Gestational diabetes is a condition in which the mother-to-be's blood sugar during pregnancy is chronically elevated due to hormonal changes that occur when she is expecting. If this condition is not managed correctly and blood sugars stay elevated, it can have adverse health effects on both mother and baby.
Gestational diabetes typically affects between 2 to 10 percent of pregnant American women, according to the Cleveland Clinic. The condition is usually temporary, meaning that mom's blood sugars typically return to normal after the baby is born. Still, it's very important to keep blood sugar levels in a healthy range during pregnancy. A family history of diabetes, being age 26 or older and being overweight before pregnancy are some of the risk factors for gestational diabetes.
For most women who have gestational diabetes, target blood sugar levels are 95 milligrams per deciliter or less before a meal, 140 or less one hour after eating and 120 mg/dL or less two hours after eating, according to the American Diabetes Association. Talk to your doctor about what may be appropriate for you.
Here are a few things your doctor might suggest to reduce high sugar levels during pregnancy.
Follow a Healthy Diet
The body gets most of its energy from metabolizing the carbohydrates in food into a sugar called glucose, aka blood sugar. But some carbs — such as the simple carbs found in refined sugar (table sugar), sugary beverages like soda and refined grains like white bread — can cause a spike in blood sugar, according to the American Heart Association.
Therefore, it's best for pregnant women who are at risk of gestational diabetes to limit or avoid sugary snacks, drinks and baked goods, as well as white bread and white rice. Since these foods and beverages can rapidly increase blood sugar levels, they can make gestational diabetes worse.
For healthy blood sugar during pregnancy, choose foods with complex carbs, like whole grain breads and brown rice. Yes, these carbs do raise blood sugar levels — but they do so more slowly. Also, be sure to eat plenty of fresh fruits and vegetables, legumes and low-fat protein along with carbs to further slow carb metabolism and keep your glucose from spiking.
Pregnant women have very specific nutritional needs. This is why the National Institute of Child Health and Human Development (NICHD) cautions them against coming up with a dietary plan on their own.
If gestational diabetes is a concern for you, consult with your obstetrician or a registered dietitian to devise a meal plan that is specific to you and your pregnancy. Guidelines for reducing blood sugar in pregnancy are generally the same, but your doctor will take into consideration your overall health, age and other factors that are specific to you.
Eat Small Meals and Hydrate Properly
It's always important to drink lots of water during pregnancy, but it's especially vital for those who have gestational diabetes. People with diabetes — including gestational diabetes — tend to urinate more, because their bodies are trying to flush out excess glucose.
Additionally, dehydration can cause high blood sugar in and of itself — less water in the body means a higher blood sugar concentration, according to the Centers for Disease Control and Prevention. The Joslin Diabetes Center's "Guideline for Detection and Management of Diabetes in Pregnancy_,"_ published in June 2018 by the American Journal of Managed Care, recommends that women with gestational diabetes drink 3 liters of water per day (about 10 cups).
Regular, moderate exercise is another important part of maintaining healthy blood sugars during pregnancy, according to the NICHD. Exercise improves the body's ability to use insulin, the primary hormone responsible for balancing blood sugar levels.
Monitor Your Blood Sugar
If you are diagnosed with gestational diabetes, your doctor may ask you to begin monitoring your blood sugar levels at home, according to the Mayo Clinic. Most glucose meters require you to prick your finger and then place a drop blood on a testing strip. Depending on the results, you can then adjust your food or medication in order to regulate your blood sugar.
Monitoring your blood sugar will be especially important if your doctor prescribes a blood sugar-lowering medication such as insulin. If that's the case, you will need to check your blood sugar regularly to make sure your blood sugar doesn't drop too low.
Because gestational diabetes may represent undiagnosed type 1 or type 2 diabetes, women with gestational diabetes should be tested for persistent diabetes or prediabetes between four and 12 weeks after delivery. In addition, because gestational diabetes is associated with an increased risk of getting diabetes later in life, women should be checked for diabetes every one to three years, depending on their other risk factors.
Take Diabetes Medications
If you've been diagnosed with gestational diabetes, your doctor may prescribe insulin or other blood sugar-lowering medications to help you manage your glucose levels. If so, be sure to take prescribed medications according to your doctor's instructions, and never stop taking them without first consulting your doctor.
Elizabeth Halprin, MD, clinical director of adult diabetes at Harvard's Joslin Diabetes Center, tells LIVESTRONG.com that some women with gestational diabetes eliminate carbs from their diet to avoid taking medication. But this is not a healthy way to reduce sugar during pregnancy. "Decreasing carb intake to zero means patients end up not getting enough nutrition," says Dr. Halprin.
If the body doesn't get enough carbs, it will burn fat for energy instead, which produces ketones. So to monitor nutrition, Dr. Halprin says, all patients with gestational diabetes at the Joslin Diabetes Center are asked to check their urine for ketones each morning. "Elevated ketone levels are detrimental to the neurological development of the fetus," she adds.
Is This an Emergency?
- Cleveland Clinic: "Gestational Diabetes"
- National Institute of Child Health and Human Development: "Managing Gestational Diabetes"
- Yale Health: "Gestational Diabetes Treatment Plan"
- Mayo Clinic: "Gestational Diabetes"
- American Heart Association: "Carbohydrates"
- American Journal of Managed Care: "Evidence-Based Diabetes Management"
- American Diabetes Association: "Gestational Diabetes: Treatment and Perspective"
- Centers for Disease Control and Prevention: "10 Surprising Things That Can Spike Your Blood Sugar"