Pregnancy bring about changes to insulin sensitivity and therefore blood sugar, and for some moms that can lead to gestational diabetes.
Carmen Alexis Miller, MS, RDN, LDN, outpatient dietitian at Our Lady of Lourdes Women’s & Children’s Hospital in Lafayette, shares her healthy eating during pregnancy tips, including specific details about managing gestational diabetes, in this ParentingU podcast episode.
Screening for Gestational Diabetes
All expecting moms are screened for gestational diabetes around the 26th to 28th week of pregnancy. The two-step process starts with a one-hour screening, to test how mom’s body reacts to 50 grams of glucose. The drink is similar a flat Fanta or other syrupy drink, and Miller encourages moms to not worry about its taste.
If blood sugar is elevated after an hour, the screening is “failed,” which means mom will come back another day for the longer, three-hour glucose test. Mom will drink 100 grams of glucose, so a more syrupy and sweeter drink, and then have her blood tested at one hour, two hours and three hours.
Only if her blood glucose is elevated during that second screening will mom have an official diagnosis of gestational diabetes.
Earlier Way to Learn Risk of Gestational Diabetes
Miller recommends that women with a strong family history of diabetes or gestational diabetes in a previous pregnancy consider having a blood test drawn earlier in pregnancy. A hemoglobin A1C test shows a three month average of blood sugar.
An elevated A1C early in pregnancy is a very good predictor of whether a mom will have gestational diabetes, and knowing earlier means she can monitor and treat it sooner in her pregnancy, which may improve outcomes.
Why Managing Gestational Diabetes Matters for Mom and Baby
Mom’s health during pregnancy impact’s baby’s health, and unmanaged gestational diabetes puts mom at very high risk for hypertension (high blood pressure) or even pre-eclampsia. Moms with gestational diabetes have a higher risk of needing a C-section and are more likely to develop Type 2 diabetes later in life.
Babies born to moms with gestational diabetes are at a higher risk of being born larger and possibly pre-term, and they are at higher risk of developing diabetes themselves.
The worst possible outcome of untreated gestational diabetes with out-of-control blood sugar is a stillbirth. Miller stresses that a diagnosis is not a death sentence but neither should it be taken lightly.
Treatment Starts with Monitoring
Fortunately gestational diabetes can be managed, and the first step is monitoring, or keeping track of blood glucose levels with regular finger sticks several times per day after eating.
A mom’s OB-GYN will help her get connected with the tools she needs to monitor and help decipher what the numbers mean. As the team lead for monitoring gestational diabetes, an OB-GYN would also be able to connect mom to a dietitian like Miller for nutritional support.
Manage with Diet
Gestational diabetes can often be controlled through diet. Moms can regularly track what they eat and how their blood sugar responds to those foods to know where they stand. As moms make changes then they can know what’s working and what’s not.
Our bodies and blood sugar levels respond differently and individually to the foods we eat. But the one thing Miller recommends all pregnant moms take off the table, especially those who have gestational diabetes, is soda. It causes skyrocketing blood sugar levels with no nutritional payoff.
Moms with gestational diabetes do have to be more mindful of what they eat and how they combine foods to avoid blood sugar swings. Miller says this is good practice for parenting, when you’ll need to plan ahead and pack for baby’s day!
Download our Focus Foods resource that lists the foods Miller recommends for all pregnant moms. Pregnant bodies require more nutrients, protein and vitamins while creating a small human. These focus foods include eggs, liver, slow-cooked meat and bone broth, leafy green vegetables, fatty fish, and full-fat dairy products.
When you focus on the recommended foods, you start with those that fill you and keep you full, leaving less room for the cravings and empty calories from foods that are less nutritious.
Miller recommends Real Food for Gestational Diabetes by Lily Nichols, RDN, CDE, as a resource for managing gestational diabetes with diet.
Mom should work with her doctor to know what amount of exercise is right for her as an individual, but in general exercise is recommended during pregnancy.
Exercise is a valuable way to manage blood sugar, too, and it doesn’t have to be strenuous. Sometimes a 10-minute brisk walk after a heavy meal can help keep blood sugar in balance.
Sometimes medication or even insulin injections are required for moms with gestational diabetes to manage the condition. Our providers are able to provide that care and guidance through all maternity.