- Gestational diabetes is diagnosed when pregnancy-related insulin resistance results in blood sugar levels that are too high.
- Most people can manage gestational diabetes through diet and exercise alone, though sometimes medication is needed.
- A meal plan with consistent meals and snacks, including complex carbohydrates, protein, and healthy fats, can help keep blood sugar levels within the healthy ranges
Gestational diabetes can be an intimidating diagnosis to receive during pregnancy. But with support from your healthcare team, you can manage your blood sugar levels and have a healthy pregnancy.
A registered dietitian can help you make a personalized gestational diabetes diet plan that includes high-fiber carbs, lean protein, and fats that you will eat at regular times throughout the day. This combination of foods slows the absorption of glucose into your bloodstream and helps keep your blood sugar levels stable.
Continue reading below to learn more about gestational diabetes, how to manage it, and strategies for meal planning.
What Is Gestational Diabetes?
Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. It is caused by hormones that are released by the placenta, which is a temporary organ that connects the uterus to the umbilical cord and delivers oxygen and nutrients to the fetus. These hormones, particularly the human placental lactogen (HPL), increase insulin resistance, which means your insulin doesn’t work as well when processing the sugars in your bloodstream.
While all pregnant people experience these hormone changes, gestational diabetes only occurs when the pancreas is unable to manage the insulin resistance. When this happens, blood glucose levels become higher than normal.
GDM is diagnosed through an oral glucose tolerance test that is routinely done after 24 weeks of pregnancy. Sometimes, people have undiagnosed diabetes before pregnancy. This is one of the reasons pregnant people should consider prioritizing routine pregnancy tests, as the tests can reveal underlying health issues, including diabetes.
Gestational diabetes can increase the risk of fetal macrosomia, a term used to describe when the fetus grows and weighs more than average. Birth complications such as preeclampsia and an increased risk of cesarean birth can also occur in people with GDM. With the help of your healthcare team, you can manage your blood glucose levels and have a healthy pregnancy even if you have gestational diabetes.
Typically, blood sugar levels return to normal soon after birth once the placenta's hormones no longer affect insulin sensitivity. However, people who have once received a diagnosis of gestational diabetes have a higher risk of developing it again in future pregnancies or developing type 2 diabetes later in life.
Symptoms of Gestational Diabetes
People with gestational diabetes usually don’t have any symptoms, making screening very important during each pregnancy. When symptoms do occur, they are often similar to those of type 2 diabetes. You may experience symptoms of high blood sugar levels, which include feeling very thirsty or having to urinate more frequently.
Talk to your doctor if you are experiencing any new or concerning symptoms.
Guidelines for Gestational Diabetes
It is important to manage your blood glucose levels to optimize your baby's health and prevent complications during pregnancy and birth.
People with gestational diabetes can monitor their blood glucose levels using finger sticks and a glucometer. A continuous glucose monitor is also recommended in some cases.
The American Diabetes Association has blood glucose level guidelines for people with gestational diabetes. These guidelines are more strict than the ones for nonpregnant individuals with diabetes because of the increased risks of high blood sugar during pregnancy. You may have different goals depending on your medical history and pregnancy.
The general blood glucose goals are:
- Less than 95 mg/dL before a meal.
- Less than 140 mg/dL one hour after a meal.
- Less than 120 mg/dL two hours after a meal.
Some people with gestational diabetes need medications to keep their blood sugar levels on target. Their doctor may prescribe Insulin because it does not pass through the placenta to reach the fetus.
Estimates show that 70-85% of people with gestational diabetes can manage their blood sugar levels through lifestyle interventions alone, which includes diet and exercise. Along with regular exercise, your gestational diabetes diet plan should provide adequate nutrition to support your pregnancy, help you meet your blood sugar goals, and allow you to gain the recommended amount of weight.
People with gestational diabetes should follow the daily nutrition goals based on the Dietary Reference Intakes (DRI) for pregnant people. Your calorie goal will depend on your pre-pregnancy BMI and how much weight your doctor recommends you gain during pregnancy.
Even though calorie goals vary from person to person, the general DRIs for pregnant people include:
- At least 175 grams of carbohydrates.
- At least 71 grams of protein.
- Fat should make up the remaining calories, with less than 7% of calories from saturated fat.
- 28 grams of fiber.
A gestational diabetes diet plan consists of three meals and two to four snacks per day. A bedtime snack is important for keeping your blood sugar levels stable overnight. Your registered dietitian will give you individualized goals for the number of carbohydrates to eat at each meal and snack.
For example, you might be able to eat 30-45 grams of carbs per meal and 15-30 grams per snack. It is important to eat a consistent amount of carbs across your meals and snacks. This helps prevent spikes and drops in your blood sugar throughout the day.
The types of carbohydrates in your diet affect blood sugar levels. Refined carbs and simple sugars are low in fiber and are absorbed into the bloodstream more rapidly, causing spikes in blood glucose levels. Complex carbs, on the other hand, are high in fiber and are digested slower. This helps stabilize blood sugar levels after a meal.
It is often best to choose whole grains and high-fiber carbohydrates, like brown rice, oats, whole grain bread, beans, lentils, and whole wheat pasta, instead of refined grains like white rice and white bread.
Consider limiting or avoiding sugar-sweetened beverages, like soda and fruit juice. These drinks cause blood sugar levels to increase rapidly due to the presence of simple sugars and lack of fiber.
Include protein-rich foods and whole carbohydrates with your meals. This will slow down digestion, help you to feel fuller, and prevent blood sugar spikes after eating.
The American Diabetes Association recommends that people with GDM work with a registered dietitian to optimize food choices and meet blood sugar targets. Consider booking a virtual appointment with a registered dietitian through Nourish.
Foods to Eat if You Have Gestational Diabetes
A helpful tool for planning meals is the diabetes plate method. This simple graphic of a plate shows the ratios of the food groups to include for optimal blood sugar control. One-quarter of the plate is carbohydrates, one-quarter is protein, and one-half is non-starchy vegetables.
Below are some examples of meals and snacks that may be most appropriate for most people with gestational diabetes. Portion sizes will depend on the individualized goals set by your registered dietitian.
- Overnight oats, prepared with greek yogurt, fruit, and nuts.
- Whole wheat toast topped with avocado and slices of hard-boiled egg.
- Whole grain freezer waffles topped with peanut butter and banana slices.
- Vegetable frittata with a side of breakfast potatoes.
- Egg salad sandwich with a side of carrot sticks.
- Whole grain pita pocket with chicken, hummus, cucumbers, tomatoes, and greens.
- Vegetable lentil soup with whole grain crackers.
- Chicken caesar salad with whole grain garlic toast.
- Baked salmon with roasted broccoli and brown rice.
- Grain bowl with quinoa, roasted veggies, and tofu.
- Turkey burger on a whole grain bun with a side salad.
- Chicken tortilla soup with corn tortilla chips.
- Greek yogurt with fruit.
- Hummus and raw veggies (cucumber, carrot, snap peas, bell pepper).
- Apple with nut butter.
- Cottage cheese and whole grain crackers.
How a Nutritionist Can Help
For individualized guidance on optimizing your blood sugar levels, consider booking an online appointment with a gestational diabetes nutritionist through Nourish. You’ll be matched with a dietitian specializing in diabetes who can guide you in creating a meal plan to help manage your gestational diabetes. Visits are 100% virtual and covered by most insurance plans.
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