Between fluctuating hormones, weird cravings and the “eating for two” mentality, pregnancy is almost like a nine-month Get Out of Jail Free card when it comes to diet and nutrition. But not all moms-to-be have the luxury of a healthy eating grace period.
Gestational diabetes, a form of diabetes that causes high blood sugar levels during pregnancy, is more common than you might think — nearly 1 out of every 10 pregnant women has gestational diabetes, according to a 2014 analysis by the Centers for Disease Control and Prevention.
“In many ways, whether or not you get gestational diabetes is out of your control,” says Dr. Richard Kaye, an OB/GYN at Texas Health Presbyterian Hospital Plano. “For whatever reason, pregnancy causes some women’s bodies to become resistant to insulin. When that happens, their blood sugar levels stay high.”
Still, some women are more likely to develop the disease than others. Women who are overweight or have a personal or family history of diabetes are at higher risk, as are moms who previously delivered a baby weighing more than 9 pounds, reveals Deborah Kalish, program coordinator and certified diabetes educator at Texas Health Plano. “It’s also more common in Hispanics, African Americans, Asians, Native Americans and Pacific Islanders than in other ethnic groups,” she adds.
EFFECTS ON MOM AND BABY
A woman with gestational diabetes transfers the high levels of sugar in her blood into her baby’s blood. The baby’s body then produces extra insulin, causing him or her to gain weight.
“When this happens, the baby grows too large,” Kalish explains. “The baby’s size makes it difficult for a vaginal birth since the baby’s arms and shoulders are too big to get through the birth canal.” Therefore, moms with gestational diabetes may need a C-section, and they are at greater risk for high blood pressure during pregnancy which is called preeclampsia.
For baby, untreated gestational diabetes can increase the risk of pre-term birth, low blood sugar at birth and even stillbirth.
The vast majority of women no longer have diabetes after delivery. But that doesn’t mean everyone’s in the clear for good, Kaye says, because having gestational diabetes increases the risk of developing type 2 diabetes down the road.
Women are automatically tested for gestational diabetes between their 24th and 28th weeks of pregnancy. If you test positive, have your OB/GYN help you schedule an appointment with a registered dietitian nutritionist or diabetes educator immediately. These professionals will help you create an individualized diet and exercise plan and set you up with a glucometer device to test your blood sugar four times daily.
Luckily, most women can control gestational diabetes with lifestyle changes alone.
“Exercise has been proven to reduce blood sugar levels,” Kalish says. “It helps the body use the insulin you have more effectively.”
But that doesn’t mean you need to take up long-distance running or kickboxing. Kalish recommends women walk 30 minutes a day, perhaps with a 15-minute walk in the morning and a 15-minute walk in the evening, or even a 10 minute walk after each meal.
And exercise is actually the smaller piece of the puzzle. The much larger piece is eating the correct portions of the right types of foods.
“Most women who test positive for gestational diabetes can use diet alone to effectively control their blood sugar levels and keep their baby healthy,” Kaye says. “A much smaller percentage will need to use insulin to control their blood sugar levels.”
The key to controlling gestational diabetes is eating in a way that prevents big fluctuations in blood sugar levels.
“If you eat too much food at one time, your blood sugar will spike,” explains Grace Rivers, Registered Dietitian Nutritionist and owner of the Dallas and Richardson nutritional counseling service Eats With Grace.
Instead, eat smaller meals throughout the day. Kalish recommends adding three snacks (midmorning, midafternoon and bedtime) to your usual schedule of breakfast, lunch and dinner. Meals should consist of lean proteins, healthy fats, vegetables and, yes, carbs.
“When women think about a diet, their first instinct is often to cut out carbs,” says Karen Bruner, the diabetes coordinator at Texas Health Presbyterian Hospital Denton. “But we actually encourage the regular intake of carbs throughout the day. Women aren’t usually aware that going too long without carbs actually raises blood sugar levels.”
At snacktime, Kalish suggests pairing one serving of carbs with one serving of protein — for example, three graham cracker squares with peanut butter.
Foods to avoid? No surprises there — fruit juice, soda, candy, the dessert menu. “Basically anything that’s simple sugar will elevate your blood sugar,” Bruner cautions.
Cutting out the good stuff (really, the bad stuff) shouldn’t leave you with a cardboard diet. We teamed up with local diabetes and nutrition experts to devise our very own not-so-boring gestational diabetes meal plan. Use our guide as a jumping-off point, but consult your doctor, registered dietitian or diabetes educator to help you determine the correct portion sizes, especially when it comes to carbs. An expert will use your height, weight, age, activity level and pre-pregnancy weight to determine the right portions to keep you and baby healthy.