If you’ve been diagnosed with gestational diabetes or if you know you’re at risk, you’re probably looking for answers about the condition, ways in which to prevent it, and the various approaches to gestational diabetes treatment. You may also have questions about the best gestational diabetes diet and how to set yourself up for a healthy pregnancy, without having to endure an overly restrictive gestational diabetes meal plan. All those questions and concerns are natural. After all, being diagnosed with gestational diabetes can cause pregnant women a lot of worry about their own health, as well as the health of their babies. But the good news is that with proper management, many women are able to prevent gestational diabetes complications.
What is gestational diabetes?
Gestational diabetes, also known as gestational diabetes mellitus, is a form of diabetes that is diagnosed for the first time during pregnancy. As with other forms of the condition, it is characterized by high blood sugar (glucose) or poorly controlled blood sugar levels.
What causes gestational diabetes?
Gestational diabetes develops when pregnant women have decreased insulin sensitivity (also known as insulin resistance) and an inadequate insulin response. It occurs when hormones produced by the placenta, the organ that develops during pregnancy to nourish a growing fetus, keep insulin from doing its job. These hormones, including estrogen, cortisol, and human placental lactogen, can block insulin and cause insulin resistance. In most cases, women’s bodies make enough insulin during pregnancy to make up for the new hormones. However, in the case of gestational diabetes, the body can’t keep up with the extra insulin requirements, so blood sugar rises to unhealthy levels. (5)(17)
Am I at risk for gestational diabetes?
Anyone can develop gestational diabetes, but some pregnant women are at a higher risk than others. According to the Centers for Disease Control (CDC), the various gestational diabetes risk factors include:
- Certain ethnicity (such as African American, Hispanic/Latino American, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander)
- Being older than 25
- Being overweight
- Having a family history of type 2 diabetes
- Having had a baby who weighed more than nine pounds at birth
- Having had gestational diabetes during a previous pregnancy
- Having polycystic ovary syndrome (PCOS) (2)
Gestational diabetes complications
When gestational diabetes isn’t well managed and blood glucose levels remain elevated, both the mother and baby can experience health problems. Common complications of gestational diabetes for the mother include:
High blood pressure
If you have gestational diabetes, you’re more likely to have high blood pressure. During pregnancy, high blood pressure can be dangerous for both the mother and the baby. High blood pressure increases the risk of heart disease, kidney disease, stroke, and a potentially deadly condition known as preeclampsia, where the high blood pressure begins to cause damage to certain organs. In addition, it can cause the baby’s growth to be stunted, increase the risk of early delivery, placental abruption, or C-section. (16)
Type 2 diabetes
About 50% of women who have gestational diabetes will develop type 2 diabetes later on. (3) One way to reduce your risk is by breastfeeding. Research shows that the longer you breastfeed, the lower your risk is of developing type 2 diabetes. (10) Common complications of gestational diabetes for the baby include:
Large birth size
Uncontrolled blood glucose can cause the baby to grow too much, which can lead to a difficult delivery or a cesarean section.
Hypoglycemia (low blood glucose)
High blood sugar in the pregnant mother can actually lead to low blood sugar in the infant, which can affect brain function. (11)
Gestational diabetes increases the risk of jaundice, a condition in which the baby’s liver can’t clear the blood of the yellow pigment bilirubin. It causes the baby’s skin and the whites of the eyes to appear yellow and can cause lasting brain damage if not managed.
Gestational diabetes can lead to respiratory distress syndrome, in which the infant has trouble breathing after birth.
Health problems later in life
If a mother has gestational diabetes, the child will be at increased risk of developing obesity and type 2 diabetes later in life. (14)
Gestational diabetes signs and symptoms
Gestational diabetes typically doesn’t present with any symptoms. That’s why gestational diabetes testing is a standard part of prenatal care.
Gestational diabetes test
Usually between 24 and 28 weeks of pregnancy, a gestational diabetes test is conducted. If you’re at a high risk, your healthcare practitioner may conduct a test as soon as you learn you’re pregnant. If the test shows that you don’t have gestational diabetes early on in pregnancy, your healthcare provider will likely test you again when you’re between 24 and 28 weeks along. There are two tests commonly used in diagnosing gestational diabetes, which include:
Glucose challenge test
Also called the glucose screening test, this is a blood test performed one hour after you drink a high-glucose beverage. The blood test looks at your blood sugar levels, and if they’re too high, further testing will be conducted.
