An educational overview of gestational diabetes, plus 4 tips to manage it without medication.
Disclaimer: This is intended for educational purposes only, not medical advice. Any questions or concerns should be addressed directly with your medical provider.
What is Gestational Diabetes and What Causes It?
Gestational diabetes is a condition diagnosed during pregnancy (gestation) and affects how the body processes sugar (diabetes).
A woman with gestational diabetes will present with high blood sugar, also referred to as hyperglycemia, that if left untreated can impact the woman’s health and the health of her baby.
Insulin is a hormone made by the pancreas and its function is to regulate the amount of glucose in the blood.
Insulin allows glucose to enter the cells to provide energy to the body.
During pregnancy, the placenta produces an increased amount of hormones that can block the effects of insulin, called the contra-insulin effect.
This usually begins in the second trimester of pregnancy around 20-24 weeks.
In normal cases, the pancreas can pump out extra insulin to help reduce glucose in the bloodstream.
Once the pancreas is no longer able to keep up with the demand for insulin to overpower the effects of pregnancy hormones, free-flowing glucose builds up in the bloodstream.
An increased amount of glucose in the bloodstream results in gestational diabetes.
What are the symptoms of Gestational Diabetes?
In most cases, a woman with gestational diabetes will not show any symptoms which is why it is important to receive prenatal care and take a glucose tolerance test with your OBGYN office.
With gestational diabetes, it is possible to have increased thirst and more frequent urination but it is difficult to distinguish these symptoms from general pregnancy symptoms.
Is Gestational Diabetes preventable?
In many cases, gestational diabetes cannot be completely prevented but there are things you can do to reduce your chances of having it.
Adopting healthy lifestyle habits before becoming pregnant like eating balanced meals, exercising regularly, and maintaining a healthy body weight can lower the risk of being diagnosed with gestational diabetes.
Risk factors that make someone more susceptible to this condition may include being overweight/obese, being pre-diabetic before pregnancy, having gestational diabetes in a previous pregnancy, family history of diabetes, or having a related medical condition like PCOS (polycystic ovary syndrome).
If you have any of these risk factors, discuss them with your healthcare provider early in pregnancy so they can determine the best way to proceed with your prenatal care.
How is Gestational Diabetes diagnosed?
The Glucose Tolerance Test
The glucose tolerance test is typically conducted in the second trimester of pregnancy between 24 and 28 weeks gestation.
Your doctor may want to conduct this test sooner if you are at risk for gestational diabetes.
The glucose tolerance test will demonstrate how the body responds to sugar (also known as glucose) and will determine any irregularities.
This test will be conducted in your doctor’s office and can take 1-3 hours.
It is recommended to fast for 8 hours before the test so try to schedule this test first thing in the morning!
Upon arrival at your doctor’s office, you will have your first blood draw to measure your fasting blood sugar levels.
You will then drink a glucose solution and have your blood drawn again after about an hour to see how your body is handling the sugar you just consumed.
The glucose solution provided by your doctor’s office is an 8-ounce (237 milliliters) bottle of liquid containing 3.5 ounces (100 grams) of sugar.
Some offices carry different flavors like grape, orange, fruit punch, etc, and it tastes like a sweet, syrupy sports drink.
Understanding the Results
Blood sugar is measured in milligrams per deciliter (mg/dl) or millimoles per liter (mmol/L).
The ranges described below are sourced from the Mayo Clinic but your doctor’s office may have different numbers they consider normal and abnormal.
The normal, fasting blood sugar range is between 70-100 mg/dl. If blood sugar levels are higher than 140 mg/dl after the 1-hour test, you will likely be asked to return another day for a 3-hour glucose tolerance test.
If blood sugar levels are over 190 mg/dl after the 1-hour test, you will be diagnosed with gestational diabetes without needing to complete the 3-hour glucose tolerance test.
The 3-hour glucose tolerance test is essentially the same as the test described above but instead of having your blood drawn one hour after drinking the glucose solution, you will have your blood drawn one, two, and three hours after drinking the solution.
This test will provide more extensive data detailing how your body is processing the high sugar content.
The normal blood glucose levels for the 3-hour test are as follows:
|Fasting||below 95 mg/dL (5.3 mmol/L)|
|After 1 Hour||below 180 mg/dL (10 mmol/L)|
|After 2 Hours||below 155 mg/dL (8.6 mmol/L)|
|After 3 Hours||below 140 mg/dL (7.8 mmol/L)|
If one of your blood sugar levels reads higher than the levels listed above, you may be asked to repeat the test another day.
If two or more of your levels read higher than the levels listed above, you will be diagnosed with gestational diabetes.
Are there any risks associated with the glucose tolerance test?
The glucose tolerance test is generally safe but you could experience headaches, lightheadedness, or nausea after the test due to the high sugar content consumed.
Think about it like eating a bunch of sugary treats, you may experience a sugar crash later in the day!
Try to eat a high-protein snack after the test and drink plenty of water throughout the day to help reduce these symptoms.
Do you have trouble drinking enough water? Check out this blog, 5 Tips to Help You Drink More Water.
Can Gestational Diabetes Affect My Baby?
