While pregnant, you’ve likely been trying to make nutritious food choices so your baby can grow healthy and strong. But sometimes, common pregnancy symptoms like nausea, food aversions and fatigue can make it difficult to eat as healthy as you’d like. Plus, it might feel harder than ever to pass up a greasy burger or extra piece of chocolate. With an upcoming test for gestational diabetes, you might be wondering if your diet could give you gestational diabetes or affect the test. And how would this diagnosis affect you and baby?
These are normal questions and concerns to have. It’s easy to worry about your decisions during pregnancy, but some circumstances – like whether you get gestational diabetes – are mostly out of your hands. It has more to do with genetics than it does with your food decisions. And if you are diagnosed with gestational diabetes, know that it’s possible to have a healthy pregnancy and baby.
Below, we discuss the causes of gestational diabetes, what puts you at risk, what you can do to prevent it, and how you can manage it if you’re diagnosed.
What is gestational diabetes?
If your glucose levels are too high, you may have gestational diabetes. Gestational diabetes (GD) is a type of diabetes that only pregnant women can get – roughly 1 in 20 women have gestational diabetes during their pregnancy. If you had diabetes before you got pregnant, it wouldn’t be considered gestational diabetes since it didn’t develop during pregnancy, so you would continue to manage it like you did before pregnancy.
Here’s how it works: After you eat, your body turns the food in your stomach into glucose in your bloodstream. Your pancreas then creates a hormone called insulin, which allows the glucose to go from your bloodstream and into your cells. This gives you a much-needed energy boost.
When you’re pregnant, your body needs more insulin than it usually does for this process to happen. If your pancreas can’t keep up, the glucose levels in your blood will get too high. This is gestational diabetes. Your baby shares your bloodstream while in the womb. Nutrients and oxygen from your blood pass into your baby’s bloodstream through your placenta, and the placenta makes hormones that can cause your cells to resist insulin. Use this as a reminder that a gestational diabetes diagnosis isn’t your fault. It may be a natural outcome of your pregnancy.
But keeping your glucose levels under control will make sure your baby stays healthy, too. And you can take extra comfort in knowing that because gestational diabetes is a condition that only affects pregnant parents, it usually goes away after your baby is born.
What gestational diabetes means for your baby
Everything you eat and drink affects your baby. When you’re pregnant, your baby shares your bloodstream, so if the glucose levels in your bloodstream are too high, then your baby’s glucose levels are also high. In order to counteract these high glucose levels, your baby’s developing pancreas will work harder to produce more insulin to even things out. This means your baby is getting more calories than they need and that they could grow bigger than normal. Macrosomia – a condition where a baby has an above-average birth weight – could lead to a c-section, traumatic birth or early delivery.
After your baby is born and begins using their own bloodstream (rather than depending on yours), the doctor will test your baby’s blood sugar to make sure it’s stable and needs no extra intervention.
If your glucose is too high during pregnancy, your baby will make extra insulin to manage the extra glucose coming from you. This extra insulin may cause low blood sugar in your baby after delivery. And while it may not pose an immediate problem, gestational diabetes can put your baby at risk for obesity as a child and type 2 diabetes as an adult.
Preventing gestational diabetes isn’t always possible
Are you worried about the extra scoop of ice cream you had last night? Just because you eat a certain type of food doesn’t mean you’ll automatically get gestational diabetes. In fact, there’s no surefire way to prevent gestational diabetes and it usually goes away after the baby is born.
Even mothers who have had gestational diabetes in a previous pregnancy may not get it with a later pregnancy. However, women who are overweight and less active are more likely to get gestational diabetes.
The causes of gestational diabetes are largely unknown
The cause of gestational diabetes is unknown, but certain risk factors may increase a mother’s chances of developing it.
Risk factors for gestational diabetes
Gestational diabetes can affect any woman, but several factors increase a mother’s chances of developing GD during pregnancy. Your chances of getting gestational diabetes may be higher based on one or more of these factors:
- Pregnant at 35 years or older
- Have a BMI of 30 or over
- Have a history of heart disease and high blood pressure
- A history of glucose intolerance
- Previously had a baby that weighed 9 lbs. or more
- Previously had gestational diabetes
- Are of an ethnic minority group (African American, American Indian and Alaska Native, Asian and Pacific Islander, Hispanic)
Symptoms of gestational diabetes
Gestational diabetes doesn’t usually have any symptoms, and if there are, they may be mild. The symptoms sometimes associated with gestational diabetes might sound pretty familiar:
- Increased thirst and hunger
- Fatigue
- Dry mouth
- Nausea and vomiting
- Frequent urination
- Blurred vision
- Genital itching
Some of these symptoms – specifically fatigue, nausea and frequent urination – are common pregnancy symptoms during the first trimester. So how do you know if you’re experiencing pregnancy symptoms or gestational diabetes? The only way to know is through testing.
How testing works for gestational diabetes
Because there are rarely any symptoms for gestational diabetes, there’s a test for it. Between 24-28 weeks, all pregnant women will go through a glucose screening – also called a glucose challenge test or the one-hour glucose test – that checks the amount of sugar in your blood. This test won’t confirm gestational diabetes, but a follow-up test will be needed if your results are higher than normal. Your gestational diabetes screening may occur earlier (during your first prenatal visit) if you have a history of gestational diabetes, obesity or diabetes in an immediate relative.
