What to Know About Gestational Diabetes

Today’s blog is going to be short and sweet (emphasis on the sweet!) as we talk about gestational diabetes and ways to manage your blood sugars before, during, and after pregnancy. 

Let’s start with a little background on gestational diabetes.

Gestational diabetes is diabetes that is diagnosed during pregnancy, in a woman who did not previously have diabetes before becoming pregnant. Gestational diabetes is characterized by abnormally high glucose, or sugar, levels in the blood. These high blood sugar levels can wreak internal havoc because glucose is circulating in the blood instead of going into and being used by the cells as it is designed to ₍₁₎.

So, why does this happen during pregnancy?

Insulin is a hormone secreted by the pancreas that normally facilitates moving glucose from the blood into the cells. In pregnancy, it is theorized that hormones produced by the placenta (estrogen, cortisol, and human placental lactogen specifically) can actually “block” insulin from functioning effectively, starting in the second trimester ₍₃₎. As the placenta grows to support the baby, more of these “contra-insulin” hormones are produced, and the risk of insulin not being able to do its job as well as it should increases. 

Why is gestational diabetes a big deal?

Diabetes, specifically during pregnancy, can affect how your baby grows and processes nutrients. 

Babies born to women with gestational diabetes tend to be larger than average (a condition known as macrosomia). This happens because babies' bodies will take extra glucose in the maternal blood and convert it to fat. This can cause babies to grow excessively large ₍₃₎. 

Gestational diabetes puts babies at risk for low magnesium and calcium levels at birth, as well as other chemical imbalances. 

It also puts babies at risk of having too low of blood glucose levels at birth. Babies’ bodies will compensate for a mother’s high blood sugar level in utero by producing more insulin to get the sugar into the baby’s cells. This poses a problem when they are born as they are no longer receiving the mother’s high-sugar blood supply via the placenta and thus may be producing more insulin than is needed. The extra insulin can lower their blood glucose levels, which warrants quick medical intervention, often via a form of glucose injected into their veins ₍₃₎. 

How can you tell if you have gestational diabetes?

Some women with gestational diabetes experience being more thirsty and having to pee more often. Others do not experience physical symptoms that point directly to gestational diabetes. This is why every woman who is pregnant and does not already have a diabetes diagnosis, gets screened for gestational diabetes between 24-28 weeks of pregnancy (sometimes earlier if the woman has additional risk factors) ₍₂₎. 

Women who develop gestational diabetes do typically return to having normal blood sugar levels after their baby and placenta are delivered. However, these women are at increased risk for developing gestational diabetes, as well as type 2 diabetes in the future, and need continued blood glucose monitoring throughout their life ₍₁₎.

What can you do about it?

Before Pregnancy:
A healthy lifestyle (how you eat and move) prior to becoming pregnant can reduce your risk of developing gestational diabetes (as well as type 2 diabetes). This includes getting regular exercise, eating a balanced diet that includes whole foods, avoiding excess sugar and refined carbohydrate intake, and maintaining a healthy weight going into your pregnancy ₍₄₎. 

During Pregnancy:
If you are diagnosed with gestational diabetes during pregnancy, there are lots of ways to properly manage your blood sugar levels. 

• Spread your food out throughout the day. Eating too much food in one sitting is more likely to spike your blood sugar levels than having smaller, more frequent meals throughout the day. It is recommended to have 3 meals, with 2-3 snacks spread out between meals each day ₍₄₎. 
• Pay attention to the type of food you are eating, specifically the amount of carbohydrates and refined sugars there are in each food. The less refined or added sugar, the better ₍₄₎. 
• Check your blood sugar regularly at home at different points throughout the day. Pay attention to blood sugar trends (example: “my blood sugar seems to be highest right after breakfast, or right after I eat a certain food.” Keep a log of this and make dietary adjustments accordingly.
•  Consider meeting with a dietician for help with meal planning and carb counting. 
• Continue to go to regular prenatal care visits with your doctor so he or she can monitor your blood glucose trends as well and recommend further adjustments or medications if needed.

After Pregnancy:
Typically gestational diabetes resolves after a woman delivers her baby, however having a history of gestational diabetes puts you at increased risk for type 2 diabetes later in your life ₍₁₎. It is important to continue to maintain a healthy lifestyle, monitor blood glucose levels, and see a doctor for regular follow up.



Have more questions about pregnancy? Need help setting up OB/GYN care? We can help with that! Call us today at 770-222-6911 or contact us here.

*The information contained in this blog is for educational and informative purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice and care of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.*

Sources:
(1) Gestational Diabetes - Symptoms & Causes - Mayo Clinic
(2) Gestational Diabetes - Diagnosis & Treatment - Mayo Clinic
(3) Gestational Diabetes Mellitus (GDM) | Johns Hopkins Medicine
(4) Dietary Recommendations for Gestational Diabetes | UCSF Health