Gestational Diabetes Management: From Causes to Cooking Pregnant

Do you feel like you are carrying a HUGE baby? It may feel that way for some, but others it’s a concern. The size of your belly does not directly correlate to the growth rate of your unborn baby, hence why we test for gestational diabetes between the 24th and 28th week of pregnancy. Gestational diabetes occurs in 7% of all pregnancies, and it has been said that that number is under represented.  If you hear I had an over 10 pound baby, unless Andre the Giant is his dad, you can pretty much assume the mom had un-diagnosed gestational diabetes. Get the answers to all your pregnancy diabetes questions in this Pregnancy Pukeology Podcast Episode 30: Gestational Diabetes Management & Diagnosis.

 

Listen to "Gestational Diabetes & How To Lower Your Sugar Naturally But Stay Sweet! Pregnancy Pukeology Podcast Episode 30" on Spreaker.

 

What is Gestational Diabetes? What causes Diabetes?

Gestational diabetes, also known as pregnancy diabetes, is a type of diabetes that is first seen during pregnancy in a woman who did not have diabetes before. Diabetes is a condition where a person develops high blood sugar levels either caused from your pancreas not secreting enough insulin (what breaks down sugar in the body) or your body being insulin resistant. Insulin is a hormone made by the pancreas that allows your body to use sugar from the carbohydrates you eat (like bread, rice, ect) for energy or store it for later use so the blood level of sugar doesn’t get too high (hyperglycemia). Moms who have never had diabetes will pass on that high sugar to the baby thru the placenta and can cause some unwanted effects on the baby.

 Side Effects of High Blood Sugar

So what’s the big deal? High blood sugar if left untreated can cause damage to the vessels that supply blood to vital organs.  Remember in past episodes I told you that your baby is receiving about 15% blood supply which is a little more than most of your organs except for your brain that gets about 20% hence why your blood volume increases and the wonderful swelling in those feet set in during your third trimester.  If you want to learn more about what to expect when you’re expecting by trimester, jump over and listen to Pregnancy Pukeology Podcast Episode 20 Pregnancy Symptoms by Trimester.

Diabetes can also increase the risk of heart disease, stroke, kidney disease, vision problems, and nervous system issues.  Have you ever heard of diabetic peripheral neuropathy? That means those long term diabetic patients who haven’t controlled their blood sugar have so much sugar surrounding their nerves that they don’t communicate and sometimes can’t feel their toes, feet, or legs.  If they stub their toe and it gets infected, the blood can’t get down there and they could potentially lose a limb.  Now for gestational diabetes it’s transient and only during pregnancy but if you have Gestational Diabetes Mellitus (abbreviated GDM) you have a 50% chance of developing type 2 diabetes later in life.

Gestational diabetes complications really affect your baby.  They are HUGE at birth.  This excessive birth weight is due directly to the extra glucose crossing the placenta which triggers your baby’s pancreas to make extra insulin. This can result in early (preterm) birth, and just because the baby looks big does not mean their lungs are fully developed.  Hence why babies of GDM moms can experience respiratory distress syndrome, low blood sugar (hypoglycemia), and type 2 diabetes later on in life.

 Glucose Test Pregnancy

You will be tested for Gestational Diabetes during your mid 20th week by either a glucose challenge test, the oral glucose tolerance test, or both. WARNING: The glucose they give you is disgusting.  I personally don’t like SUPER sweet things and it tasted like they melted a bunch of starbursts.  I personally would wear a NoMo Nausea Band, you know the one that took away your morning sickness, to the appointment because the combination of not eating and that nasty stuff can make you nauseated.

 

 


 

Glucose Test during Pregnancy: 1 Hour Glucose Test

This is also named the glucose screening test.  A health care provider will draw your blood 1 hour after your drink this sweet liquid containing glucose.  You don’t have to fast for this test, meaning you can eat or drink before your visit.  If your blood glucose is too high, above 140, you will need to return to do an oral glucose tolerance test while fasting, nothing to eat or drink before this visit so try to schedule an early appointment. If your blood sugar comes back at 200 or more, you have type 2 diabetes (notice I said YOU have type 2 not just because of your pregnancy.)

 3 Hour Glucose Test

The oral glucose tolerance test (OGTT for short) measures your blood glucose after you fast (nothing to eat or drink) for at least 8 hours. Your blood will be drawn by a medical professional.  Then you will drink a liquid containing glucose.  Make that early appointment ladies! Then you will need your blood drawn every hour for 2 to 3 hours.  A high blood glucose level at any 2 or more means you have gestational diabetes.  The GDM diagnosis requirements following the blood glucose value will also be on our Pregnancy Pukeology Podcast Blog page, just visit NoMoNausea.com/blogs/healthandwellness.

