You don’t know what gestational diabetes or, more precisely, gestational diabetes mellitus (GDM) is? Are you looking to understand how you can help change your diet? Read on to find out how to find the answers, learn practical tips for improving your diet, how to reduce your risk of developing type 2 diabetes, and how to improve your sugar levels with food.
What is gestational diabetes mellitus?
Gestational diabetes is a high blood sugar (glucose) level that develops during pregnancy and, in most women, improves after giving birth. Less than one in five women are affected by GDM.
Although it can occur at any stage of pregnancy, it is more common during the second and third trimesters.
Gestational diabetes occurs when your body is unable to produce enough insulin (a hormone that controls blood sugar levels) to meet your extra needs during pregnancy.
Although it is possible to improve your sugar levels with food, for some people this is not enough and medication is necessary.
Who is at risk for gestational diabetes?
Although any woman can develop GDM during pregnancy, you are at greater risk if:
- your body mass index (BMI) is > 30
- you had GDM in a previous pregnancy
- one of your parents or siblings is diabetic
- you have ever had a baby who weighed 4.5 kg (10 lb) or more at birth
- you are of black, Afro-Caribbean, Middle Eastern or South Asian descent, regardless of where you were born.
If any of these apply to you, discuss screening for GDM with your midwife.
Symptoms of gestational diabetes
For most women, GDM does not cause any symptoms, making screening important to test your blood sugar and diagnose GDM.
However, some women may experience symptoms if their blood sugar gets too high (hyperglycemia), such as:
- feel tired
- increased thirst and drinking more alcohol than usual (polydipsia)
- need to urinate more often (polyuria)
- a dry mouth
Even during a normal pregnancy, some women experience some of these symptoms, which are not necessarily a sign of GDM. Therefore, if you are concerned about the symptoms you are experiencing, it is best to speak to your midwife or doctor.
GDM Screening
Your midwife or doctor will ask you questions to determine your risk of developing GDM at your first appointment (also called a check-in appointment). If you are at increased risk, you will be offered an oral glucose tolerance test (OGTT), which takes approximately 2 hours.
This involves having a fasting blood sugar level, meaning you have not eaten or drunk anything for 8 to 10 hours. Then after a glucose drink in the hospital, another blood sample is taken two hours later.
How does gestational diabetes affect pregnancies
While most women with GDM have otherwise healthy pregnancies, for some women, GDM can cause problems such as:
- your baby is gaining more weight than usual (macrosomy). This can increase the risk that your baby will get stuck and require an instrumental delivery or cesarean section.
- too much amniotic fluid (polyhydramnios), which can cause premature labor or problems with delivery
- premature birth before the 37th week of pregnancy
- high blood pressure (pre-eclampsia) which can lead to other significant complications if left untreated
- increased risk of your baby developing jaundice which may require treatment
- rarely, the loss of your baby (stillborn).
Change your diet and lifestyle
To protect your baby and your long-term health, it is important to keep your blood sugar level stable between 4 and 7 mmol. Changing your diet to make healthier choices and making sure you exercise regularly will help you achieve a healthy weight and keep your blood sugar levels within the normal range.
During the first two trimesters of your pregnancy, you don’t need any extra calories. Instead, be wary of the “eating for two” myth, as this can affect your portion sizes and blood sugar levels. During the third trimester, you may need an extra 200 calories per day, which is the equivalent of a small yogurt or half a sandwich.
How to Improve Your Sugar Levels with Food
Many people find that reducing sugary foods and portion control can play an important role in controlling your blood sugar levels.
Ultimately, the best way to achieve a healthy weight is through regular exercise and a healthy diet that follows these principles:
- eat lots of different colored fruits and vegetables (50% of your plate)
- choose whole grains (bulgur, teff, millet, brown rice, brown bread) (25% of your plate – or the size of your fist)
- choose lean or plant-based proteins (25% of your plate)
- eat a handful of nuts a day and add seeds to your diet
- drink water
- eat fatty fish once a week
- Enjoy healthy unsaturated fats such as avocados, canola and extra virgin olive oils.
- Help your microbiome thrive by eating 30g of fiber per day and fermented foods, like kimchi and kefir.
All carbohydrates affect your blood sugar, but healthier whole carbohydrates break down more slowly (low glycemic index) and therefore have less impact on your blood sugar.
Over the course of a day, try to have the following:
- at least 5 servings of a variety of fruits and vegetables (one serving is the size of your palm)
- 2 servings of lean non-dairy protein such as
- 60-90g (size of a pack of cards) cooked lean meat
- 140g cooked fatty fish (palm-sized) – aim for 1 serving per week
- 140 g cooked fish (palm-sized)
- 2 eggs
- 4 tablespoons / 100g tofu
- 1 tbsp/30g nuts or nut butter
- 4 heaped tablespoons / 150 g cooked legumes and beans
- 1 serving of complete carbohydrates with each meal
- 1 slice of bread
- 2-3 tablespoons cooked pasta
- 2-3 tablespoons of cooked rice
- 1 medium baked potato with skin
- 2 egg-sized new potatoes (boiled)
- 3 tablespoons of oatmeal
- 3 servings of dairy products or calcium-rich foods per day
- 1 glass of milk or unsweetened enriched plant-based alternative (200 ml)
- 1 small pot of yogurt or enriched unsweetened plant-based alternative (125 mg)
- 1 piece of hard cheese the size of a matchbox (30 g) or 2 pieces of soft cheese the size of a matchbox (80 g)
Try to choose:
- healthy unsaturated fats like olive oil, canola oil or avocado oil instead of saturated fats like butter
- lean protein sources such as plant sources, fish or poultry instead of red meat
- water instead of sugary drinks and dilute fruit juice 1:10 in water
- fruit like a desert
Try to avoid:
- sugar in hot drinks
- energy drinks
- processed foods like cakes, chocolates, ice creams and cookies.
- Sugar can be added to foods in a variety of formats, so know what to look for and avoid
- glucose
- sucrose
- dextrose
- fructose
- lactose
- maltose
- Honey
- invert sugar
- syrup
- corn sweetener
- molasses
- fried foods, try poaching, steaming or grilling them instead.
- Low-fat foods often contain sugar to make them tastier, which is more likely to affect your blood sugar.
You will be closely monitored during pregnancy and delivery, and if your blood sugar level does not return to the normal range due to changes in your diet, you may also need medication.
How Exercise Can Help Gestational Diabetes
If you’re already active during your pregnancy, you can safely maintain your exercise levels, but try not to do more than before. If you are able to exercise, try to help control GDM and reduce your future risk of type 2 diabetes by doing:
- 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity
- 2 sessions of bodybuilding or muscle strengthening exercises.
Summary of Gestational Diabetes
I hope this article helped you understand what gestational diabetes is and how to improve your sugar levels with food. Making these changes can also help reduce your long-term risk of type 2 diabetes.
For more information on what to eat while pregnant, download my free pregnancy meal planner and nutrition checklist and check out my book “Eating While Pregnant.”