Understanding and managing gestational diabetes: Everything you need to know

Pregnancy is full of exciting changes, but it can also bring unexpected challenges. One such challenge is gestational diabetes mellitus (GDM)—a condition that develops during pregnancy when the body struggles to manage blood glucose levels. The tricky part? It may not always come with easy-to-spot symptoms, but rest assured that you'll undergo routine testing to screen for the condition in every pregnancy. While a diagnosis of GDM may feel overwhelming, it’s important to remember that with knowledge and proactive steps, you can manage gestational diabetes and ensure both your health and that of your baby. 

What is gestational diabetes?

Gestational diabetes occurs when your body is not able to produce enough insulin to regulate blood glucose during pregnancy. Insulin is a hormone that helps control blood glucose levels, and during pregnancy, your body needs more insulin due to hormonal changes. For some women, the body cannot keep up with this increased demand for insulin. This can lead to elevated blood sugar levels because there is not enough insulin to process the buildup of blood sugar.

Gestational diabetes doesn't usually develop until around the 24th week of pregnancy. Toward the end of your second trimester, your birth provider will recommend an oral glucose challenge, which is a screening tool to check for GDM. During the test, you'll drink a glucose solution, wait three hours, and get your blood tested to measure your blood glucose levels. In some cases, you may need to go back for a second oral glucose challenge. 

And if you end up with a diagnosis of GDM? Know that the condition is highly common. The Centers for Disease Control and Prevention estimates that every year, between 2% and 10% of pregnancies are affected by gestational diabetes.

Symptoms of gestational diabetes

In many cases, symptoms of GDM are generally mild—or may not appear at all. Be on the lookout for the following signs, but trust that the oral glucose test is the best way to know if you have the condition. 

• Increased thirst
• Fatigue
• Increased urination 

Gestational diabetes risk factors

While anyone can develop gestational diabetes, certain factors increase your risk, including:

• Having a family history of diabetes
• Being overweight before pregnancy
• Being older than 25 when pregnant
• Having had gestational diabetes in a previous pregnancy

Although gestational diabetes typically resolves after giving birth, it is essential to manage it during pregnancy to avoid complications like premature birth, high birth weight, or an increased risk of developing type 2 diabetes later in life—for both you and your little one.

Preventing gestational diabetes

While you cannot completely control every factor that contributes to gestational diabetes, there are several things you can do to reduce your risk, especially if you're planning a pregnancy or already expecting:

1. Adopt a balanced, nutrient-rich diet

Nutrient deficiencies have been linked to an increased risk of gestational diabetes. WeNatal for Her supports optimal nutrient stores and lowers risk of deficiencies during each stage of pregnancy. 

2. Maintain a healthy weight

If you are planning for pregnancy, clinical research shows that achieving a healthy weight for your body frame before conception can significantly reduce the risk of gestational diabetes. Even losing a small amount of weight (around 5% to 7% of your body weight) can reduce your risk.

3. Stay Active

Regular physical activity is supportive in preventing gestational diabetes. Aim for at least 30 minutes of moderate exercise, like walking, swimming, or prenatal yoga, on most days of the week. Exercise improves your body’s ability to use insulin and regulate blood sugar.

 4. Monitor your blood sugar levels

If you're at higher risk, your birth provider may recommend periodic blood sugar tests during pregnancy to catch any early signs of gestational diabetes. Early detection is key to managing the condition effectively.

 5. Reduce stress

Research shows there's a link between stress and the onset of GDM: There's a correlation between high levels of stress hormones, such as cortisol, and insulin resistance, which means that taking steps to reduce your stress and increase your resilience may help ward off the condition.  

Lifestyle changes to manage gestational diabetes

If you’ve been diagnosed with gestational diabetes, it is natural to feel anxious. However, there are many ways you can take charge of your health and improve outcomes for both you and your baby. While medications or insulin may be necessary in some cases, lifestyle changes play a crucial role in managing the condition.

1. Follow a low glycemic eating plan

Working with a dietitian, you can create a meal plan that helps stabilize your blood sugar. Focus on balanced meals that include plenty of non-starchy vegetables (leafy greens, broccoli, cauliflower), lean proteins (chicken, turkey, grass-fed beef), and whole food carbohydrates (berries, potatoes, butternut squash). Avoid processed foods with added sugar that cause blood sugar spikes, such as white bread, sugary cereals, or soft drinks.

2. Meal timing and portion control

Eating smaller, more frequent meals can help keep blood sugar levels stable throughout the day. Aim for three main meals and one or two smaller snacks, and avoid long gaps between eating. When eating starchy foods like carbs, balance them with proteins and healthy fats to slow down the absorption of glucose.

 3. Stay active during pregnancy

Light to moderate exercise, such as walking or prenatal yoga, can make a big difference in managing gestational diabetes. Body weight exercises that utilize your big muscle groups help your body use insulin more efficiently and can lower blood sugar levels after meals.

4. Track your blood sugar

Monitoring your blood sugar regularly will help you understand how your body responds to different foods and activities. Your birth provider will guide you on how often to check your levels, but typically, you’ll need to test your blood sugar after meals and before bedtime. Staying informed about your levels empowers you to make adjustments in real-time. One of my favorite ways to track is through the Levels continuous blood glucose monitor (CGM). 

5. Manage your stress

Reducing stress is sometimes just about carving out small moments to reset and stay present. Write a list for yourself of activities you love that help you feel less stressed, like journaling, meditating, exercising, spending time in nature, getting sufficient sleep or socializing with good friends, and then aim to incorporate those into your daily routine.  

A note from WeNatal: Understanding a gestational diabetes diagnosis

It is important to remind yourself that a diagnosis of gestational diabetes is not a reflection of anything you have done wrong. It is simply a challenge that requires a shift in lifestyle, and with the right steps, you can manage it effectively. By following a balanced diet, staying active, and working closely with your healthcare provider, you can improve your health and give your baby the best possible start in life. Remember, you are strong, capable, and equipped with the tools to navigate this journey with confidence.

References:

Feng, Y., Feng, Q., Qu, H. et al. Stress adaptation is associated with insulin resistance in women with gestational diabetes mellitus. Nutr. Diabetes 10, 4 (2020). doi:10.1038/s41387-020-0107-8

Lust O, Chongsuwat T, Lanham E, Chou AF, Wickersham E. Does Exercise Prevent Gestational Diabetes Mellitus in Pregnant Women? A Clin-IQ. J Patient Cent Res Rev. 2021;8(3):281-285. Published 2021 Jul 19. doi:10.17294/2330-0698.1811

Mierzyński R, Poniedziałek-Czajkowska E, Sotowski M, Szydełko-Gorzkowicz M. Nutrition as Prevention Factor of Gestational Diabetes Mellitus: A Narrative Review. Nutrients. 2021; 13(11):3787. doi:10.3390/nu13113787

Sampathkumar S, Parkhi D, Ghebremichael-Weldeselassie Y, Sukumar N, Saravanan P. Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus-a systematic review and meta-analysis of 257,876 pregnancies. Nutr Diabetes. 2023;13(1):22. Published 2023 Nov 16. doi:10.1038/s41387-023-00251-5

Tokarz VL, MacDonald PE, Klip A. The cell biology of systemic insulin function. J Cell Biol. 2018;217(7):2273-2289. doi:10.1083/jcb.201802095