Managing Gestational Diabetes

According to the Centers for Disease Control and Prevention, gestational diabetes affects up to 10% of pregnant women in the US. The condition occurs during pregnancy when the body doesn’t make enough insulin, a hormone that acts like a key to let blood sugar into cells in the body for use as energy. Hormonal changes and weight gain during pregnancy cause the body to use insulin less effectively, increasing the need for insulin.

Gestational diabetes is both preventable and treatable. Women should understand its risks and implement a healthy diet and lifestyle before becoming pregnant, according to Drs. Elizabeth Boham and Mark Hyman. In a recent podcast on the subject, the doctors emphasized that women who are pre-diabetic, obese, overweight, or have excess belly fat, or those who belong to certain ethnic groups (Native American, Hispanic, African-American, and Asian) are at a higher risk of developing gestational diabetes. A mother-to-be can check her insulin levels with a fasting blood test to determine if she is diabetic or pre-diabetic before becoming pregnant.

Left untreated, gestational diabetes can have long-term adverse effects on both the child and the mother. The child may be at risk for not only an above-average birth weight (>8 lbs 13ozs) but also elevated risks of insulin resistance, diabetes, weight gain, and obesity as an adult. Mothers with gestational diabetes have a higher risk of caesarean section delivery and of type 1 and type 2 diabetes, cardiovascular disease, and metabolic syndrome after delivery.

Drs. Boham and Hyman stressed the importance of a proper diet—healthy fat, protein, and fiber—for women who are planning to get pregnant and those that are pregnant to keep blood sugar levels stable. The doctors said the notion that “I’m pregnant, I can eat what I want” is “nonsense.” Dr. Boham stated that women should not consume extra calories during the first trimester, and should increase their daily calorie intake during the second and third trimesters by only 350 and 450 calories, respectively. Women should keep healthy foods on hand to satisfy their cravings and avoid refined carbohydrates and simple sugars. Supplementation with carnitine, an important nutrient that helps support energy metabolism, may be required for women on low or no animal protein diets. Good prenatal vitamins contain both carnitine and L-methylfolate, a bioequivalent form of folic acid that may be better tolerated and more effective for some women.