OK, you have been diagnosed with gestational diabetes. Don’t panic, get informed. The numbers are significant, and warrant attention. According to the Center for Disease Control and Prevention, the prevalence may be as high as 9.2 percent of pregnancies, and is higher in women of minority groups, women of Hispanic, African, Asian, Native American, and Pacific Island ancestry.
The good news is that most women with gestational diabetes go on to have a successful pregnancy and to deliver a healthy baby. Remember if ever there is a time to be informed about and follow a healthy diet this is that time. The mother’s health and the baby’s normal development depend on it!
So what is gestational diabetes? According to the NIH - National Institute of Diabetes and Digestive and Kidney Diseases, it is a type of diabetes that develops only during pregnancy and usually disappears after delivery. Screening for occurrence for women without known risk is recommended between 24-28 weeks of pregnancy. Where there is clear risk, screening should be at the first prenatal doctor visit.
Focus for mother and baby when gestational diabetes is diagnosed is consistent, carefully management of blood sugars. Uncontrolled blood sugar levels heighten problems during the gestation term for mother and baby. Increased probability of a C-section delivery and even fetal death either before or shortly after birth are extreme complications of gestational diabetes.
Specific pregnancy concerns and complications in gestational diabetes for the baby include: excessive growth and high birth weight, respiratory distress, low blood sugar and seizures immediately after delivery, and a higher risk of developing obesity and type 2 diabetes later in life.
For the mother health issues can include high blood pressure and preeclampsia, and development of diabetes in the future. A healthy diet, appropriate weight gain (as recommended by the PCP) and moderate exercise significantly decreases pregnancy risks. Achieving normal body weight after delivery with consistent exercise decreases lifetime risks.
So let’s get to it, what’s to be done to avoid non-desirable outcomes and have the best pregnancy and delivery possible? General recommendations for managing gestational diabetes (G.D.) and successful delivery are good meal planning, adequate physical activity, and, in some cases, medication and blood sugar monitoring to support controlled blood sugar.
It is important to be meet with a registered dietitian to have nutritional needs assessed and a personalized meal plan designed. This should include calculating the amount of carbohydrates needed at meals and snacks, and instruction on how to count carbohydrates. Carbohydrate counting is of significant importance to controll blood sugar, as carbohydrates raise blood sugar rapidly. Additionally, the meal plan should be well-balanced, with consistent meal and snack timing. Include a variety of nutrients, limit caffeine and avoid alcohol all together. It is well intended to repeat that normalizing blood sugar in pregnancy and controlling weight gain improves maternal and fetal outcomes.
Individualized meal plan strategies should at least distribute one’s food intake between three meals and often include two or three snacks each day. Overeating at one time can cause blood sugar spikes and skipping meals can lead to uncomfortable lows and inconsistent nutrient resources for mom and baby. Balancing food groups at each meal/snack supports more consistent blood sugar. Carbohydrate foods are found in the bread and starch group, the fruit group (high in natural sugars but better than juices because they are high in fiber), and even in milk (high in calcium). Portion control is paramount.
Breakfast still the most important meal of the day! Blood sugar can be difficult to control in the morning, when normal fluctuations in hormone levels occur. Refined cereals mean lots of carbohydrate and along with fruits and milk may result in post-breakfast blood sugar level increases. A better outcome is achieved when breakfast includes carbohydrate plus protein, and it is often better tolerated.
All meals and snacks should strictly limit sweets and desserts! Cakes, cookies, candies and pastries tend to have excessive amounts of carbohydrates. These foods often contain large amounts of fat and offer very little in terms of nutrition. Additionally, avoid all regular sodas and sugar-sweetened beverages.
Read food labels to identify less obvious names for sugars added to foods including but not limited to: Honey or syrup, raw sugar, barley malt, beet sugar, brown sugar, sucrose, buttered syrup, cane-juice crystals, cane sugar, caramel, carob syrup, corn syrup, corn syrup solids, date sugar, dextran, dextrose, fructose, high fructose corn syrup, glucose, invert sugar, malt syrup, molasses, malto-dextrin, and turbinado sugar. Consult with your dietitian regarding the use of artificial sweeteners.
Gestational diabetes is seemingly a woman’s issue but it is more! The circumstances and outcomes of one’s pregnancy affect everyone in the family and ultimately the total society. Healthy babies contribute to the well being of the society so healthy management of gestational diabetes is important to us all.
As always, for the health of it…
Melanie Ajanwachuku, B.S., R.D.N., CDE, is a Medical Nutrition Therapy Consultant serving the High Desert.