What is Gestational Diabetes and How to Manage It
Gestational diabetes mellitus (GDM) is diabetes that occurs in pregnancy. Though it may be scary to hear that you’ve been diagnosed with GDM, it is common and very manageable, often with just diet and exercise. Today I’ll talk about what GDM is and how to manage it so that you can have a healthy pregnancy and prevent the development of type 2 diabetes in the future.
Complications
GDM is high blood sugar in pregnancy, often due to hormonal changes. The body needs more insulin in pregnancy, but if the cells don’t respond to the insulin as they are supposed to (insulin resistance), blood sugar levels become elevated. This extra sugar crosses the placenta, giving the baby extra calories and causing him or her to grow too big.
A bigger baby increases the likelihood of an earlier delivery or complications during delivery, as well as possibly raising the baby’s risk for being overweight or developing diabetes later in life. The CDC estimates that every year GDM occurs in 2-10% of pregnancies. About 50% of women who have GDM eventually develop type 2 diabetes.
Risk factors
Being overweight or obese
Sedentary lifestyle
History of gestational diabetes in a prior pregnancy
Family history of diabetes
Polycystic ovary syndrome (PCOS)
Delivering a baby more than 9 lbs in a previous pregnancy
Management
GDM is usually managed by:
Checking blood sugar at home (usually 4 times per day - before breakfast and 1-2 hours after each meal)
Increasing activity level
Modifying diet
Medications are sometimes needed as well if diet and lifestyle changes aren’t able to keep blood sugar levels in the desired range. Oral medications are sometimes an option, but often insulin injections are recommended.
Exercise recommendations
The Physical Activity Guidelines for Americans recommend that pregnant women do at least 150 minutes of moderate-intensity aerobic physical activity each week. It is especially helpful to walk or do something active after eating as this can help bring blood sugar levels down more quickly. If blood sugars are high before breakfast (fasting levels), try walking or another form of exercise after dinner.
Diet recommendations
Carbohydrates
Though many women may think they can’t eat any carbs after being diagnosed with GDM, this is not actually the case. Carbs are important as an energy source for mom and baby; it is recommended to consume at least 175 grams of carb per day during pregnancy. As with type 1 and type 2 diabetes, it’s best to space carbs throughout the day to prevent blood sugar spikes. The body is also more sensitive to carbs earlier in the day, so a lower carb, higher protein breakfast may be necessary.
General guidelines for carb intake are:
15-30 grams carb at breakfast
30-45 grams carb at lunch
30-45 grams carb at dinner
0-30 grams carb per snack (at least two snacks per day)
As with any healthy diet, the best carbs are high fiber options like whole grains, starchy veggies, and small amounts of fruit and dairy; the fiber in the carbs can help stabilize blood sugar and prevent it from spiking too high. It’s best to avoid foods with added sugars, like soda and other sugary drinks, flavored yogurts, and sugary breakfast cereals.
Protein and fat
Eating protein and fat with carbs helps to keep blood sugar levels more stable. Reducing carbs without replacing them with something else can leave you feeling hungry all the time, so it’s best to increase your consumption of protein and healthy fat at meals and snacks to fill you up and prevent blood sugar spikes.
Postpartum
After delivery, it’s important to follow steps to reduce your risk of developing type 2 diabetes in the future. Be sure to read my post about diabetes prevention for more info! If you’ve been diagnosed with GDM and want to meet 1:1 with me for a more individualized plan, then check out my services page or schedule a free call for more info.
