Gestational Diabetes
Gestational diabetes affects 7-14% of all pregnant women. There is conflicting information about how to test, monitor and treat this disease. However, by adjusting your gestational diabetes diet and activity levels you can control the disease.
What is the definition of gestation?
Gestation is the period of development of a baby in the mother’s uterus. During gestation, the mother can develop diabetes, known as gestational diabetes.
This article contains all the information you need to know about gestational diabetes including gestational diabetes diet recommendations. If you are interested in learning more about proper nutrition during pregnancy, read this article on Prenatal Nutrition.
What is diabetes?
Diabetes is a metabolic nutritional disorder characterized by an abnormally high level of blood glucose (blood sugar) and the excretion of the excess glucose in the urine. These high levels of blood glucose lead to difficulties with carbohydrate metabolism.
What is carbohydrate metabolism?
When carbohydrates are metabolized, the body breaks down the starches you eat and converts them to glucose, a simple sugar. Glucose is the primary nourishment for cells and for generating energy. Pancreatic cells regulate the use of glucose functions as a gatekeeper, which allows or denies glucose access to the cells. When glucose enters the cells, it combines with oxygen to create carbon dioxide and water. Energy is released during this process. The energy is used for maintaining body temperature and taking care of nerve tissue, especially in the brain.
How is carbohydrate metabolism different during pregnancy?
When you are pregnant your body changes how it metabolizes carbohydrates, fats, ketones and proteins. This is to ensure that the developing baby gets proper nutrition. The placenta, the hormones, and the mother’s body fat reserves suppress insulin. As your pregnancy progresses, your pancreas generates more insulin to compensate. This allows sugars to stay in your bloodstream for long periods of time, which keeps them available for your baby’s growth and development. This process peaks during the last trimester, when your baby is putting on weight and needs support for all of that growth.
All of these changes result in your glucose levels, after a meal, measuring the same or higher than non-pregnant women. Fasting glucose levels also rise as your pregnancy progresses. This is all normal and healthy, and the placenta regulates glucose delivery to your baby.
However, this sophisticated system does not work when your insulin-producing cells are damaged. Your pancreas will resist the entry of insulin i.e. insulin resistance. The cells throughout your body will starve from the lack of nourishment, leading to organ failure in the mother and complications for the baby, if left untreated.
What is gestational diabetes?
Gestational diabetes includes:
- All diabetic diagnoses established after conception.
- Transient impaired glucose regulation
- No longstanding diabetes damage to the maternal blood vessels or kidneys
What are the symptoms of gestational diabetes?
General symptoms of gestational diabetes include fatigue, frequent urination, excessive thirst, blurry vision, low blood volume, ketoacidosis (an accumulation of ketones in the body).
What are the factors that increase my likelihood to develop gestational diabetes?
Factors that increase your risk for gestational diabetes are obesity, having too much amniotic fluid, a family history of diabetes, previously having given birth to a very large baby, having had a stillbirth or a child with a birth defect. Women over twenty-five, women with a history of alcoholism, with an eating disorder or a nutritional deficit, as well as women who do not exercise regularly are also at increased risk of developing gestational diabetes.
What are the risks to the developing baby?
Babies of diabetic women can grow larger. When the mother’s blood has too much glucose, the baby’s pancreas produces more insulin in an attempt to use the glucose. The baby then converts the extra glucose to fat. The combination of high blood glucose levels from the mother and high insulin levels in the baby result in large deposits of fat in the baby, causing the baby to grow larger, especially in the face and shoulders.
The biggest risk to babies of mothers with gestational diabetes are those associated with larger babies and include should dystocias and risks associated with surgical deliveries. Additionally, there is an increased risk for premature rupture of membranes and breech positioning. Also, extreme levels of blood sugar (low or high) in early pregnancy can result in malformations or miscarriage. Undiagnosed, untreated gestational diabetes can lead to kidney malfunctions which can result in complications for the developing baby.
What are the gestational diabetes risks to the newborn?
When untreated and uncontrolled, high blood glucose in the mother will produce high insulin levels in the baby during labor. This can cause the baby’s blood glucose levels in the baby to plummet immediately after delivery. If this condition is not corrected immediately, the baby can develop tremors, respiratory distress, listlessness, abnormal crying, feeding difficulties, possible convulsions and/or potential brain damage. Babies of diabetic mothers can also be born with chemical imbalances such as low serum calcium or magnesium levels.
What can a gestational diabetes mother do to reduce the risks to her newborn?
