Gestational diabetes (GDM) usually happens in the second half of pregnancy. It is a type of diabetes that occurs in women while they are pregnant who didn’t have diabetes beforehand. What this means is women have elevated blood sugar levels while they are pregnant. While we don’t really know the exact cause of gestational diabetes, it’s thought that hormones play a major role. During pregnancy, your placenta makes hormones that cause glucose to build up in your blood. Usually, your pancreas can send out enough insulin to handle it. But if your body can’t make enough insulin or stops using insulin as it should, your blood sugar levels rise, and you get gestational diabetes.
Gestational diabetes happens only during pregnancy because once you get rid of your placenta after birth, gestational diabetes generally goes away. It is possible to develop gestational diabetes in the first pregnancy or to find out about it because one already has diabetes that hasn’t been detected before. The body becomes slightly resistant to insulin to provide the fetus with more glucose. In some cases, the body becomes unresponsive to it or produces it in negligible quantities. When this happens, Gestational Diabetes occurs.
Women with gestational diabetes usually don’t have symptoms. Most find out that they have it during a routine screening.
You may notice that:
You’re thirstier than usual
You’re hungrier and eat more than usual
You pee more than usual
You’re more likely to get gestational diabetes if you:
Were overweight before you got pregnant
Are African-American, Asian, Hispanic, Alaska Native, Pacific Islander, or Native American
Have blood sugar levels that are higher than they should be but not high enough to be diabetes (this is called prediabetes)
Have a family member with diabetes
Have had gestational diabetes before
Have polycystic ovary syndrome (PCOS) or another health condition linked to problems with insulin
Have high blood pressure, high cholesterol, heart disease, or other medical complications
Have given birth to a large baby (weighing more than 9 pounds)
Have had a miscarriage
Have given birth to a baby who was stillborn or had certain birth defects
Are older than 25
The American Diabetes Association recommends these targets for pregnant women who test their blood sugar:
Before a meal: 95 mg/dL or less
An hour after a meal: 140 mg/dL or less
Two hours after a meal: 120 mg/dL or less
There are two classes of gestational diabetes. Women with class A1 can manage it through diet and exercise. Those who have class A2 need to take insulin or other medications.
If you find yourself diagnosed with gestational diabetes, first and foremost don’t panic. It’s totally common and nothing to stress about! It’s definitely best to speak with your doctor and work with a dietician who specializes in GDM management too. And remember that usually it can be managed through lifestyle changes and diet alone! Sometimes medication is necessary, but that will be determined by your doctor and dietician based on your blood glucose monitoring.
The best diet for managing diabetes is one that includes whole grains, lean protein, healthy fats, fresh fruit, and vegetables – which as you can see is not much different from an average, balanced diet! The combination of eating foods with protein, fiber (from whole grains, fruit, and vegetables), and healthy fats helps slow the breakdown of food in your stomach so glucose can be gradually released into your bloodstream, therefore avoiding a rise in blood sugar.
When people hear diabetes, I know they immediately think “I need to cut out carbs!” But I can’t stress enough how far that is from the truth. Carbs play a crucial role in our body for SO many reasons, and whole grains provide fiber, which is again needed to help slow down digestion and the release of glucose into the bloodstream.
So now you might be thinking, “Well how do I apply those components into everyday meals?” Below are some easy, balanced examples to get you started!
1 roti can be substituted with 3 tablespoons of cooked rice occasionally, preferably brown rice.
Choose wholegrain varieties where possible and include a range of millets in your diet. Popular options include finger millet (ragi), pearl millet (bajra), sorghum (jowar) and foxtail millet (kangni), and kodo millet (kodra). Your doctor or dietician can help you pick the right ones for you.
Fruit is a healthy part of any diet, although women with GD find some fruits too sugary for their bodies to tolerate. Try to pick fruits with a low glycaemic index (GI) such as apple (seb), guava (amrood), pear (nashpati), plum (aloo bukhara), sweet lime (mausambi), peach (aadoo), Indian gooseberry (amla), Indian blackberry (jamun) or papaya (papita).
Use minimal oil and fats when preparing meals. The target for a total of no more than 2-3 teaspoons per day. There's also no need to load up on ghee or other fatty foods.
Don't skip meals. Be consistent about when you eat meals and the amount of food you eat at each one. Your blood sugar will remain more stable if your food is distributed evenly throughout the day and consistently from day to day.
Limit your intake of foods and drinks that contain simple sugars such as fizzy drinks, fruit juice, flavored teas, and flavored waters, and most desserts – or avoid them altogether. These foods can quickly elevate your blood sugar. Ask your doctor about using foods sweetened with an artificial sweetener if you need a sweet fix.
Lastly, in addition to diet, physical activity plays a role in managing blood sugar levels as well. Exercising helps create insulin sensitivity, which helps your body absorb glucose better from the blood. Trust me, I know that exercise can be tough during pregnancy, and you definitely don’t have to do anything crazy. Even a 20-30 minute walk can help a lot.
Most importantly, GDM is not a reason to exclude foods from your diet or go on a crazy restrictive diet. Remember, you’re still pregnant, after all! Listen to your body, honor your hunger, and try to make your meals as balanced as possible to help you feel your best throughout the rest of your pregnancy.
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