Glucose challenge test
Your doctor will prompt you when to take the glucose challenge test. It usually occurs at your clinic’s laboratory and may be set up as its own appointment or after a routine prenatal appointment. Here’s what you’ll do when you take the gestational diabetes test:
- Drink a sugary drink – a concentrated glucose solution (50 grams of glucose dissolved in 8 to 10 ounces of water) – within five minutes.
- Wait for one hour in the waiting room. This gives your body time to digest the drink to see how your body handles glucose. You may feel nausea, lightheaded or sweaty after the drink. During this hour, you cannot eat or drink anything, but you can have sips of plain water to help calm your stomach and manage any side effects of the drink.
- After one hour, you will get your blood drawn in order to test your glucose levels.
- You’ll then receive your results, usually within a day or two.
Gestational diabetes screening results: Glucose challenge test
If your results are less than 130 mg/dL, there is little to no risk of gestational diabetes. If your glucose levels are high and more than 130 mg/dL, you’ll need to schedule another appointment at the lab to take another glucose test to confirm GD.
Follow-up test for gestational diabetes: The glucose tolerance test
The follow up glucose tolerance test is a little different from the first glucose challenge test. The main difference is that the glucose tolerance test requires a 12-hour fast before you go back to the lab.
Once you arrive, you’ll drink the same sugary drink and wait for one hour. After that hour, you’ll get your blood drawn again. The lab tech will repeat the blood draw after the second hour, and sometimes after the third hour.
Gestational diabetes screening results: Glucose tolerance test
Your doctor will share your results within a couple days. If your blood sugar levels are greater or equal to 95 mg/dL after fasting, or if it meets or exceeds any two of the following three – 180 mg/dL at 1 hour, 155 mg/dL at 2 hours, 140 mg/dL at 3 hours – your doctor will diagnose you with gestational diabetes.
But you won’t have to navigate living with GD on your own. Your doctor will introduce you to a diabetes educator and dietitian to develop a plan to manage your gestational diabetes.
Gestational diabetes treatment
Take comfort in knowing gestational diabetes is treatable, and you may not have to continue managing diabetes after you give birth. Your doctor and care team are there to answer all your questions and help you adjust to the condition throughout your pregnancy. In general, here’s some changes you can expect during the rest of your pregnancy if you are diagnosed with GD:
Make changes to how you eat
The good news is most women can manage gestational diabetes and keep their blood sugar levels stable by changing their food choices and portion sizes. And of course, that’s easier said than done, especially if you’re dealing with pregnancy cravings. It can be challenging, but you don’t have to go at it alone.
A dietitian or nutritionist will help you develop a food plan that is nice to your pancreas, so it doesn’t have to work so hard to make insulin. This pregnancy diet will include eating healthy foods and drinks in three meals with snacks in between. By spreading out your meals, you can help keep your blood sugar from spiking.
Exercise
Daily exercise can help keep your blood sugar levels stable. While your OB-GYN will work with you to create an exercise plan, they’ll almost always recommend walking. Walking is a low-impact exercise great for all expecting parents. Walking for 10-15 minutes after each meal can help control your blood sugar in addition to 30 minutes of aerobic exercise – swimming, cycling, yoga – at least five days a week.
Test your blood sugar
In addition to your new diet, you’ll also have to monitor your own blood sugar. You’ll be given a glucose meter and finger stick. First thing in the morning and after your three largest meals, you’ll use the finger stick and place a drop of blood into the glucose meter to test your blood sugar. You’ll continue visiting your care team to help monitor your results and manage the diabetes. This team may include a diabetes educator, registered dietitian, OB-GYN or maternal fetal medicine nurse practitioner.
Give yourself additional insulin
If your body doesn’t respond to your new eating pattern, you will need additional insulin. You’ll be given an insulin pen with small, thin needles. It’s common to need a dose of insulin four times per day – usually before each meal and at bedtime.
Gestational diabetes after pregnancy
Gestational diabetes will go away after delivery, but you’ll need to remember that the distinction is in the word “gestational.” You have to be pregnant to get GD but getting it once does increase the risk of getting it in a future pregnancy. It also puts you at a higher risk of developing diabetes later in life. If you have gestational diabetes, you have a 50% chance of getting type 2 diabetes.
However, developing type 2 diabetes can be prevented by losing weight and exercising daily. Your doctor will keep monitoring you. You’ll be tested for diabetes 6-8 weeks after you’ve delivered your baby, again in one year and then every three years. If you don’t get diabetes within 10 years, your chances of getting the disease are very low.
Don’t let gestational diabetes stop you from a full, healthy pregnancy
Being diagnosed with gestational diabetes is difficult news to hear. Just remember that it’s treatable and your health care team is ready to provide support. And it can start as early as your first prenatal appointment. Here, you and your women’s health specialist can discuss any concerns or potential issues, including gestational diabetes. Gestational diabetes may change your pregnancy plan, but your team will help you manage it to continue keeping you and your baby happy and healthy.