Oral glucose tolerance test
This test checks your blood sugar levels after you’ve been fasting for at least eight hours. You’ll start by having your blood drawn, and then you’ll drink that glucose beverage again. Then for the next two to three hours, you’ll have your blood drawn each hour. If you have more than two high glucose measurements during the test, you will typically receive a diagnosis of gestational diabetes. Some research has also found that a blood test to measure Hemoglobin A1c (HbA1c) can predict gestational diabetes risk as early as the first trimester. The HbA1c test gives a snapshot of your blood sugar levels over the past couple of months. (6) If testing reveals that you do have gestational diabetes, your integrative healthcare team can assist you in exploring your options for management and treatment.
Gestational diabetes treatment
The goal of gestational diabetes treatment is to keep blood sugar levels at a healthy level. For many women, gestational diabetes is manageable with lifestyle shifts, such as a modified diet and regular physical activity. Some of the same recommendations that patients receive for the management of type 2 diabetes are applicable to those with gestational diabetes as well. For others, insulin injections may be necessary.
Research has found that probiotics might be able to reduce the risk of gestational diabetes (7), as well as reduce the risk of adverse outcomes, including inflammation and oxidative stress in pregnant women and jaundice and blood sugar issues in babies. (9)(19)
Supplementing with inositol during pregnancy has been linked to lower rates of gestational diabetes and preterm delivery. (18)
Women with low levels of vitamin D are more likely to develop gestational diabetes. (12) Vitamin D supplementation also appears to help control blood sugar in women who do have gestational diabetes, but more research is needed. (15)
This mineral is associated with decreased inflammation in women with gestational diabetes and lower risk of jaundice and hospitalization for their babies. (1) Even though research examining the use of these supplements is promising, be sure to consult your healthcare practitioner for guidance before adding any supplements to your wellness plan. Always follow the recommendations of an integrative health expert who knows you and your specific situation, and be sure to inform them of any supplements you may be taking.
Gestational diabetes diet
If you have gestational diabetes, you’ll likely work with a practitioner to design a diet plan for your pregnancy. A gestational diabetes diet plan is designed to keep your blood sugar within healthy limits. If this can be accomplished through a dietary intervention, you may be able to avoid taking pharmaceutical medications like insulin, according to a position statement from the American Diabetes Association. (13) So what does a gestational diabetes diet entail? The fundamental part is restricting carbohydrate intake. According to this study, you may have to keep your carbohydrate intake to no more than 30% to 40% of your total calorie intake, but this depends on the individual. (8) That’s because carbohydrates cause your blood sugar levels to rise. Here are some common ways to have a satisfying diet while also cutting down on carbohydrates:
- Enjoy two to four servings of fruit (not fruit juices) daily
- Fill up on non-starchy vegetables, such as leafy greens, summer squash, broccoli, cauliflower, and asparagus
- Have two or three servings of protein from sources such as meat, poultry, fish, beans, eggs, or nuts per day
- When eating carbohydrates, avoid simple carbs like potatoes, white rice, and sugar. Instead, opt for whole grains like brown rice, quinoa, and farro. Whole grains not only have more nutrients, but they also cause less of a blood sugar spike than simple carbohydrates. (4)
It may take some time to adjust to this new way of eating, but the benefits are great for pregnancy and beyond.
The bottom line
A gestational diabetes diagnosis is not the news you want to hear when you’re pregnant. But the bright side is that with the right diet and regular exercise, 70% to 85% of women can successfully control their gestational diabetes without pharmaceutical intervention. (13) These healthy new lifestyle habits will benefit you and your baby, not only during pregnancy but for years to come.
