Gestational Diabetes And Nutrition

Introduction

What is gestational diabetes?

Gestational diabetes is when the glucose levels in the blood become elevated (hyperglycemia) but do not exceed the diagnosis of diabetes.1 Gestational diabetes develops during pregnancy, usually in the second or third trimester, and usually recedes after birth.2

Gestational diabetes arises when the body cannot produce enough insulin to meet the demand of pregnancy. Insulin is a hormone that helps to control blood glucose levels, a lack of insulin can lead to increased levels of glucose in the blood. Additionally, if the body is unable to use the insulin effectively, this is referred to as insulin resistance and the glucose in the blood is not absorbed and used as energy by the cells.3 

Symptoms

The symptoms of gestational diabetes include the following: 

  • Frequent urination, especially at night 
  • Thirst 
  • Fatigue 
  • Unintentional weight loss 
  • Itching of genitals 
  • Blurred vision 

Some women may not experience any symptoms and will only find out of their diagnosis through blood test results towards the end of the pregnancy. Common pregnancy symptoms tend to be quite similar to the symptoms of gestational diabetes making it quite difficult to diagnose, hence why the oral glucose tolerance test is used. 

A balanced diet reduces the risk of developing gestational diabetes

A balanced diet can help to keep your blood glucose levels in a healthy range. If we consume a carbohydrate-rich diet, this can elevate our blood glucose levels and contribute to the risk of gestational diabetes. Ensure you are consuming balanced diet with a variety of foods such as vegetables, pulses, fruits, and low glycaemic index carbohydrates.4 It is advised to consult a dietitian if you are diagnosed with gestational diabetes, as they can provide you with dietary advice and help to manage your gestational diabetes with diet. 

The importance of a balanced diet whilst pregnant

It is important to have a balanced diet during pregnancy to ensure you are meeting the nutritional demands for both yourself and the baby’s growth and development. Your diet can impact the baby’s long-term health all the way into adulthood.5  

Dietary recommendations for managing gestational diabetes

Foods with low GI index

The Oxford dictionary defines Glycaemic Index as a figure representing the relative ability of a carbohydrate food to increase the level of glucose in the blood. In simpler terms, it is a rating system for foods that contain carbohydrates and it measures how quickly each food can impact your blood glucose levels.6

It is advised to eat foods with a low glycaemic index score as they are metabolised more slowly and cause a gradual rise in blood glucose levels. They also help to control our appetite and keep us feeling fuller for longer. Low glycaemic index foods usually score 55 or below and include some of the following foods.1

  • Brown rice 
  • Whole grains 
  • Sweet potato 
  • Plain milk/yoghourt 
  • Vegetables 
  • Most fruits (not all) 

In general, high-fibre foods tend to have a lower glycaemic index value and include foods such as whole grains, vegetables, pulses, and fruit. 

However, it is not to say that all low glycaemic index foods are the healthier or better choices, some foods can be classed as low glycaemic due to their high-fat content (e.g chocolate) but it does not mean that it is advised to consume with every meal. It is important to choose a balanced diet that contains all the essential macronutrients, vitamins, and minerals. 

Protein-rich foods

Protein is an important macronutrient in pregnancy, it supports the baby’s growth and development of new tissues, hormones, antibodies, and enzymes.7 Protein also helps to keep you feeling fuller for longer and does not have a great effect on blood glucose levels as carbohydrates do. Some great sources of protein include: 

  • Beans and pulses 
  • Meat 
  • Fish 
  • Poultry 
  • Nuts 

Lean meat and fish

Fish helps to provide key nutrients in pregnancy to support the child’s brain development, spinal cord development, and immune system. Fish contains omega-3 and omega-6 fats, iron, iodine choline, vitamin b12, vitamin D, and protein.8 It is important to note that it is advised to avoid fish with high levels of mercury such as swordfish and sharks as mercury can cause damage to the baby’s development. Despite the many health benefits of fish, it is recommended to eat no more than two portions of oily fish a week due to the levels of toxins it contains. 

The recommended choices of fish include:

  • Anchovy 
  • Herring 
  • Hake 
  • Salmon 
  • Shrimp 

Lean meats such as chicken, turkey, and beef are high in vitamins and minerals and are a great source of high-quality protein. However, it has been shown that having a high intake of red or processed meats may increase your risk of developing gestational diabetes during pregnancy.9,10

It is advised to limit your consumption of any red or processed meats and opt for healthier alternatives when possible. You must ensure to fully cook all proteins before consumption to destroy any harmful bacteria and viruses. 

Conclusion

During pregnancy, it is not uncommon to develop gestational diabetes due to the body’s inability to make enough insulin. This causes a rise in blood glucose levels which is usually identified by the oral glucose tolerance test. Factors such as a high BMI, lack of exercise, prediabetes, or having had gestational diabetes in your previous pregnancy can increase your risks. 

It is vital to follow the dietary recommendations stated above to manage your blood glucose levels during pregnancy as developing gestational diabetes can increase your risk of developing type 2 diabetes post-pregnancy. This also puts your baby at a higher risk of developing type 2 diabetes in the future. 

References

  1. Diabetes [Internet]. [cited 2022 Oct 24]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes 
  2. Gestational diabetes [Internet]. NHS.UK. 2017 [cited 2022 Oct 24]. Available from: https://www.nhs.uk/conditions/gestational-diabetes/ 
  3. Gestational diabetes [Internet]. RCOG. [cited 2022 Oct 24]. Available from: https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/gestational-diabetes/ 
  4. What can I eat with gestational diabetes? [Internet]. Diabetes UK. [cited 2022 Oct 24]. Available from: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/i-have-gestational-diabetes 
  5. Healthy eating in pregnancy | nidirect [Internet]. 2019 [cited 2022 Oct 24]. Available from: https://www.nidirect.gov.uk/articles/healthy-eating-pregnancy 
  6. What is the glycaemic index (Gi)? [Internet]. NHS.UK. 2018 [cited 2022 Oct 24]. Available from: https://www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/ 
  7. Lactation I of M (US) C on NSDP and. Protein and amino acids [Internet]. National Academies Press (US); 1990 [cited 2022 Oct 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235221/ 
  8. Nutrition C for FS and A. Advice about eating fish. FDA [Internet]. 2022 Sep 28 [cited 2022 Oct 24]; Available from: https://www.fda.gov/food/consumers/advice-about-eating-fish 
  9. Red alert: processed and red meat [Internet]. Diabetes UK. [cited 2022 Oct 24]. Available from: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/what-is-a-healthy-balanced-diet/processed-and-red-meat 
  10. Marí-Sanchis A, Díaz-Jurado G, Basterra-Gortari FJ, de la Fuente-Arrillaga C, Martínez-González MA, Bes-Rastrollo M. Association between pre-pregnancy consumption of meat, iron intake, and the risk of gestational diabetes: the SUN project. Eur J Nutr. 2018 Apr;57(3):939–49.

Darija Golubovic

Bachelor's degree, Nutrition Sciences, The Manchester Metropolitan University, England

I graduated from Manchester Metropolitan University with a First Class in Nutritional Science BSc.
I aim to continue promoting health, wellbeing and fitness and influencing healthy food choices and sustainability.
Registered Associate Nutritionist delivering the NHS Diabetes Prevention Programme.

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