Introduction
Gestational diabetes mellitus (GDM) is a distinct manifestation of diabetes that arises during pregnancy, affecting the way the body processes glucose. GDM is characterised by elevated blood sugar levels that can pose risks to both expectant mothers and the developing foetus. The understanding and management of GDM have emerged as an essential component of contemporary maternal healthcare as the prevalence of the condition has gradually increased.
Gestational diabetes occurs when hormonal changes during pregnancy lead to insulin resistance. This means the body cells do not respond effectively to insulin, the hormone responsible for lowering blood sugar. Consequently, there is a possibility of increased blood glucose levels, which might have detrimental effects on both maternal and foetal health. The incidence of gestational diabetes varies across different populations and regions, but estimates suggest that around 7% of pregnancies globally are affected by this condition.1
Effective management of gestational diabetes is crucial, given its possible implications for the health of both the mother and the foetus. Unregulated blood sugar levels in pregnant individuals diagnosed with GDM can lead to a range of problems, including preeclampsia, premature birth, and the need for a caesarean section.2 For the foetus, the implications of uncontrolled GDM can lead to excessive growth, increased risk of birth injuries and increased risk of metabolic complications in later life.3
Diet is one of the most important factors to consider while managing gestational diabetes. The low-carbohydrate diet, sometimes known as the "low-carb" diet, has become more popular. A diet that is low in carbs emphasises consuming fewer carbohydrate-dense meals, the ingestion of which can lead to sharp increases in blood sugar levels. The goal is to maintain stable blood sugar levels and enhance overall metabolic control by reducing the number of carbs consumed and opting instead for a diet with a higher proportion of complex carbohydrates, lean proteins, and healthy fats.
Benefits of a low carb diet for gestational diabetes
The low-carb diet is a nutritional approach that prioritises the reduction of carbohydrate consumption, explicitly targeting those rapidly absorbed carbs that lead to substantial increases in blood sugar levels. The primary emphasis of this dietary approach centres on consuming foods abundant in protein, beneficial fats, and dietary fibre while concurrently restricting the intake of simple sugars and processed carbs.
One notable benefit of a low-carbohydrate diet for managing gestational diabetes is its favourable influence on controlling blood sugar levels. Carbohydrates are macronutrient that has the highest impact on blood glucose levels. The body undergoes slower and more consistent rises in blood sugar levels after meals by reducing the consumption of readily digestible carbs. The decreased blood glucose levels seen might potentially mitigate the drastic variations in blood sugar levels frequently observed in gestational diabetes.4
A low-carb diet also makes the body rely more heavily on fats as an energy source, the process of which is called ketosis. Not to be confused with diabetic ketoacidosis, which is a dangerous state in type 1 diabetes, nutritional ketosis from a managed low-carb diet may help stabilise blood sugar levels and reduce insulin resistance.5
Weight gain is natural and expected during pregnancy, but excessive weight gain can lead to gestational diabetes. A low-carb diet can help individuals lose weight by lowering their overall caloric intake and making them feel full by eating foods high in nutrients. This way of eating has been linked to better weight control and better metabolic indicators in pregnant women.6
In addition to regulating blood sugar levels, a low-carb diet can positively influence cardiovascular health and overall well-being. By prioritising the consumption of whole foods and limiting the intake of refined sugars, individuals might potentially mitigate the likelihood of experiencing substantial weight gain, hypertension, and other metabolic disruptions frequently linked to gestational diabetes.7
Designing a low carb pregnancy diet plan
Before implementing any substantial modifications to one's diet, it is essential to get guidance from a healthcare professional or a certified dietician, as the needs of pregnant individuals can vary widely.
- Identifying appropriate carbohydrate sources: Opt for whole grains like quinoa, brown rice, and whole-wheat pasta. These complex carbohydrates release energy gradually, helping to maintain stable blood sugar levels. Choosing fibre-rich sources like legumes, vegetables, and berries. Fibre slows down digestion and absorption, preventing rapid spikes in blood sugar.
