Gestational Diabetes: Risk, Reality, and Reduction
Even if you’ve never had a baby, you’ve most certainly heard from friends or family of that day during their second or third trimester that most women dread…the day they visit their practitioner and take the oral glucose tolerance test for gestational diabetes. For some women it means close monitoring and a strict diet for the remainder of their pregnancy if they happen to fail the test; for others it simply means a morning of attempting to gulp down that thick, sweet orange drink and waiting patiently for the results. While it may seem that the outcome of this test is out of your hands, there is much you can do from the moment you discover you are pregnant to help reduce your risk of developing gestational diabetes, manage your symptoms if you are diagnosed, and there are even things you can do to possibly avoid taking this test at all.
First, let’s take a step back and discuss exactly what gestational diabetes is. Hormonal changes during pregnancy can cause your cells to become less responsive to insulin, a hormone that is produced in the pancreas to help keep your blood glucose levels from getting too high or too low. When you eat, your blood sugar naturally rises and insulin is released from the pancreas to move the glucose out of your bloodstream and into your cells for energy or storage. If your pancreas can’t produce enough insulin to keep up with your body’s demand, you can end up with too much glucose in your bloodstream (also referred to as hyperglycemia, high blood sugar or insulin resistance) and you are said to have gestational diabetes.
Certain factors can help to reduce your risk of developing gestational diabetes, such as entering into pregnancy at a healthy weight and proper weight gain during pregnancy. The American Congress of Obstetricians and Gynecologists recently reported that entering into pregnancy with a BMI between 30 and 39.9 (higher than 30 is considered obese) was associated with an increased risk of many maternal complications, including gestational diabetes1.
Although gestational diabetes is temporary for most women and your blood sugar levels should return to normal after delivery, there are very serious maternal and fetal complications that can easily be avoided through diet and lifestyle. Because the glucose in your blood is transferred to your baby’s blood via the placenta, if your blood sugar levels are elevated, your baby’s will be as well. This constant cycle of elevated glucose and insulin can cause your baby to gain too much weight in utero and be born at a high birth weight. This increases risk for preterm birth, birth injuries, and cesarean delivery. The risks extend beyond labor and delivery, though. Research shows that large for gestational age babies can go on to become overweight or obese during childhood and adolescence and have an increased risk of developing type 2 diabetes later in life2.
So, what can you do today to reduce your risk of developing gestational diabetes and the potential complications that come along with it? It’s simple…move your body daily (even just a short walk!) and eat real food. It’s never quite that simple, though, is it? To be a little more specific, there are certain foods you want to avoid in order to prevent the blood sugar spikes that contribute to insulin resistance. These include refined carbohydrates like most breads, pastas, pastries and fast food and foods high in refined sugars like soda, fruit juice, candy, cakes and cookies. These foods are mostly made up of carbohydrates and, with little fiber to slow their digestion, they enter your bloodstream quickly and cause blood sugar to rise rapidly. Instead, focus on more balanced meals and snacks with protein, fat, and carbohydrates. This balanced combination slows digestion, resulting in more steady blood sugar levels.
Protein can include meat, seafood, eggs, dairy, beans, lentils, nuts, or seeds. Healthy fats include cold-pressed oils like olive oil or coconut oil, butter or ghee (clarified butter, for those who are intolerant to dairy), and avocado. When you think of carbohydrates, don’t forget that fruits and vegetables are carbohydrates, too. There is nothing wrong with including whole grains like brown rice and quinoa on your pregnancy plate, but consider them a compliment to your overall meal instead of giving them a starring role. Make sure you are including a lot of variety in your diet, too. Include some lean meats like poultry with fattier meats like salmon and pork. Eat both saturated and unsaturated fats and a colorful array of fruits and vegetables.
Food quality is a bit outside of the scope of this discussion, but the quick explanation is to buy organic produce and dairy and pastured, naturally-raised meat and eggs whenever possible. When buying packaged products, look for those with just a few simple ingredients and make sure you know what each of those ingredients is. The wonderful thing about eating this way throughout your pregnancy is that a diet just like this has been shown to decrease the risk of developing gestational diabetes and is also similar to the diet prescribed to women who are diagnosed with gestational diabetes. By starting out your pregnancy on the right foot with healthy, whole foods you will naturally be consuming the foods that help to keep blood sugar balanced and hold gestational diabetes at bay.
There is an unexpected downfall, however, to following a low-glycemic diet. It is possible that when test day rolls around and you drink the orange concoction containing 50 grams of pure glucose, you may receive a false positive result as your body is not used to such a rush of glucose in one sitting. Outside of this, maybe you just aren’t thrilled with the artificial flavors and colors used to make the drink. Either way, you do have alternatives that can still help to safely determine if your blood sugar needs to be monitored more closely. Many practitioners now allow you the option of consuming real food before taking the test, such as juice or fruit. You may also be able to use a blood glucose monitor and a food log to track your food intake and subsequent blood sugar levels for a period of time, at least one to two weeks. Your health insurance may even cover the cost of the testing supplies. If you are not comfortable taking the oral glucose tolerance test, discuss these options with your practitioner.
I believe that real food, exercise, sleep, and stress reduction can help us all to be the healthiest, happiest version of ourselves. This is even more important during pregnancy, as even while they are in the womb, we are shaping the future health of our children. It is truly a gift and a blessing to be given the opportunity to nourish our babies by nourishing our own bodies and helping them to grow into healthy babies for life.
Tarah Chieffi is a writer, blogger, aqua fitness instructor, and holistic nutrition educator in Southern Indiana. She recently earned her Master of Science in Health and Nutrition Education from Hawthorn University.
Tarah’s passion is working with women before, during, and after pregnancy to help families achieve health and happiness through lifestyle, physical fitness and real food. Tarah’s writing has been featured in Paleo Living Magazine, Paleo Magazine Insider, and Southern Indiana Fitness Source. Her first book, The Everything® Paleo Pregnancy Book (F+W, 2015), is available through Amazon.com and nationwide in Barnes and Nobles stores.
You can learn more about Tarah’s and her preconception, pregnancy and family nutrition coaching services by visiting her website, WhatIGather.com.