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- Ahmadi S., Naderifar M., Samimi M., Mirhosseini N., Amirani E., Aghadavod E., Asemi Z. (2018). The effects of magnesium supplementation on gene expression related to inflammatory markers, vascular endothelial growth factor, and pregnancy outcomes in patients with gestational diabetes. Magnes Res 31(4), 131-142. https://pubmed.ncbi.nlm.nih.gov/31099333/
- Diabetes Risk Factors. (2020, March 24). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/risk-factors.html
- Gestational Diabetes. (2019, May 30). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/gestational.html
- Gestational diabetes diet. (n.d.). Medline Plus. https://medlineplus.gov/ency/article/007430.htm
- Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes
- Hinkle, S. N., Tsai, M. Y., Rawal, S., Albert, P. S., & Zhang, C. (2018). HbA1c measured in the first trimester of pregnancy and the association with gestational diabetes. Scientific Reports, 8(1), 12249. https://www.nature.com/articles/s41598-018-30833-8
- Homayouni, A., Bagheri, N., Mohammad-Alizadeh-Charandabi, S., Kashani, N., Mobaraki-Asl, N., Mirghafurvand, M., Asgharian, H., Ansari, F., & Pourjafar, H. (2020). Prevention of gestational diabetes mellitus (GDM) and probiotics: mechanism of action: a review. Current Diabetes Reviews, 16(6), 538–545. https://pubmed.ncbi.nlm.nih.gov/31544699/
- Jovanovic-Peterson, L., & Peterson, C. M. (1990). Dietary manipulation as a primary treatment strategy for pregnancies complicated by diabetes. Journal of the American College of Nutrition, 9(4), 320–325. https://www.tandfonline.com/doi/abs/10.1080/07315724.1990.10720387
- Karamali, M., Nasiri, N., Taghavi Shavazi, N., Jamilian, M., Bahmani, F., Tajabadi-Ebrahimi, M., & Asemi, Z. (2017). The effects of synbiotic supplementation on pregnancy outcomes in gestational diabetes. Probiotics and Antimicrobial Proteins, 10(3), 496–503. https://link.springer.com/article/10.1007/s12602-017-9313-7
- Ley, S. H., Chavarro, J. E., Li, M., Bao, W., Hinkle, S. N., Wander, P. L., Rich-Edwards, J., Olsen, S., Vaag, A., Damm, P., Grunnet, L. G., Mills, J. L., Hu, F. B., & Zhang, C. (2020). Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus. Diabetes Care, 43(4), 793–798. https://care.diabetesjournals.org/content/43/4/793
- Low blood sugar – newborns. (n.d.). Medline Plus. https://medlineplus.gov/ency/article/007306.htm
- Lu, M., Xu, Y., Lv, L., & Zhang, M. (2016). Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis. Archives of Gynecology and Obstetrics, 293(5), 959–966. https://pubmed.ncbi.nlm.nih.gov/26825733/
- Management of Diabetes in Pregnancy. (2016). Diabetes Care, 40(Supplement 1), S114–S119. https://care.diabetesjournals.org/content/40/Supplement_1/S114
- National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2012). Am I at risk for gestational diabetes? https://www.nichd.nih.gov/sites/default/files/publications/pubs/Documents/gestational_diabetes_2012.pdf
- Ojo, O., Weldon, S. M., Thompson, T., & Vargo, E. J. (2019). The effect of vitamin D supplementation on glycaemic control in women with gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. International Journal of Environmental Research and Public Health, 16(10), 1716. https://pubmed.ncbi.nlm.nih.gov/31100793/
- Preeclampsia and High Blood Pressure During Pregnancy. (2019, October). ACOG. https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy
- Symptoms & Causes of Gestational Diabetes. (2020, October 20). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/symptoms-causes
- Vitagliano, A., Saccone, G., Cosmi, E., Visentin, S., Dessole, F., Ambrosini, G., & Berghella, V. (2018). Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Archives of Gynecology and Obstetrics, 299(1), 55–68. https://pubmed.ncbi.nlm.nih.gov/30564926/
- Zhang, J., Ma, S., Wu, S., Guo, C., Long, S., & Tan, H. (2019). Effects of probiotic supplement in pregnant women with gestational diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes Research, 2019, 1–12. https://pubmed.ncbi.nlm.nih.gov/31583250/