1 Hour Glucose Test Normal Range & 3 Hour Glucose Test Results

Your healthcare provider (OBGYN or Midwife) will draw your blood and if any of the following chart comes back with a blood glucose above the normal range you have Pregnancy Diabetes.  Normal range for a 1 hour glucose test is a blood glucose under 140 mg/dL. If your blood glucose is above 140, your healthcare provider will ask you to do a 3 hour glucose test with the diagnosis of gestational diabetes results below. 

 

DIAGNOSIS OF GESTATIONAL DIABETES

1 Hour Glucose Screening Test at 50g sugar

*Blood drawn required NO FASTING

1 hour > 140 mg/dL

3 Hour OGTT at 100g sugar

*Blood drawn required FASTING

**Diagnosis of GDM requires 2 of the following blood values

Fasting > 95 mg/dL (>5.3 mmol/L)

1 hour > 180 mg/dL (>10.0 mmol/L)

2 hours  > 155 mg/dL (>8.6 mmol/L)

3 hours  > 140 mg/dL (>7.8 mmol/L)

 

Gestational Diabetes Diet: Diabetic Meal Plan & Snacks for Gestational Diabetes

You don’t have to be super sweet when you have gestational diabetes. Here are some ideas to help you control your blood sugar and as a result the blood glucose of your baby.

Gestational diabetes diet tricks: Eat well and keep your sugars under control

  1. Eat snacks in between your meals.

 And try to eat smaller meals. 2 snacks, one in between your 3 meals, and your good to go.  Here's a great 150 calorie snack idea chart.  Remember to buy your lunch meat that is free of preservatives and comes from the deli and seafood that is low in mercury. 

  1. Eat a reasonable portion of starches and carbohydrates.

Try a bun-less burger using your lettuce instead, so that you can have a spoonful or two of mash potatoes.

  1. Drink one cup of milk at a time.

Milk, lactose, is a sugar, or you may want to try soy or almond milk because those are protein based.

  1. Limit your fruit portions.

Fruit, fructose, is a sugar.  Make snack size bags of fruit so you eat a handful of grapes and not the whole bag. Fruit is better than sweets, but remember everything is good in moderation.

  1. Breakfast is a must.

I’m sure you’ve heard breakfast is the most important meal of the day, well it is because you have all day to burn off those calories.

  1. Avoid fruit juice.

Naturally flavored waters are so good and if you squeeze some lemon, lime, or let cucumber sit it’s delicious.

  1. Add artificial sweeteners instead.

Splenda, Sunett, Equal, NutraSweet have all been approved during pregnancy.

  1. Don’t trust the label.

When something says “sugar free” read the back because mannitol, maltitol, sorbital, xylitol, and isomalt are all sugar-alcohols.  Instead read the total number of carbohydrates. Carbohydrate-free is truly sugar free like diet sodas and sugar free jello.

Easy Gestational Diabetes Meal Plan

I always tell my gestational diabetes patients you can have a ½, ¼, ¼ plate.  What that means is half of your plate with a Non Starchy Vegetable like asparagus, bean sprouts, bell peppers, broccoli, cauliflower, cucumber, edamame, mushrooms, spinach. A fourth of a plate of proteins like animal meats (chicken, steak, ground beef), beans, eggs, seafood, seeds, or tofu. And make the last one fourth good carbohydrates like brown rice, corn, lentils, oats, peas, plantain, potatoes, quinoa, fruits, or 100% whole wheat.

 

Eat this NOT that

Think of sprouted toast instead of white bread, zoodles (zucchini noodles) instead of regular, make your own dressings using lemon, seafood is your friend, and cauliflower can be used in place of rice and even pizza crust.  There are so many incredible products out there to help you keep your blood sugar low, so try them. If you want other great list of snacks, go over to Pregnancy Pukeology podcast episode 16 What you should be eating in pregnancy.  Think of it like your snack calendar ideas for the perfect pregnancy diet. Remember the health of your baby is dependent on what you put in your mouth, and how active you are, so find a tribe (walk-n-talk) or just get out there and be active and I bet your food "encourager" will be right beside you.

 

 

February 27, 2020 by Dr. Jacqueline Darna
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