Gestational diabetes is a type of diabetes that can develop during pregnancy in women who did not have diabetes before getting pregnant. Gestational diabetes affects how the body processes sugar (glucose) and can cause high blood sugar levels in pregnant women.
Controlling blood sugar levels through diet, exercise, and medication (if needed) is important for the health of both the mother and the baby. The good news is that gestational diabetes often goes away after the baby is born. However, having gestational diabetes does increase a woman’s risk of developing type 2 diabetes later in life.
What causes gestational diabetes?
During pregnancy, the placenta produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin. This is called insulin resistance. Insulin is needed to transport glucose from the bloodstream into the cells to be used for energy. With insulin resistance, glucose builds up in the blood instead of being absorbed by the cells. The pancreas tries to make more insulin to overcome the insulin resistance, but eventually the pancreas can’t keep up. This results in high blood sugar levels that define gestational diabetes.
Some women have a higher risk of developing gestational diabetes if they:
- Are overweight or obese prior to pregnancy
- Have a family history of type 2 diabetes
- Are older than 25 years of age
- Have had gestational diabetes in a previous pregnancy
- Have previously given birth to a baby weighing more than 9 pounds
- Have polycystic ovary syndrome (PCOS)
- Are of Aboriginal, Hispanic, South Asian, Asian or African descent
Why is it important to control blood sugar with gestational diabetes?
Uncontrolled blood sugar levels during pregnancy can increase risks for both the mother and the developing baby. Risks include:
For the mother:
- Preeclampsia – high blood pressure and signs of damage to other organ systems, most often the liver and kidneys
- Need for cesarean section delivery
- Developing type 2 diabetes after pregnancy
For the baby:
- Excessive growth leading to a large baby, increasing chance of injuries during delivery
- Low blood sugar after birth
- Breathing problems
- Increased risk of obesity and type 2 diabetes later in life
Following a healthy gestational diabetes diet helps control blood sugar, provides adequate nutrition for mom and baby, and prevents excessive weight gain during pregnancy.
Gestational Diabetes Diet Overview
The main dietary goals for managing gestational diabetes are:
- Achieve consistent control of blood sugar levels
- Provide adequate calories for appropriate weight gain
- Include essential vitamins and minerals
- Drink plenty of water to stay hydrated
This is accomplished by following a meal plan that spreads carbohydrates evenly throughout the day. Carbohydrates have the biggest impact on blood sugar levels. Protein and fat have minimal effects on blood sugar and help satisfy hunger.
Portion sizes are also important when planning gestational diabetes meals and snacks. Checking blood sugar levels regularly and tracking food intake can help determine appropriate portion sizes and nutrient ratios tailored to your needs.
Key Elements of a Healthy Gestational Diabetes Diet
- Lean proteins – Choose varieties like chicken, turkey, fish, eggs, tofu, beans, lentils, and Greek yogurt. Have protein at each meal and snack.
- Non-starchy vegetables – Fill half your plate with broccoli, spinach, green beans, carrots, cauliflower, cucumbers, peppers, tomatoes, etc. Go easy on high-carb veggies like potatoes, corn, and peas.
- Whole grains – Opt for whole grains like oats, quinoa, brown rice, whole wheat pasta and bread over refined grains like white rice and bread.
- Fruits – Stick to lower sugar fruits like berries, grapefruit, melon and apples. Limit higher sugar fruits like bananas, grapes, mangos and pineapples.
- Dairy – Choose plain, unsweetened yogurt and milk. Limit sweetened dairy products.
- Heart-healthy fats – Include sources like olive oil, avocados, nuts, seeds and fatty fish like salmon and sardines.
- Water – Stay well hydrated by drinking plenty of water and limiting sugary drinks like juice and soda.
It’s also important to control portion sizes and carb counts at meals and snacks. Checking blood sugar 1-2 hours after eating can help determine appropriate carb limits tailored for you.
