: Insulin is a hormone in the body that helps to lower your rising blood sugars whenever you eat. When insulin isn’t being used by the body properly, it can cause higher-than-normal sugar in the blood. The same goes for women who do not produce enough insulin to counteract rising blood sugar.
• Pregnancy hormones can be the cause: When women become pregnant, their bodies start to make extra hormones to help support the pregnancy and growing baby. This can disrupt the body’s use of insulin. This means regulating sugar in the blood becomes difficult and ultimately, causes a rise in blood sugar levels.
• Having a family history of diabetes: It is suggested that genes play a part in gestational diabetes, especially if diabetes runs in your family history. It doesn’t mean you’re guaranteed to get gestational diabetes, it just means you may inherently have a higher risk of developing it in the future.
• Gaining too much weight or being overweight can cause high blood sugar: One of the reasons your insulin may not be working well is because of excess body fat. Higher body fat can cause a lack of control in rising blood sugar. To manage your weight, discuss lifestyle strategies with your provider and a dietician. They can create a plan that meets your individual needs and will help to control your blood sugar.
• Eating the wrong type of food or too much food: Try to maintain a healthy diet by eating nutritious and non-processed foods. Maintaining a balanced diet and healthy lifestyle during pregnancy is essential to reducing the risk of developing gestational diabetes.

What Are the Symptoms of Diabetes During Pregnancy?

Some of the common signs of gestational diabetes can be:

• Weakness
• Fatigue
• Frequent urination
• Hunger and thirst

These symptoms are sometimes common with pregnancy which can make it difficult to discern the two. A blood test is the only way to know if your blood sugar is higher than it should be. Consult with your healthcare provider about checking your blood sugar.

If it is higher than normal, you and your doctor can discuss a plan to help you keep your blood sugar in a safe range. This not only helps some of the side effects during pregnancy but also improves you and your baby’s health.

Managing Diabetes and Pregnancy

Believe it or not, managing gestational diabetes can be very effective! First and foremost, it’s very necessary to continue scheduling all of your appointments. Aside from your doctor’s help, there are a few things you can do on your own to help manage gestational diabetes:

• Make sure to test your blood sugar at home.
• Maintain your blood sugar within the normal range by choosing the right foods. Properly portion out each meal.
• Avoid excess sugar and sweet foods.
• Make sure to record all meals throughout the day.
• Gain weight slowly.
• Stay active with approval from your medical team.
• Keep a record of baby kicks.
• And lastly, relax!

Stay Active

Incorporating an exercise program is very beneficial. Before deciding to do so, talk to your doctor about what exercises are safe for you. One of the best is walking! Aim to walk at least once a day for a goal of 20 minutes, especially after a meal. This can help to lower your blood sugar.

Make it fun! Walk with a friend or family member, and wear comfortable clothing and footwear. If you notice any pressure or contractions, it may be safer to stop walking and talk to your doctor. Remember to note your baby’s movement before and after exercise and follow your doctor’s advice.

Staying active can help:

• Reduce stress
• Control excessive weight gain
• Lower blood sugar
• Increase cardiovascular strength
• Prepare for labor
• Help you feel more confident and better about yourself!

Manage Your Meals

Here are a few tips to help you manage your blood sugar when preparing your meals:

• Eat a balanced diet and moderate your portion sizes. When it comes to managing diabetes and pregnancy, the types and amounts of carbs you consume are important.
• There are foods to limit and avoid, but it does not mean you have to give them up entirely. Every food group has a purpose. Creating a balance of the foods you need and want to eat is the key! After all, carbs are important for energy and fuel. They are essential not just for you, but also for the baby!
• When choosing the right carbs, think about carbs that are slow digesting. Carbs like brown rice, whole-grain cereals, and bread are the “low, slow carbs” that do not spike blood sugar. In contrast, carbs such as honey, corn sweeteners, cookies, pastries, sugary juices, and sodas cause blood sugar to rise quickly.
• Try to include more foods such as non-starchy vegetables (tomatoes, mixed green salad, broccoli, spinach, carrots, and asparagus), brown rice, nut butter, and low-glycemic fresh fruits like strawberries.
• Try to limit or avoid carbs such as starchy vegetables (corn, peas, plantains, parsnips, etc.), highly processed breakfast cereals, potatoes, noodles, energy drinks, sodas, high glycemic fruits (such as watermelon and pineapple), dried fruits, and sweetened coffee drinks.

Further, the amount of carbs you should consume is dependent on how far along your pregnancy is and up-to-date blood sugar readings.

Portion Control

One of the best ways to keep the proper amount of carbohydrates in your meals is with portion control. This can help keep your blood sugar in ranges that are considered normal. Look to keep it simple and couple your carbs with a lean source of protein.

For example:

15g of carbohydrates in one serving:

• ¼ cup of tuna with 6 wholegrain crackers
• ½ toasted whole grain English muffin with 1 scrambled egg and spinach
• 2 large rice cakes and 1 hard-boiled egg

More foods to include are:

• Lean Proteins: Poultry, pasteurized, hard cheeses, lean meat, and fish
• Low Glycemic Fruits: Peaches, apples, strawberries, plums, and cherries
• 100% Whole Grains: Whole grain bread, tortillas, and pasta
• Legumes: Dried beans, lentils
• Healthy Fats and Oils: Safflower, olive oil, and canola

If you can emphasize any meal, place it on breakfast! In the morning, blood sugars tend to be at a higher level. Eating a small and healthy breakfast within an hour of waking up will be beneficial in combating that spike. Avoid breakfasts like instant cereals, and large quantities of fruit or milk, and look to include non-starchy vegetables, eggs, whole wheat bread, and/or mixed berries.

Don’t Forget To Relax!

Health is an ongoing feat and it is normal to feel a little worried during pregnancy. Learning you are diabetic and pregnant can add to that stress. Support from your family, friends, and most importantly your healthcare team can make a big difference!

Finding ways to lower stress can help you feel better physically and mentally. Talk to your friends and family, listen to music, watch your favorite TV show, read a book, etc. Do something that you enjoy!

Have Questions About Diabetes and Pregnancy? Call Rosh Maternal & Fetal Medicine IN NYC!

Following these steps can help manage diabetes during pregnancy while also promoting healthy habits that may prevent diabetes later in life.

Staying healthy in the long term is the best way to have a healthy pregnancy and continue to stay healthy post-pregnancy. If you have any questions or concerns, call our doctors at Rosh Maternal and Fetal Medicine or book an appointment online. Our OBGYN specialists are here for you!