Gestational diabetes and pregnancy

Every year, up to 10% of pregnancies in the United States are affected by gestational diabetes. A type of diabetes that occurs only during pregnancy, gestational diabetes can have serious health implications, including an increased need for a cesarean section delivery, high blood pressure, depression during and after birth, premature birth, and an increased lifetime rate of diabetes for both mothers and their children.

The good news is that gestational diabetes can be controlled. But first, let’s talk about what gestational diabetes is and risk factors.

During pregnancy, a woman’s body goes through many changes, including producing more hormones and, often, weight gain. In addition, the placenta begins to produce hormones that cause sugar to build up in the blood. If your pancreas is unable to create enough insulin to handle the increased sugar level, or, your body stops using insulin as it should, your blood sugar levels rise, and you get gestational diabetes. While it typically occurs in the middle of the pregnancy, most women don’t realize they have it until it’s detected by a routine pregnancy screening. This is because there are usually no symptoms associated with gestational diabetes.  The screening test that they will ask you to do is called a glucose tolerance test.

While any pregnant person can develop gestational diabetes, your risks go up if you:

• are over 25 years of age
• were overweight prior to becoming pregnant
• are prediabetic
• have high blood pressure, high cholesterol, or heart disease
• have a family history of diabetes
• are African American, Asian, Hispanic, Alaska Native, Pacific Islander, or Native American
• have polycystic ovarian syndrome
• have had gestational diabetes before
• have given birth to a large baby (weighing more than 9 pounds)
• have had a miscarriage or given birth to a stillborn baby or baby with certain birth defects

Again, the good news is that gestational diabetes can be controlled. Depending upon the severity of your condition, simple modifications to diet and exercise may be all that’s needed, or you may need to take insulin or other medications. You will also need to test your glucose for the remainder of the pregnancy. 

Some tips for taking control include:

Eat a healthy, low-sugar diet. 

Stick to a diet that keeps your blood sugar levels in check. This may include:

• Eating three small meals a day along with two or three snacks about the same times every day.
• Avoid sugary snacks and drinks—think cookies, candy, soda, and juice—and opt for natural sugars like fruits and vegetables.
• Aim for 20-35 grams of fiber a day. Good sources include whole-grain breads, cereals, brown or wild rice, vegetables, and fruit.
• Limit saturated fats to less than 10% of your daily calories. Common sources of saturated fats include butter, bacon and other cured meats, cheese, chocolate, and ice cream.

That said, you do want to be sure to eat a variety of foods to ensure you get essential vitamins and minerals. If you're concerned, ask your doctor for advice. He or she may recommend a daily supplement.

Keep moving

Thirty minutes of moderate-intensity activity—think walking, swimming, chasing a toddler on the playground, or light strength training— at least five days a week.

Keep weight gain in check

While gaining weight while pregnant is a given, gaining too much weight or gaining weight too fast can make it difficult manage your blood sugar. Speak to your doctor about what is the appropriate amount of weight for you to gain during pregnancy. 

While gestational diabetes goes away after delivery, for some women diabetes may stay. Talk to your doctor about getting tested after delivery and again 6 weeks after delivery.  

Paula Haytko, RN is a diabetes educator at Southwestern Vermont Medical Center.