Sample Menu for One Day with Gestational Diabetes
Here is an example of what a day’s menu might look like when following a gestational diabetes diet:
Breakfast
- 2 eggs scrambled with 1/2 cup black beans and 1/2 cup spinach
- 1 slice 100% whole wheat toast with 1 teaspoon butter
- 1 cup Greek yogurt mixed with 1 cup blueberries and 1 tablespoon slivered almonds
- Water or unsweetened tea
Morning Snack
- 1 medium apple sliced with 2 tablespoons natural peanut butter
- Water
Lunch
- Tuna salad made with 3 ounces tuna, 2 tablespoons mayo, celery, lettuce on 2 slices whole wheat bread
- Carrots and cucumbers with 2 tablespoons hummus
- 1 cup steamed broccoli
- Water
Afternoon Snack
- 1 part-skim mozzarella cheese stick
- 10 whole wheat crackers
Dinner
- 3 ounces grilled salmon
- 1/2 cup brown rice
- 1 cup roasted Brussels sprouts
- Green salad with 2 tablespoons light Italian dressing
- Water
Evening Snack
- 1 cup plain Greek yogurt mixed with 1/2 cup raspberries and 1 ounce slivered almonds
This provides balanced nutrition with lean protein, fruits, vegetables, whole grains, and healthy fats at each meal. Carbohydrates are spread evenly throughout the day to help maintain steady blood sugar control. Portion sizes can be adjusted based on individual needs determined by blood sugar testing.
Foods to Avoid with Gestational Diabetes
While no foods are completely off limits, there are certain foods that should be limited or avoided to help control blood sugar with gestational diabetes.
Sugary foods:
- Candy
- Cookies
- Cakes
- Muffins
- Sweetened beverages like soda and sweet tea
- Fruit juice
- Ice cream
- Most desserts
These foods are quickly broken down into sugars and can cause spikes in blood glucose levels.
Refined grains:
- White bread
- Pasta
- White rice
- Crackers
Refined grains act more like sugars in the body than complex carbohydrates. Choosing whole grain options provides more fiber and nutrients.
Processed foods:
- Fast food
- Frozen meals
- Canned soups
- Pre-packaged snacks like chips
- Lunchmeats
- Hot dogs
- Artificial sweeteners
These are often loaded with calories, refined carbs, sodium, and chemicals. Fresh, whole food options are recommended instead.
Sugary drinks:
- Soda
- Sweet tea
- Fruit punch
- Energy drinks
- Specialty coffees with syrups
The high amounts of rapidly absorbed sugars in these drinks can cause blood glucose spikes and crashes. Stick with water, unsweetened tea, coffee, and milk.
Fruits to be cautious with:
- Bananas
- Grapes
- Pineapple
- Mango
- Watermelon
These fruits are higher in natural sugars. Small portions paired with protein or fat can help prevent surges in blood sugar levels.
Starchy vegetables:
- Potatoes
- Corn
- Peas
- Winter squash
Pairing these with protein and eating small portions can help regulate their effects on blood sugar.
While none of these foods are completely forbidden, limiting intake and portion sizes of them helps manage gestational diabetes through diet. Checking your blood sugar before and after meals can help determine your body’s response to different foods. This allows you to create a personalized gestational diabetes diet that meets your needs.
Tips for Eating Out with Gestational Diabetes
You can still enjoy eating out at restaurants during pregnancy with gestational diabetes. It just takes some extra planning and wise menu selections. Here are some tips:
- Review the menu online and decide what you will order ahead of time. Look for grilled, baked or broiled meat entrees served with non-starchy vegetables.
- Request sauces and dressings on the side to control how much you use.
- Ask if whole wheat pasta or brown rice can be substituted for white refined options.
- Order a side salad with vinegar dressing instead of carb-heavy bread, potatoes or fries.
- Be cautious with soups, as they may contain refined grains or starchy vegetables. Broth-based soups are a good option.
- For sandwiches, choose whole grain bread and load up on veggie toppings while limiting condiments.
- Avoid breaded, fried appetizers and entrees which can be high in carbs.
- Request plain roasted or grilled chicken and fish instead of dishes glazed or breaded in sugary sauces.
- Opt for water or unsweetened iced tea instead of soda, sweet tea, juices, or lemonade.
- Share a dessert with someone instead of eating a full serving yourself.
- If in doubt about a menu item, ask the server for modifications or more details.
Planning ahead takes the guesswork out of eating out with gestational diabetes. You can still enjoy restaurant meals as part of your gestational diabetes diet.
