Protect your baby.
When you’re pregnant, dieting seems perfectly counterintuitive: You are, after all, eating for two. But if you’ve been diagnosed with gestational diabetes, you have to control your carbohydrates like never before. And you may have to take insulin for the first time in your life, too.
“The advantage of treating gestational diabetes is that there is a very obvious short-term gain for aggressive treatment, and that’s a healthy baby,” says Robert Ratner, the chief scientific and medical officer at the American Diabetes Association. Treatment is also short-term, which makes women more likely to adhere, he adds. “Women with gestational diabetes are far and away the best [diabetes] patients.”
Know the risk factors.
The biggest risk factors for gestational diabetes are being overweight or obese. Nonwhite people are also at higher risk, as well as older women, Ratner adds. “Diabetes has historically been viewed as a disease of aging,” Ratner explains, so as women increasingly delay childbirth, we see more age-related gestational diabetes. And the further away ethnic minorities — say, Asians — get from their traditional diet, the more marked spike in diabetes, he adds. Women with immediate relatives who have Type 2 diabetes are also at risk, as well as those whose mothers had the condition during pregnancy.
Get tested early.
Gestational diabetes is traditionally diagnosed at week 24 of pregnancy because the pathophysiology of the disease doesn’t manifest until then, Ratner explains, adding that women can actually be diagnosed between weeks 24 and 28. The condition is mostly caused by pregnancy-induced hormonal changes, and all pregnant women should get a glucose test at their first prenatal visit, Ratner says. This identifies women — as many as 25 to 30 percent — who had diabetes going into pregnancy and didn’t even know it. Those women are highly susceptible to developing gestational diabetes and can start eating a low-carb diet and taking other preventive measures, he adds.
Lower your carbs.
This is probably the most important measure to take when you have gestational diabetes. Carbs convert to sugars, which make your blood sugar surge. The ADA recommends a minimum of 175 grams per day (one slice of bread is 15 grams), but some women elect to go lower. “That level can actually be too large of an amount that unnecessarily leads [women] to go on insulin,” says Lily Nichols, a registered dietitian specialized in gestational diabetes. Instead, bulk up your protein, veggies and healthy fats.
Focus on real food.
Nichols, whose book “Real Food for Gestational Diabetes” is due out next year, encourages her clients to “focus on mindful eating” rather than caloric restriction. She also wants people to only focus on cutting carbs, not fat, salt or anything else that could be distracting. Specific food recommendations include non-starchy veggies such as those that are cruciferous and leafy (no potatoes, corn, peas, sweet potatoes, butternut squash); fruits such as berries and oranges instead of orange juice (more fiber, less sugar); meat, fish, eggs and lower-carb dairy products; nuts and seeds; small amounts of legumes; and monounsaturated fats like those found in avocados.
Break a sweat.
The vast majority of pregnant women are not elite athletes, so there’s probably little risk of oxygen feeding muscles instead of the baby during intense workouts, Ratner says, adding that for most women, “It’s OK to exercise hard.” The American Congress of Obstetricians and Gynecologists recommends exercising 30 minutes a day, and strength training two or three times a week. Limit contact sports, as well as those that involve balls, bouncing or anything in which you risk falling, Nichols says. “Even walking 10 minutes after a meal will do it to lower blood sugar.”
Monitor your weight.
Obese and overweight women don’t need to gain as much weight during pregnancy as normal-sized women because they can transfer some of that weight to the baby. The Institute of Medicine recommends women at a healthy weight gain an average of 25 pounds; that changes to 15 to 25 pounds for overweight women, and 11 to 20 pounds for obese women. However, if a woman’s BMI exceeds 40, she may only gain a few pounds. The good news? The weight comes off quickly. “I always remind my pregnant women that you know you are going to lose 10 to 12 pounds in a matter of 45 minutes [after delivery],” Ratner says.
Take insulin if necessary.
Women with gestational diabetes need to monitor their glucose levels continuously, and if diet and exercise don’t control those levels well enough, they’ll have to take insulin. While there has been some controversy over the safety and efficacy of drugs like metformin, Ratner says, “Insulin is safe and far and away the most effective therapy.” He adds that women typically only have to take insulin for 16 weeks at most. “People can do almost anything for a short amount of time.”
Know the consequences of your condition.
Most women diagnosed with gestational diabetes are indisputably good patients because they know the consequences of inaction are dire — for both their babies and themselves. At worst, gestational diabetes increases the risk of stillbirths and miscarriages. Babies born tend to be bigger in size, but behind in development of key organs like lungs, as well as bone marrow and electrolytes. It also puts both the baby and mother at risk for developing diabetes at some point. Almost 80 percent of women with gestational diabetes develop Type 2 diabetes, half within five to 10 years of delivery, Ratner says.
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How to Cope With Gestational Diabetes originally appeared on usnews.com