A baby whose mom is diagnosed with gestational diabetes may be at higher risk for different health problems.
Some include various chemical imbalances but the main two health issues for babies affected by gestational diabetes are high birth weight and low blood sugar after delivery.
High birth weight is also described as macrosomia. Babies receive all their nutrients from their mom’s blood so if a mom has gestational diabetes, her baby is receiving glucose-rich blood.
The baby’s excess glucose is converted into and stored as fat which causes the baby to grow larger.
Moms delivering a large baby may encounter complications during birth such as difficult labor, vaginal tears, and an increased risk of needing a cesarean delivery.
Due to their size, larger babies are also at a higher risk of shoulder dystocia, a term used to describe the baby’s shoulders getting stuck in the mom’s pelvis during delivery.
Low blood sugar is also described as hypoglycemia.
If a baby’s mom has gestational diabetes, it can cause the baby to have low blood sugar at birth.
This is because the mom has excess glucose in her blood and that blood is being transported to the baby in the womb.
The baby’s pancreas will then start producing more insulin to combat the high blood glucose coming from the mom.
Once the baby is born and is no longer receiving the mom’s blood supply but is still producing extra insulin, the extra insulin can process too much glucose in the baby’s bloodstream leading to hypoglycemia.
During labor, the medical staff may need to administer an insulin injection to keep the mom’s blood sugar levels in a normal range to help prevent the baby’s blood sugar from dropping too low after delivery.
The newborn baby will have periodic blood draws after birth to monitor their blood sugar levels.
Babies born with excess insulin in their system may also be at risk for obesity and developing type 2 diabetes as adults.
Help! I Just Got Diagnosed with Gestational Diabetes.
According to Diabetes Canada and this 2019 medical journal, 3% to 20% of pregnancies experience gestational diabetes every year so know you are not alone.
Although gestational diabetes is considered a pregnancy complication and should be taken seriously, you don’t need to worry too much because there are many ways to manage it.
A healthy diet, moderate exercise, and only gaining the recommended weight for pregnancy can help keep high blood glucose levels under control.
Medication to control gestational diabetes like metformin or injectable insulin is also an option if needed.
Will Gestational Diabetes Last After Giving Birth?
In many cases, gestational diabetes will go away after giving birth.
Your doctor may recommend continued monitoring of blood sugar even after delivery to ensure your blood sugar levels return to normal.
Your doctor may also recommend additional blood sugar tests 6 to 12 weeks after delivery because having gestational diabetes can increase your risk of developing Type 2 diabetes after pregnancy.
4 Tips to Help Manage Gestational Diabetes Without Medication
Here are 4 tips to help you manage gestational diabetes without medication. Please talk to your healthcare provider or registered dietician before making any significant diet changes.
Eat balanced meals and avoid skipping meals:
When preparing your plate for each meal, use this formula as a guideline: half your plate non-starchy vegetables, a quarter of your plate lean protein, and a quarter of your plate whole grains.
Try to eat three balanced meals and two to three snacks a day. Spacing out your meals and snacks evenly throughout the day will help stabilize your blood sugar levels and prevent blood sugar spikes after eating.
Eating Bird Food is a great resource of healthy recipes for meals, snacks, and drinks!
Meet with a registered dietician if you need more guidance.
Incorporating vinegar into your diet lowers the glycemic load of your foods.
It may sound a little crazy but vinegar can be a powerhouse against blood sugar spikes.
The acetic acid in vinegar slows the metabolism of starches into glucose and signals the muscles to absorb glucose as it appears in the bloodstream therefore lowering the blood sugar spikes after eating.
The most popular method of adding vinegar to your diet is drinking a 1 tablespoon of vinegar (pasteurized apple cider vinegar, wine vinegar, rice vinegar, coconut vinegar) diluted in a glass of water before each meal.
For more information about how vinegar helps manage blood sugar levels and vinegar drink ideas, take a look at How to use vinegar to manage blood sugar: the ultimate 2022 guide by Jessie Inchauspé, founder of the Glucose Goddess movement.
If you’re going to have something sweet, pair it with protein.
Pairing a sugary dessert or drink with protein can reduce the glycemic index by slowing down the blood sugar spike, allowing the body to process the sugar efficiently.
For example, if you are eating a sweet pastry for breakfast, pair it with eggs or bacon for extra protein.
Add light to moderate exercise to your daily routine.
If you do not regularly exercise, try adding a light walk to your daily routine. Increase your pace and distance over time to build stamina. Once you feel comfortable and have permission from your doctor, add strength training exercises at least twice a week. Aim for about 30 minutes of exercise at least 5 days a week.
Gestational diabetes is considered a pregnancy complication and if left untreated, can lead to health problems for mom and baby.
With lifestyle changes, a healthier diet, more exercise, and using these helpful tips, gestational diabetes can be managed without medication and you can carry on with a smooth pregnancy and delivery.
Though you will no longer have gestational diabetes after giving birth, you will want to continue making healthier lifestyle changes to reduce your risk of developing gestational diabetes with a future pregnancy and reduce your risk of developing Type 2 diabetes.
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