By Wendy Hodsdon, ND

You are pregnant and notice that you are thirstier, hungrier, and more tired than usual. You also have to go to the bathroom all the time. While these are all normal, common symptoms of pregnancy, they can also be signs of gestational diabetes, which is diabetes developed during pregnancy. 2 to 7 percent of women develop gestational diabetes, making it a common complication of pregnancy.

Gestational diabetes is routinely tested for during weeks 24 to 28 of pregnancy with a Glucose Challenge Test (GCT). It entails drinking a high-sugar drink and then assessing blood sugar levels. If test results show high levels, a Glucose Tolerance Test (GTT) is used to confirm the diagnosis of gestational diabetes.

Pregnancy hormones are a reason why diabetes develops during pregnancy. These hormones cause a woman's body to produce less insulin, which makes blood sugar levels rise. However, the body cannot increase insulin production to metabolize these higher blood sugar levels. Most women who develop diabetes during pregnancy are not diabetic after the baby is born, though they are more likely to develop diabetes as they get older.

Risk factors for gestational diabetes

Women are more likely to develop gestational diabetes if they:

• Have had this condition in previous pregnancies
• Have a strong family history of diabetes
• Are obese (with body mass index over 30)
• Have sugar in their urine
• Have had history of a stillbirth or a baby with birth defects.

Effects of gestational diabetes

Diabetes that develop during pregnancy can usually be managed with diet and exercise. Most women with this condition give birth to normal, healthy babies. However, if the gestational diabetes is not controlled, there can be complications for both baby and mother. Later in pregnancy, mothers with gestational diabetes are more at risk of preeclampsia, high blood pressure with protein in the urine; and of having a stillborn baby.

When there is too much sugar in the mother's blood, the baby must compensate by making more insulin with its pancreas. This is hard for the baby's developing pancreas, and eventually, the baby puts on extra weight. When a baby is too large, childbirth is more difficult and more likely to involve complications.

Gestational diabetes may also affect the baby after birth. Although the baby is no longer getting high levels of sugar from the mother, it may still be making extra insulin, causing it to suffer from low blood sugar levels. Babies whose mothers have had gestational diabetes also are more at risk of jaundice, red blood cell disorders, and low calcium levels.

Treating gestational diabetes with diet

Managing diabetes during pregnancy requires close monitoring of a woman's blood sugar or glucose levels. To keep blood sugar levels stable, do not skip meals. It is especially important not to miss breakfast. Eating 3 small- to medium-sized meals a day with snacks can help stabilize blood sugar levels quickly. The principles of a healthy diet are good for everyone. In addition to pregnant women, these eating guidelines will also benefit their partners and children:

• Focus on nutritional value. Eliminate foods that do not offer the vitamins and minerals necessary for making a healthy baby.

• Eliminate simple sugars and simple carbohydrates. Simple carbohydrates and sugar are absorbed quickly into the bloodstream, causing blood sugar levels to rise very quickly, and placing a burden on the pancreas. It is better to eat complex carbohydrates with fiber that are absorbed more slowly.
• Incorporate food variety. Make sure to eat a variety of foods throughout the day. Get some protein at every meal and balance it with a wide variety of colorful vegetables and small amounts of complex carbohydrates. Eat fruit in small amounts. Fruit juice contains concentrated sugar and is best avoided.
• Eat high fiber foods. These include vegetables, beans, whole grains, and some fruit. Fiber slows the absorption of sugar into the bloodstream and helps maintain healthy blood sugar levels.
• Limit sweets. Sweets cause rapid increases in blood sugar levels. Avoid artificial sweeteners, which have an unknown effect on the brains of developing babies. After 4 to 7 days of not eating sugar, cravings for sweets usually diminish. (For more information on sugar substitutes for diabetics see the following article: Sugar Substitutes: Can Diabetics Use Them?)
• Get into an exercise routine. During pregnancy, it is important to obtain permission from a doctor before exercising. Gentle to moderate exercise for 30 minutes a day decreases blood sugar levels and is tolerated well by most women.

If blood sugar levels are still not under control with diet and exercise, a health care practitioner may recommend insulin shots. This can be beneficial in preventing the complications of gestational diabetes.

Conclusion: gestational diabetes - follow a healthy diet, low in sugar

Most women who develop gestational diabetes go back to normal blood sugar levels after pregnancy, but are at a higher risk of developing diabetes later in life. Their babies also have a higher chance of childhood and adult obesity. A healthy balanced diet that is low in sugar and includes lots of colorful vegetables is beneficial for both women and children.

For more tips on changing your diet to manage your sugar levels see the following articles from TheDietChannel: Diabetes & Diet: Control Your Blood Sugar with Mini-Meals and 3 Holiday Eating Strategies for Diabetics.