- Incorporating lean proteins and healthy fats: Lean protein sources such as lean meats, poultry, fish, eggs, and plant-based proteins like tofu and legumes are ideal. Protein supports foetal growth and helps control blood sugar. Try integrating sources of healthy fats like avocados, nuts, seeds, and olive oil. Healthy fats are essential for a baby's brain development and provide sustained energy to the mother.
- Prioritising nutrient-dense fruits and vegetables: Consuming a range of colourful fruits and vegetables ensures a diverse array of vitamins, minerals, and antioxidants. These nutrients contribute to the pregnant individual's overall health and that of the baby. While fruits are nutritious, they contain an abundance of natural sugars, a spot for natural fruits and monitor portion sizes to manage carbohydrate intake.
- Hydration and the role of water in a low-carb diet: Adequate hydration is vital during pregnancy. Water helps transport nutrients, regulate body temperature, and maintain amniotic fluid levels. Aim to drink plenty of water throughout the day. Water can also help curb hunger and promote a feeling of fullness, which can be especially helpful when following a low-carb diet.
Monitoring and managing blood sugar levels
Regular blood glucose monitoring is fundamental to the effective treatment of gestational diabetes. Monitoring provides real-time insights into how dietary choices influence blood sugar levels. Understanding ideal blood sugar ranges is essential for maintaining optimal health. In most cases, medical professionals will offer patients specific target ranges for their blood sugar levels while fasting (i.e., before meals) and postprandially (i.e., after meals). These goals help minimise drastic changes in blood sugar that have an unhealthy effect on both the expectant mother and the baby. Checking blood sugar levels helps observe trends in how the body reacts to various meals and types of food. If readings continually fall outside the target ranges, the pregnant individual needs to adjust their diet. A low-carb pregnancy diet may help regulate blood sugar but is not for everyone. If blood sugar levels stay high after diet changes, medical advice should be sought.
Lifestyle considerations
- Incorporating regular physical activity: Physical exercise helps manage gestational diabetes, as regular exercise improves insulin sensitivity and blood sugar management. Activities like walking, swimming, and prenatal yoga can improve well-being and help maintain a healthy pregnancy weight.
- Managing stress and sleep for better blood sugar control: Stress and sleep deprivation can raise blood sugar levels and impair glucose metabolism. Reducing stress with deep breathing, meditation, and mindfulness in addition to getting sufficient sleep, can help regulate blood sugar.
- Potential impact of gestational diabetes on future pregnancies and type 2 diabetes risk: Managing gestational diabetes goes beyond the current pregnancy. It is essential to be aware of the fact that having gestational diabetes raises the likelihood of subsequently being diagnosed with type 2 diabetes. Adopting a low-carb pregnancy diet, maintaining a healthy weight, and staying physically active can reduce this risk. In addition, monitoring blood sugar levels consistently even after pregnancy can assist in identifying any changes that might be of concern in the future.
Adapting the diet post pregnancy
These healthy habits developed during pregnancy can have lasting benefits. By consistently placing emphasis on the consumption of rich nutrients, lean sources of protein, and health-promoting fats, individuals may effectively contribute to their overall well-being and mitigate the likelihood of chronic conditions. Consuming a well-balanced diet may contribute successfully to the regulation of blood sugar levels, the maintenance of healthy body weight, and the provision of vital nutrients for both the mother and the child.
Gestational diabetes is associated with a higher risk of acquiring type 2 diabetes in later years. Routine health examinations, including blood glucose assessments, play a crucial role in the surveillance of potential indicators of diabetes. Maintaining an ongoing collaboration with a healthcare practitioner is advisable to effectively manage health and obtain valuable guidance about maintaining a well-balanced diet and lifestyle, which may help offset the abovementioned risks.
