Gestational Diabetes and What You Can Do About It

Doing the glucose fasting test is par for the course in pregnancy. While the sweet, orange liquid may not taste the best, it is best that you take the test for gestational diabetes mellitus (GDM)--one of the most common complications of pregnancy. If you’ve been told that you have GDM, you may wonder what it is and why it happens, as well as what can be done to help you and your baby have a healthy pregnancy.

Why GDM?

Your body goes through many metabolic changes as the baby grows, with levels of the hormones estrogen and progesterone rising and contributing to increased insulin levels. Somewhere around four to eight weeks into the pregnancy, your body uses more glucose and, together, these changes may result in a lower level of fasting glucose. 

With the progression of pregnancy into the second and third trimesters, even more hormones spring into action, such as cortisol, prolactin, placental lactogen, and more estrogen and progesterone which can lead to issues with insulin resistance (when your muscles, liver, and bodyfat resist the signal that insulin sends out, asking that glucose be diverted from the bloodstream so that your body’s cells can use it). It is here that your pancreas must send up to three times more insulin into the body trying to get the glucose it needs to fuel the body. For women with a predisposition to diabetes, such as overweight and obesity, this can become an issue that results in GDM, which, according to the American Diabetes Association, is experienced in up to 10% of pregnancies in the United States.

What does GDM do?

GDM puts you at increased risk of hypertensive disorders such as preeclampsia and eclampsia (serious conditions from high blood pressure that can damage organs and possibly cause seizures), as well as gestational hypertension (high blood pressure the develops in pregnancy). The baby can receive excess glucose that is then stored as fat, which can lead to problems with their shoulders at birth, and put baby at risk for breathing problems and the development of obesity and type 2 diabetes later in life. This is why it is important that you receive treatment for GDM.

What is the treatment for GDM (and how can diet and exercise help)?

The management of GDM is threefold and begins with a nutrition therapy and physical activity plan. Checking blood sugar levels is also an important part of this treatment. Diet should include a well-balanced eating plan to promote blood sugar control. Watching calories can help ensure that the optimal amount of pregnancy weight is gained, but not too much. Lean proteins such as chicken, fish, turkey, and eggs can help provide necessary nutrients without excess carbohydrates. Supplements such as vitamin D and calcium may help reduce blood sugar levels. A registered dietician experienced with GDM will likely oversee your plan to ensure you stay on track for your health and that of your baby. Physical exercise such as walking and swimming is an important component of this program. These measures, however, may not be enough to control GDM and medication such as insulin may be necessary.

Thankfully, GDM usually goes away after the baby is delivered. Occasionally, type 2 diabetes may develop afterwards, which is why it is important for women who have had GDM continue to eat a healthy diet and ensure they get enough exercise to help prevent this from happening. Ask your doctor for more information about GDM.