A Nutrition Plan for Gestational Diabetes

  • 1st Revision: Adam M Lane
  • 2nd Revision: Jasmine Yeh[Linkedin]
  • 3rd Revision: Olivia Sowerby

What is gestational diabetes?

Gestational diabetes is a type of diabetes observed in pregnant people assigned female at birth (AFAB) who did not have diabetes before pregnancy. Gestational diabetes is typically diagnosed between 24 to 28 weeks of pregnancy. People AFAB diagnosed with gestational diabetes need to take insulin, but it can also be controlled by following a healthy, active lifestyle and eating nutritious foods.1 

Symptoms

Usually, no symptoms occur with gestational diabetes, but some individuals may feel thirstier and pass more urine than usual if they have gestational diabetes.2 Gestational diabetes can be diagnosed using an Oral Glucose Tolerance Test (OGTT) during 24 to 28 weeks of pregnancy.3

Risk Factors and Causes

Cause

Insulin is a hormone produced by the pancreas that regulates the glucose level in the blood. During pregnancy, extra insulin is needed by the body.  When the body cannot make that insulin, it results in gestational diabetes. When a woman gets pregnant, she undergoes many changes in her body, like gaining weight and hormonal imbalance. Subsequently, this can result in insulin resistance in which cells cannot use insulin properly. Insulin resistance is typical during late pregnancy.

Risk Factors

Being Obese or Overweight 

Being obese or overweight is directly associated with a higher risk of developing gestational diabetes because there is a higher possibility that obese or overweight individuals are resistant to insulin. Significant weight gain during pregnancy is another risk factor for developing gestational diabetes.

Genetics

People AFAB are more likely to develop gestational diabetes if someone in their immediate family already has diabetes. Therefore, the inheritance of genes is another crucial factor contributing to gestational diabetes.2 

Ethnicity

Pregnant people AFAB of South Asia, Africa, or middle eastern countries have higher chances of getting gestational diabetes.9 

Previous Pregnancy(s)

During a previous pregnancy, if the baby's weight was equal to or more than 4.5 kg, there is an increased chance that the mother will develop gestational diabetes in subsequent pregnancies.3

Complications

Developing gestational diabetes can cause various issues for both the mum and the baby due to an imbalance of blood sugar levels. Some common complications are detailed below. 

Baby Becoming Overweight

As babies get most of their nutrients from their mum, the high blood sugar levels observed in people AFAB with gestational diabetes can cause the baby to become overweight prior to birth. Subsequently, this can cause the mum to become uncomfortable during the last months of pregnancy because of the extra weight of the baby. This additional weight can cause an issue for both the mum and the baby at delivery, as it increases the likelihood of delivering the baby via caesarean section (c-section). A C-section is a procedure in which the baby is delivered through an operation. This operation can cause increased stress on the mum; subsequently, they may require more time for recovery.2 Lastly, due to the baby being overweight, there is an increased risk of nerve damage for the baby because there is more pressure on their shoulders during pregnancy.

Preeclampsia

This is when an individual’s blood pressure is chronically high. The symptoms of this condition are high blood pressure, urine containing protein and swelling in the fingers and toes. High blood pressure is harmful to both the baby and the mum. It can cause early delivery of the baby and an increased chance of the mum having a stroke (chance of brain damage) and seizure during the delivery, increasing labour pain.10

Hypoglycemia

This is a severe and fatal condition of low blood sugar levels. It is essential to treat this disease as early as possible as the baby will likely also have low blood sugar after birth. Thus, it is essential to check the baby's blood sugar after the delivery. Hypoglycemia is typically caused by diabetes medications and insulin consumption.8

The Diabetes Diet

Transforming the diet will aid in lowering blood sugar which can positively impact the baby and reduce the risk of complications linked to gestational diabetes.4 Detailed below are some diet changes that can be applied to combat gestational diabetes:

  1. Healthier Carbs: Try to switch to healthy carbohydrates as different carbohydrates are processed by the body at different rates. In the bloodstream, carbohydrates convert into sugar. Therefore, it can impact the blood glucose levels of the body. So, it becomes crucial to switch to healthy carbohydrates rather than processed carbohydrates, for example switching white rice for brown rice.4
  2. Cut Down Sugar: Eliminating sugar from the diet can be beneficial as, with diabetes, the body will find it more difficult to process the sugar. It is essential to cut down the sugar in every form(i.e. different foods and drinks). Try an alternative natural sweetener instead of sugar.4
  3. Portion Size: Usually, three meals and three snacks in a day are recommended for people AFAB with gestational diabetes. If a person consumes a large portion of food in one go, more insulin is required for processing the sugar present in that meal. The body needs less insulin if a woman eats a small portion of foods after a fixed-time gap.4
  4. Snacks: Eating snacks is essential for a woman with gestational diabetes because missing a snack or a meal can lower blood sugar levels; therefore, the liver must break down glucose into the bloodstream to provide us with the energy to do work.The pancreas would then generate more insulin, but this is not possible in gestational diabetic people AFAB. Therefore, there is a possibility that sometimes the body will produce more insulin than required, leading to an imbalance of blood sugar levels.4
  5. Avoid Diabetic Foods: Diabetic foods are quite expensive and do not offer any particular health benefits to people. They are also known to upset the stomach and affect the blood sugar levels of individuals consuming them.
  6. Glycaemic index: You should replace foods containing a high glycaemic index with  lower glycaemic index foods as they take longer to be broken down by the body. This ensures that blood sugar levels will slowly rise after eating these kinds of foods.4
  7. Manage Your Weight: Weight gain can cause hypertension and interrupt blood sugar levels. Therefore, it is essential to exercise and eat healthy food during pregnancy. Managing weight can decrease the chance of developing Type 2 diabetes and gestational diabetes in the long run.4
  8. Eat More Fish: It is recommended to eat two portions (220-300g) of oily fish per week as it can help develop good heart health for the mother and proper development of the baby.4