Adapting eating habits post-pregnancy involves transitioning wisely, knowing the long-term benefits of a healthy dietary pattern, and staying aware of potential diabetes risks. Maintaining a healthy diet and lifestyle grants the mother and child a healthy lifestyle even in their later years.
Conclusion
In the journey of pregnancy, managing the risk of gestational diabetes holds paramount importance. If a mother is at risk of or diagnosed with GDM, a low-carb pregnancy diet offers a powerful tool for maintaining stable blood sugar levels and promoting the health of both mother and baby. By choosing nutrient-dense whole foods, emphasizing lean proteins and healthy fats, and incorporating controlled carbohydrates, you have the means to navigate gestational diabetes with greater confidence.
While embarking on motherhood, remember that your well-being is closely intertwined with that of your baby. Adopting a low-carb diet tailored to your needs, aligning with healthcare professionals' guidance, and taking proactive steps to ensure a healthier pregnancy journey can help control the effects of GDM. Embrace regular physical activity, manage stress, and prioritize adequate sleep. A mother's dedication to these aspects of lifestyle will have positive ripple effects on her current pregnancy and her future health.
Summary
Gestational Diabetes Mellitus (GDM) is diabetes that develops during pregnancy, affecting glucose management and posing risks to both mothers and foetuses. This condition affects approximately 7% of pregnancies globally and arises due to hormonal changes causing insulin resistance and leading to elevated blood sugar levels. Managing GDM is crucial to avoid complications such as preeclampsia, premature birth, and birth injuries. A low-carbohydrate (low-carb) diet, emphasizing protein, healthy fats, and complex carbs, has benefits for managing GDM. It helps stabilize blood sugar levels, promotes ketosis, aids weight control, and improves cardiovascular health. This diet should be tailored with guidance from healthcare professionals. Monitoring blood sugar levels and incorporating exercise, stress management, and adequate sleep are crucial. GDM increases the risk of future type 2 diabetes, making post-pregnancy diet and lifestyle adaptation important for long-term health. A low-carb diet can effectively manage GDM, promoting stable blood sugar levels and overall well-being for both mother and baby.
References
- International Diabetes Federation (IDF) (2017) IDF Diabetes Atlas. 8th Edition, International Diabetes Federation, Brussels. - References - Scientific Research Publishing [Internet]. Scirp.org. 2017 [cited 2023 Aug 3]. Available from: https://scirp.org/reference/referencespapers.aspx?referenceid=2187493
- American Diabetes Association. 2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes—2021. Diabetes Care [Internet]. 2020 Dec 4 [cited 2023 Aug 3];44(Supplement_1):S15–33. Available from: https://pubmed.ncbi.nlm.nih.gov/33298413/
- Metzger BE, Lowe LP, Dyer AR, Trimble ER, Sheridan B, Hod M, et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. N Engl J Med [Internet]. 2009 Feb 1 [cited 2023 Aug 3];58(2):453–9. Available from: https://pubmed.ncbi.nlm.nih.gov/19011170/
- Farabi SS, Hernandez TL. Low-Carbohydrate Diets for Gestational Diabetes. Nutrients [Internet]. 2019 Jul 27 [cited 2023 Aug 3];11(8):1737–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723585/
- Yancy WS, Foy ME, Chalecki AM, Vernon MC, Westman E. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab (Lond) [Internet]. 2005 Dec 1 [cited 2023 Aug 3];2(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/
- Andrea Mario Bolla, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes. Nutrients [Internet]. 2019 Apr 26 [cited 2023 Aug 3];11(5):962–2. Available from: https://pubmed.ncbi.nlm.nih.gov/31035514/
- Gardner CD, Trepanowski JF, Del LC, Hauser ME, Rigdon J, John, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion. JAMA [Internet]. 2018 Feb 20 [cited 2023 Aug 3];319(7):667–7. Available from: https://pubmed.ncbi.nlm.nih.gov/29466592/