Exercise Recommendations with Gestational Diabetes
Adding in regular exercise along with your gestational diabetes diet can help keep blood sugar levels in check. Exercise helps improve your body’s use of insulin so glucose can be absorbed by the cells. Moving your body also expends energy (calories) helping prevent excessive weight gain.
Aim for at least 150 minutes of moderate intensity exercise per week, or about 30 minutes per day on most days of the week. Brisk walking is a safe, effective exercise for most women with uncomplicated pregnancies. Other good options include stationary cycling, swimming, a prenatal exercise class, or other activities approved by your healthcare provider.
Check your blood sugar levels before and after exercise to see how different durations and intensities of activity impact your glucose control. Pay attention to any signs of low blood sugar like shakiness, sweating, rapid heartbeat, tiredness, hunger, blurry vision, confusion, or headaches. Carry a fast-acting carb like glucose tablets in case your blood sugar drops too low and you need to quickly elevate it.
Stay well hydrated by sipping water before, during, and after workouts. Listen to your body and avoid exercising to the point of exhaustion. You may need to modify your exercise routine as your pregnancy progresses. Let your healthcare team know about your exercise habits and ask about any precautions you should take.
Regular exercise benefits both mom and baby when combined with a healthy gestational diabetes diet. Moving your body can help you better manage blood sugar levels during pregnancy and prepare for labor and delivery.
Medications and Monitoring for Gestational Diabetes
Diet and exercise are the first line treatments for managing gestational diabetes. If blood sugar levels cannot be adequately controlled with lifestyle adjustments alone, medications may be recommended to help lower and stabilize glucose levels.
The most commonly prescribed medication for gestational diabetes is insulin. Different types of insulin are available. Your healthcare provider will determine the appropriate type and dosage depending on your needs and response.
Insulin helps move glucose from the bloodstream into the cells so it can be used for energy. Some women only need insulin at night to control fasting blood sugar levels. Others require insulin injections two or more times per day to regulate glucose after meals.
Oral diabetes pills are sometimes used instead of or in addition to insulin. Metformin and glyburide are two oral medications that may be options for controlling gestational diabetes. Your doctor will discuss with you the pros and cons of each medication and the best treatment plan for your situation.
Frequent blood sugar monitoring is essential if using medication for gestational diabetes. You will be taught how to check your own blood glucose levels using a finger stick test and glucometer device. Testing is needed:
- First thing in the morning prior to eating
- 1 or 2 hours after each meal
- Before bedtime
- Sometimes in the middle of the night
- Prior to, during, and/or after exercise sessions
Keeping detailed records of your blood sugar numbers, diet, activity, and medication doses is vital. You will have regular medical appointments to review this information, monitor your progress, and make adjustments to your treatment plan as needed. Controlling gestational diabetes takes diligence, but it provides the best chance of having a healthy pregnancy and delivery.
After Pregnancy – Reducing Your Risk of Type 2 Diabetes
While gestational diabetes usually resolves after delivery, having gestational diabetes significantly increases a woman’s risk of developing type 2 diabetes later in life. Up to half of women with a history of gestational diabetes go on to be diagnosed with type 2 diabetes within 5-10 years after delivery.
Making healthy lifestyle choices after pregnancy can help lower your chances of getting type 2 diabetes. Here are some tips:
- Aim for a healthy body weight. Losing extra pregnancy pounds through diet and exercise reduces insulin resistance.
- Breastfeed if possible. Breastfeeding can benefit mom’s health and helps promote weight loss.
- Follow a balanced, low-sugar diet with lean proteins, fruits, vegetables, whole grains, and healthy fats.
- Limit processed foods, refined carbs, and sugary desserts and drinks.
- Stay active with at least 150 minutes per week of brisk walking or other moderate exercise.
- Get screened for diabetes 6-12 weeks after your baby is born, then every 1-3 years.
Making nutrition, exercise, and regular medical follow-up priorities after your pregnancy can reduce the likelihood of developing type 2 diabetes later on. Staying healthy provides benefits for both you and your family.
Conclusion
Gestational diabetes is manageable with a combination of meal planning, activity, and medication (if needed). Focus on foods that provide balanced nutrition for you and baby without spiking blood sugar. Checking your glucose levels regularly and tracking your diet and exercise habits helps determine what works best for your body. While gestational diabetes requires some extra effort, take it one day and one meal at a time. You’ve got this mama!