Meal and Snack Ideas

  1. Whole-wheat pasta
  2. Starchy vegetables, such as corn and peas
  3. Green leafy vegetables
  4. Vegetable Soups
  5. Fruits, mainly citrus fruits
  6. Porridge
  7. Low-fat natural yoghurt
  8. Peanut butter with whole-grain slices of bread
  9. Fish
  10. Yams
  11. Noodles
  12. Soy milk
  13. Nuts like almonds, walnuts, raisins
  14. Fruit Loaf
  15. Teacake
  16. Chickpea and tuna salad
  17. Lentils
  18. Chicken pittas
  19. Vegetable omelette
  20. Wholemeal pancakes, including cheddar cheese and green leafy vegetables
  21. Thai curry
  22. Salad including chicken and soybean
  23. Tofu 
  24. Use olive oil for cooking food

Conclusion

Approximately 10% of pregnant women have gestational diabetes every year in the United States.6 Gestational diabetes is a severe condition that can prove to be dangerous for both the baby and the mother; therefore, it needs proper treatment at an early stage of diagnosis. It can mostly be treated by following a healthy lifestyle, including a balanced diet and regular exercise. Some women still need insulin to control gestational diabetes. The insulin doses should decrease to the pre-pregnancy levels after the delivery of the child; otherwise, it can lead to hypoglycemia. The caesarean section is more often observed in women not suffering from diabetes.7 An oral glucose tolerance test between 24 to 28 weeks of pregnancy is used to diagnose gestational diabetes. This includes a blood test done after fasting for 8 to 10 hours.8 The long-term effects of gestational diabetes are type 2 diabetes and suffering from gestational diabetes again during a subsequent pregnancy.

References

  1. CDC. “Gestational Diabetes and Pregnancy | CDC.” Centers for Disease Control and Prevention, 14 July 2020, https://www.cdc.gov/pregnancy/diabetes-gestational.html.
  2. “Symptoms & Causes of Gestational Diabetes | NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational/symptoms-causes. Accessed 19 Mar. 2022.
  3. “What Is Gestational Diabetes?” Diabetes UK, https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes. Accessed 19 Mar. 2022
  4. “Gestational Diabetes Diet • Gestational Diabetes UK.” Gestational Diabetes UK, 9 Aug. 2015, https://www.gestationaldiabetes.co.uk/gestational-diabetes-diet/.
  5. Gestational Diabetes Diet: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/007430.htm. Accessed 20 Mar. 2022.
  6. Gestational Diabetes - Symptoms, Treatments | ADA. https://www.diabetes.org/diabetes/gestational-diabetes. Accessed 20 Mar. 2022.
  7. January 15, Editor on, et al. “Finding out You Have Gestational Diabetes Can Be Very Frightening. Not Only Do You Have to Deal with All the Emotions (the Ups and the Downs) and the Questions That Come with Being Pregnant, but Also the Uncertainty of This New-Found Condition.” Diabetes, 15 Jan. 2019, https://www.diabetes.co.uk/gestational-Diabetes.html.
  8. “Gestational Diabetes.” Nhs.Uk, 20 Oct. 2017, https://www.nhs.uk/conditions/gestational-diabetes/.
  9. Yuen L, Wong VW. Gestational diabetes mellitus: Challenges for different ethnic groups. World J Diabetes [Internet]. 2015 Jul 25 [cited 2022 May 27];6(8):1024–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515442/
  10. Pre-eclampsia [Internet]. nhs.uk. 2018 [cited 2022 May 27]. Available from: https://www.nhs.uk/conditions/pre-eclampsia/

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Samriti Juneja

Masters of Science in Human Nutrition, University of Aberdeen, Scotland, UK
Researched about to carry out the tissue analysis of metabolic tissues from the GPR75 knockout mice to identify the changes in gene expression, protein expression and histology. Furthermore, observing its relationship with obesity.

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