Early and frequent breastfeeding balances out and prevents low blood sugar in your baby. In a hospital, treatment for babies with low blood sugar ranges from a 12 hour to a 24 hour stay in the NICU with baby heel pricks every half to three hours to monitor blood levels until they return to normal levels.
Does gestational diabetes disappear after birth?
Gestational diabetes tends to disappear after pregnancy. However, the likelihood of developing adult onset diabetes significantly increases in women with gestational diabetes. Mothers with gestational diabetes sometimes revert back to their previous diet and lifestyle after having “made it” through the end of the pregnancy. For this reason, it is important for expecting mothers to continue with balanced diets and exercise regimens as a lifelong commitment.
Gestational diabetes changes muscle physiology. Women with gestational diabetes who had a cesarean section have a significant increase in incontinence and decreased vaginal pressure two years post-cesarean, compared to women who were otherwise healthy but had cesarean births.
What kind of diet should I eat to prevent gestational diabetes?
Preventing diabetes through proper nutrition and regular exercise is the best approach. Making sure that the calories you take in have a high nutritional value is key. In general, to maintain steady blood sugars, you should eat small, frequent meals throughout the day. Each meal should be high in protein and chromium and contain complex carbohydrates and fiber. Incorporate vegetables, fruits, nuts and legumes in your diet. Avoid eating processed food, which is high in simple carbohydrates.
Exercising everyday is also an important preventative measure. Consider taking walks after every meal to help metabolize your food in a health way.
Here are some ideas for simple, healthy and nutritious recipes:
Good Foods for Healthy Blood Sugar Levels
In addition to making good meal and exercise choices, you can make some simple additions to your intake every day:
Jerusalem artichokes or string bean skin tea
Consider eating thinly peeled and sautéed Jerusalem artichokes or drinking a cup of tea made from string beans. Both of these introduce inulin to your blood stream. Inulin is a precursor to insulin.
Vitamin B6
Vitamin B6 plays a role in hundreds of chemical reactions in the body, including helping release glucose from cells. In addition, B6 creates amino acids, which build proteins, essential for the repair and growth of tissue. It helps the body make serotonin, norepinephrine, dopamine, and GABA – all important neurotransmitters for pregnancy and birthing. Vitamin B6 also helps with vascular health and in metabolizing food for energy. Foods rich in vitamin B6 include rice bran, sesame seeds, chickpeas, wheat bran, bananas, avocado, salmon, dark turkey meat, acorn squash, spinach and raisins.
Cinnamon
Cinnamon has hypoglycemic, antioxidant and insulin-enhancing properties.
Onions
Onions have allicin and allyl propyl disulfide, which help block sudden increases in blood sugar levels. Try adding onions to salads, and other dishes.
Broccoli
Broccoli is high in chromium, an essential mineral that facilitates the entry of glucose into the cells by working with insulin. Additionally, broccoli is high in vitamin C, folic acid, potassium, carotenoids and fiber. Eat raw or steam it lightly. Here you can find a delicious and easy recipe for Broccoli soup
Beans
Beans are high in complex carbohydrates and fiber, and they contain a high percentage of vitamins and minerals. Black beans help prevent blood sugar form rising too quickly after a meal.
Glycemic Index
Good food choices are those that have low glycemic values, offer plenty of nutrients and are low in calories. High glycemic foods quickly and significantly increase in blood sugar. While low glycemic foods release glucose slowly and steadily into the bloodstream.
Exercise
Exercise helps increase glucose uptake into the cells of muscles regardless of insulin levels.
Testing and Screening for Gestational Diabetes
There are two types of tests: the glucose challenge test (GCT) and the oral glucose tolerance test (OGTT).
The glucose challenge test (GCT) is a screen in which the mother drinks glucola, a substance which contains 50 grams of glucose. After an hour blood is then drown from the mother and her blood sugar levels are tested. If the mother’s blood sugar level is high, the mother will be asked to take the oral glucose tolerance test (OGTT).
The oral glucose tolerance test (OGTT) begins with drawing blood from the mother after a ten hour overnight fast. The mother is then given 100 grams of glucose to drink, and blood samples are taken after one, two and three hours. If two or more values are high, the mother is considered to have gestational diabetes.
There is no evidence supporting the reliability of results of the oral glucose tolerance test (OGTT). The World Health Organization has recommended not using this test as an initial diagnosis of diabetes. Consult your health provider for other alternatives you should consider, including alternative tests such as postprandial testing, HgA1c testing and fasting blood sugar tests.
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