Gestational Diabetes (GD)
Written by: Kelly-Marie Andersen; LIU Post Dietetic Interns
Are you nervous about your glucose tolerance test? This test measures your body’s response to glucose (sugar) and screens for Gestational Diabetes, diabetes that appears while pregnant.
Most pregnant women take this test between weeks 24 and 28. If you’re at higher risk for GD, your practitioner might perform the test early. This test has two steps; first, drink a sugary solution and wait an hour. After the hour is up, your blood sugar is measured to determine if you might have gestational diabetes.
Getting diagnosed with Gestational Diabetes might feel overwhelming at first, but it is more common than you think! Know that it can be managed with careful monitoring and treatment. Learn more about what you can do to have a safe and healthy pregnancy.
★ WHAT IS GESTATIONAL DIABETES?
Gestational Diabetes (GD) is a type of diabetes first diagnosed or recognized during pregnancy. According to the Centers for Disease Control and Prevention, in the United States, 2-10% of pregnant women are affected by GD. A mother can develop GD for the first time during pregnancy or may have had underlying blood sugar issues before pregnancy that went unnoticed. As a result, blood sugar levels for women with Gestational Diabetes are typically higher than they should be during pregnancy.
★ WHAT CAUSES GESTATIONAL DIABETES?
The body produces higher levels of pregnancy hormones, such as insulin, and goes through other changes like weight gain during pregnancy. These changes cause your body to become insulin resistant, which leads your cells to use insulin less effectively, altering natural insulin production. Insulin helps with blood sugar management and keeps blood sugar levels within the normal range.
What causes the development of pregnancy diabetes is the body not making enough insulin to maintain normal blood sugar levels, leading to having too much sugar in the blood. Often many pregnant women have some insulin resistance during late pregnancy. Women who have insulin resistance before pregnancy are more likely to have gestational diabetes due to the increased need for insulin from the start of gestation.
★ WHAT ARE THE RISK FACTORS FOR GESTATIONAL DIABETES?
It is important to remember that GD pregnancy can develop in women regardless of any potential risk factors, and there is no surefire plan on how to avoid Gestational Diabetes. Many risks of Gestational Diabetes are similar to those associated with Type 2 diabetes. For example, you are at risk for developing GD if:
- You have a family history of Type 2 or prediabetes.
- Your mother had gestational diabetes when pregnant with you.
- You have a family history of having large babies.
- You are overweight or obese before conception.
- You have PCOS (polycystic ovarian syndrome)
- You're older than the age 25
- You are African American, Native American, Asian, Hispanic, or Pacific Islander.
★ WHAT ARE THE SIGNS AND SYMPTOMS OF GESTATIONAL DIABETES?
Typically, most women do not experience any Gestational Diabetes symptoms, and because there are no warning signs of Gestational Diabetes, the importance of testing routinely is that much more significant.
However, possible GD signs and symptoms include:
Sugar in the urine
Frequent bladder, vaginal, and skin infections
You should contact your doctor if you’re experiencing new or unusual symptoms during pregnancy. Your healthcare provider may be able to determine if you have developed Gestational Diabetes or any condition.
★ HOW IS GESTATIONAL DIABETES DIAGNOSED?
A glucose tolerance test is usually administered at 24 to 28 weeks of pregnancy. During this standard gestational diabetes test, a sugary drink is given to pregnant mothers, and following consumption, their blood sugar levels are measured and screened. Alternatively, some women may opt to have an A1C test done instead during their first trimester.
A hemoglobin A1C test is a simple blood sample that measures your average blood sugar levels for the past couple of months. It is essentially a reflection of your pre-pregnancy blood sugar levels. This test can help diagnose or help rule out type 2 diabetes or prediabetes. If your blood sugar is in the prediabetic range, you will likely fail the glucose tolerance test and experience diabetes during pregnancy.
The challenge with this test is that it will not be as reliable if given during the later stages of pregnancy and may alter the Gestational Diabetes test results. Therefore, this test only serves as a helpful GD screening option during the early stages of pregnancy.
★ HOW DOES GESTATIONAL DIABETES AFFECT THE MOTHER?
High blood sugar can predispose both mom and baby to many issues during pregnancy, and Gestational Diabetes causes several consequences, including:
High Blood Pressure: high blood sugar and high blood pressure often go hand in hand. High blood pressure predisposes the mother to preeclampsia, a dangerous condition that can lead to severe or fatal complications for mother and baby.
Cesarean birth: Having a C-section delivery is much higher if you have Gestational Diabetes.
Large Birth Weight: High blood sugar can influence the baby's development and is a risk for macrosomia, which occurs when the baby grows too large (more than 9 pounds).
Early (preterm) birth. The risk of early delivery before the due date is higher for mothers with GD. Also, if the baby is large, an earlier birth may be recommended. Therefore, the average week of delivery with Gestational Diabetes may be earlier than usual.
Shoulder Dystocia: This often happens when a baby is very large, and their shoulders become stuck inside the pelvis during labor. This Gestational Diabetes complication can lead to heavy bleeding postpartum.
Future diabetes. You will most likely get gestational diabetes in future pregnancies after having it during a past pregnancy.
★ HOW DOES GESTATIONAL DIABETES AFFECT THE BABY?
