Managing Gestational Diabetes with Lifestyle and Nutrition

Pregnancy comes with many to-dos, and those diagnosed with gestational diabetes have another item on their list – monitoring and managing their blood sugar levels.

The good news is that with proper nutrition, a healthy lifestyle, and sometimes medication, gestational diabetes can be effectively managed, and the health of mom and baby can be maintained.

How is gestational diabetes diagnosed?

Gestational diabetes is a temporary type of diabetes that occurs only in pregnancy. It affects approximately 5-9% of pregnancies in the United States.

Any pregnant woman can develop gestational diabetes, so it’s recommended that all pregnant women be screened. This occurs sometimes early in the pregnancy or around 24 to 28 of gestation, depending on your risk factors. Risk factors for gestational diabetes include:

• Being overweight or obese.
• Having a personal or family history of diabetes.
• Having a previous birth of an infant that weighed more than nine pounds.
• Increasing age – maternal age of over 30 or 35 years.
• Having polycystic ovary syndrome (PCOS).
• Being of a certain race or ethnicity that is at a higher risk – such as Asian or Hispanic.

A glucose challenge test is performed to screen for gestational diabetes. During this test, you drink a sugary drink, and your blood sugar is measured one or two hours after drinking the liquid. If blood sugar levels are not within the desired range, a diagnostic test, called a glucose tolerance test, is performed. This diagnostic test is similar to the screening test; however, blood sugar is taken before drinking the sugary drink, and at additional intervals for several hours after drinking it.

If a woman is diagnosed with gestational diabetes they will work with their OB-GYN and other specialists to manage their condition, sometimes including a dietician and a diabetic educator.

How is gestational diabetes treated?

The first step to managing gestational diabetes is making changes to diet and lifestyle to keep blood sugar at safe levels for mom and baby.

When a meal and exercise plan is established, pregnant women can monitor blood sugar levels to see if they are within the targeted range. Typically, if you have gestational diabetes, it is recommended that you test your fasting blood sugar each morning, and your blood sugar one hour after every meal.

The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant women with gestational diabetes maintain the following blood glucose levels:

• Fasting, before breakfast: 95 mg/dL or less. 
• One hour after a meal: 140 mg/dL or less. 
• Two hours after a meal: 120 mg/dL or less.

If the changes in lifestyle and nutrition aren’t able to get blood glucose levels in check, insulin therapy, and sometimes a diabetes medication called Metformin, will likely be recommended.

Nutrition for Gestational Diabetes

Women diagnosed with gestational diabetes should meet with a dietitian. Meeting with a registered dietitian can help women develop a diet plan and assist with helping keep blood sugars in the target range during pregnancy.

Meal plans for gestational diabetes should focus on consuming a diet rich in nutrient-dense foods such as lean proteins, non-starchy vegetables, whole grains, and some fruits such as apples or berries. Large portions of processed carbohydrate-containing foods, such as pastries and fried foods should be limited because these foods may cause your blood sugar levels to rise above the targeted range.

Exercise for Gestational Diabetes

Exercise is a vital component to having a healthy lifestyle before, during and after pregnancy. Exercise can be a natural way to help your body lower blood sugars, especially after a meal.

During and after exercise, your body draws on reserve sugar stores and then replenishes the stores with sugar from your blood. Regular exercise also improves insulin sensitivity, meaning your body can better use insulin to absorb glucose in your blood.

Pregnant women who are diagnosed with gestational diabetes should focus on getting at least 30 minutes of exercise almost every day. Talk to your OB-GYN about what type of exercise is best for you during pregnancy.

Medication for Gestational Diabetes

For some women with gestational diabetes, exercise and diet changes may not bring blood sugar levels into the target range. This is mostly due to hormone changes in the woman's body, not anything they are doing wrong.

Insulin is given in the form of an injection and may be administered by the patient once a day or multiple times per day with meals. Insulin injections are safe for both mom and baby.

Will gestational diabetes go away postpartum?

For most women, blood sugar levels go back to normal postpartum. Blood sugars will be checked in the hospital and at follow-up visits with your doctor after giving birth.

If your blood sugar levels don’t go back to safe levels postpartum, you may have been prediabetic or had unknown type 2 diabetes before getting pregnant. If managing your blood sugar levels is now part of your everyday life, your provider will refer you to a specialist to develop the best treatment plan for you.

According to the Centers for Disease Control and Prevention (CDC), women who have gestational diabetes are at a higher risk of developing type 2 diabetes later in life. “As much as 50% of women with gestational diabetes will develop Type 2 diabetes after pregnancy,” shares Kathryn Rodeman, MD, an endocrinologist with ProMedica Physicians Perrysburg Endocrine.

It’s important for women who have had gestational diabetes to maintain a healthy lifestyle with good nutrition and frequent exercise to put themselves at a lower risk of developing type 2 diabetes. “Weight loss following pregnancy to a healthy BMI is critical in preventing or delaying the onset of Type 2 diabetes,” Dr. Rodeman shares.