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Gestational Diabetes: Pregnant Mom Eating

Important Facts You Should Know About Gestational Diabetes in 2023

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Recently, a friend and fellow registered dietitian told me at her baby shower, “You’re not going to believe this – I have gestational diabetes.” She is someone who has never struggled with weight, eats a balanced diet and exercises regularly. So, when she went for the oral glucose tolerance test at 28 weeks into her pregnancy and got the results that her glucose was too high, she was stunned. In honor of my friend and her healthy and beautiful baby boy, this post is devoted to answering some common questions about gestational diabetes.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that specifically occurs during pregnancy in patients who don’t already have diabetes. It happens when pregnant patients develop high blood sugar levels. Around 10% of pregnancies in the United States are affected by gestational diabetes and managing gestational diabetes well will ensure you have a healthy pregnancy and baby.

What causes gestational diabetes?

Gestational diabetes is often associated with overweight or obesity but can also happen in women without any of the common risk factors. The underlying cause is insulin resistance. Insulin in the body plays a crucial role in processing glucose. Large amounts of pregnancy hormones can cause the body’s cells to become resistant to insulin. Many endocrinologists think all pregnant women experience it to some degree. In the case of diagnosed gestational diabetes, more significant insulin resistance occurs during pregnancy and leads to blood sugar levels being too high. It is different from pre-existing diabetes, in that glucose levels typically return to normal after delivery.

While it is not always possible to prevent gestational diabetes, there are steps you can take to reduce your risk, including:

  • Living a healthier lifestyle, maintaining a well-balanced diet and regular exercise that is approved by your doctor.
  • If you are planning to become pregnant, and are overweight, talk with your doctor about healthy ways to lose some excess weight.

Why is controlling blood glucose during pregnancy important?

Uncontrolled blood glucose during pregnancy most commonly can result in having a baby who is larger than average at birth. This can make the delivery more difficult and can increase risk of shoulder dysplasia during delivery. Other complications to the newborn can include low blood sugar after delivery, respiratory distress syndrome, low calcium levels, and in very rare cases, still birth. For mom, uncontrolled blood sugar increases the risk of developing pre-eclampsia.

What are symptoms of gestational diabetes?

Gestational diabetes doesn’t typically have symptoms. Certain medical history may put you at an increased risk of developing it, such as a family history. If symptoms are experienced, they are usually very mild and may include:

  • Tiredness
  • Excessive thirst
  • Excessive urination
  • Blurred vision
  • Yeast infections

All symptoms that most women would attribute to pregnancy in general. The only way to know for sure you have gestational diabetes is to be tested.

How Is gestational diabetes diagnosed?

A glucose screening is typically conducted within 24 to 28 weeks of pregnancy with an oral glucose tolerance test. It is a one-hour test ordered by a doctor, which shows how well your body is processing glucose. Here is what to expect:

  • Your fasting blood sugar level will be tested first. You will need to fast eight hours before the test. It is a one-hour test,
  • You will then drink a special sweet beverage
  • Your glucose level will then be tested after one-hour.
  • If the fasting and/or one-hour test is above goal, you will need to continue on for a 2-hour and 3-hour check.

Your physician will likely diagnose you with gestational diabetes if your:

  • Fasting blood sugar level are greater than or equal to 95 mg/dL or 105 mg/dL
  • 1-hour blood sugar level is greater than or equal to 180 mg/dL or 190 mg/dL
  • 2-hour blood sugar level is greater than or equal to 155 mg/dL or 165 mg/dL
  • 3-hour blood sugar level is greater or equal to 140

Who is at risk of gestational diabetes?

Anyone can develop gestational diabetes, but you can be at an increased risk if you:

  • Are overweight, obese or not physically active
  • Are older than 25
  • Have polycystic ovary syndrome
  • Have high blood pressure or heart disease
  • Have had gestational diabetes with another baby
  • Are pregnant with multiple babies
  • Have a family history of diabetes
  • Gain excessive weight during pregnancy

How is gestational diabetes treated?

Often gestational diabetes can be managed with diet and light to moderate exercise, following a consistent carbohydrate diet with three meals and two to three snacks daily is recommended. Meals should be balanced with a lean protein, non-starchy vegetables and moderate amount of carbohydrate. Choose foods with more complex carbs like whole grains, beans, winter squashes, milk, and yogurt – rather than simple carbs in food containing white flour or added sugar, sugary beverages, candies, or desserts. A diabetes educator can provide a more individualized plan. If glucose readings remain consistently above goal, the health care provider may start medication. Metformin or insulin are the preferred medications for uncontrolled blood glucose during pregnancy.

What are the blood glucose goals during pregnancy?

Women with gestational diabetes need to test blood glucose four times daily and bring a log of readings to healthcare appointments. Fingerstick readings using a glucometer should be checked fasting (before eating anything) first thing in the morning and two hours after each meal. Ideal glucose levels for the fasting reading is 95 or less and 120 or less, two hours after a meal.

Does gestational diabetes increase risk of diabetes later in life?

Gestational diabetes does increase the risk of developing Type 2 diabetes later in life. Your doctor will test you for diabetes six to 12 weeks after your baby is born, and again every one to three years. It is important to continue with healthy eating habits, exercise and lifestyle changes after pregnancy to reduce future diabetes risk.

The key to prevention is knowing your risk for diabetes. Take our free risk test today.


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