High blood sugar can affect the baby in several ways. Such as:
Birth Defects and Malformations: Elevated blood sugar, even mild levels, increases the risk of neural tube defects and congenital heart defects.
Obesity and Type 2 diabetes: Higher blood sugar levels throughout pregnancy will deliver more fuel to the baby. As a result, they tend to have a higher percentage of body fat than usual. Additionally, elevated blood sugar may impair pancreatic development, so consequently, babies are at risk for developing obesity and type 2 diabetes later in life.
It is important to remember that maternal blood sugar passes to the baby, but maternal Gestational Diabetes insulin does not. Therefore, when exposed to higher blood sugar levels, the baby releases extra insulin. Their pancreas grows larger than average and becomes accustomed to secreting large amounts of insulin, resulting in higher fat accumulation.
Hypoglycemia: The baby’s sugar supply is cut off once the umbilical cord is severed after birth. Since they are already primed to produce extra insulin, the sudden stop to their mother's streamline of sugar supply can cause them to become hypoglycemic.
Breathing Difficulties: Babies born to mothers with GD may experience breathing problems, including respiratory distress syndrome (RDS).
Jaundice: When a baby's liver is not fully developed or does not work correctly, their eyes and skin may appear yellow.
★ HOW TO TREAT GESTATIONAL DIABETES AND PREVENT GESTATIONAL DIABETES IN THE FUTURE?
Working with your provider to monitor and control your blood sugars is critical for GD management. Additionally, adopting a lifestyle consisting of healthy foods and regular exercise will help lower your risk of developing type 2 diabetes. It also helps you sustain a healthy weight and prevents Gestational Diabetes. Combining all the above is the best Gestational Diabetes treatment for a healthy pregnancy and healthy baby.
Managing Blood Sugar: Working with your health care team will help you understand how to check your blood sugar and how often. They will also help you know what normal glucose levels in pregnancy should be and how to control them. In addition, they may provide you with a Gestational Diabetes sugar levels chart, which can be a valuable resource to reference throughout your GD pregnancy.
Exercise: Incorporating physical activity into your daily routine helps combat insulin resistance. Aim to be active for 30 minutes 5 days a week to help control blood sugar.
Nutrition: It is imperative for mothers with GD to understand the foods that raise blood sugar, such as foods higher in carbohydrates, particularly refined and processed carbs.
Furthermore, consuming a good prenatal vitamin is essential for promoting the health of mothers and their babies before, during, and after pregnancy. An excellent over-the-counter option is The Feed Mom and Me Prenatal Vitamin, rich in key nutrients like methyl folate and omega 3 fats to help nourish mom and baby. Additional supplements for mothers with GD include L-carnitine to support the body's utilization of food for energy, and Myo-inositol, which aids with insulin sensitivity.
★ GESTATIONAL DIABETES FOOD LIST
Making healthy choices like choosing nutrient-dense foods that help nourish you will assist with blood sugar management. A complete meal composed of good healthy fats, proteins, and fiber will help to keep your blood sugar stable. Consuming too many carbohydrates can lead to spikes in your blood sugar.
Working with a credible Registered Dietitian can assist you with lowering the glycemic impact of your dietary habits. They can provide you with an individualized Gestational Diabetes diet consisting of meals and snacks for Gestational Diabetes and ultimately guide you towards a healthier lifestyle.
Here is a list of some foods to eat with gestational diabetes:
Healthy Fats such as avocado, seeds, olive oil, nuts, and nut butters (almond, peanut butter, etc.)
Proteins such as chicken breast, fish, turkey, and eggs.
Non-Starchy Vegetables such as broccoli, carrots, celery sticks, cucumbers, green beans, peppers, salad greens, and spinach.
Complex Carbohydrates such as brown rice, greek yogurt, steel oats, sweet potatoes, whole-wheat bread.
Low-glycemic fruits such as blueberries, raspberries, strawberries.
Citrus Fruits such as grapefruits, oranges and tangerines. When drinking fruit juices, opt for ones without added sugar.
★ DOES GD GO AWAY AFTER PREGNANCY?
If you have blood sugar issues during pregnancy, there is a high chance you'll have blood sugar issues later in life, usually within the first 5-10 years after pregnancy. However, mothers with prenatal diabetes should refrain from feeling discouraged by a Gestational Diabetes diagnosis. View this as an opportunity to implement healthier lifestyle changes to reduce the risk of developing type 2 diabetes later in life
- Blood Sugar & Carbohydrates (clevelandclinic.org)
- Is Celery Good or Bad for Diabetics? - Diabetes Self Caring
- Gestational diabetes diet: MedlinePlus Medical Encyclopedia
- Diabetes and pregnancy — Gestational diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/diabetes-gestational.html.
- American Diabetes Association. Standards of medical care in diabetes — 2020. Diabetes Care. 2020; doi:10.2337/dc20-SINT.
- Gestational diabetes. (n.d.). Retrieved March 15, 2022, from https://www.marchofdimes.org/complications/gestational-diabetes.aspx
- Mayo Foundation for Medical Education and Research. (2020, August 26). Gestational diabetes. Mayo Clinic. Retrieved March 15, 2022, from https://www.mayoclinic.org/diseases-
- Gestational diabetes. ACOG. (n.d.). Retrieved March 15, 2022, from
- Products. feedmomandme. (n.d.). Retrieved March 15, 2022, from