The Right Approach to Manage Gestational Diabetes at Home

Some expecting mothers, without any history of diabetes prior to conception, encounter an unanticipated surge in their sugar levels during pregnancy because their bodies start resisting insulin. In most cases, the elevated sugar levels tend to resolve as soon as the baby is born. This form of temporary diabetes is known as gestational diabetes mellitus (GDM) and typically develops between the 24th and 28th weeks of pregnancy. Along the same lines as other types of diabetes, gestational diabetes also affects how your cells process sugar or body glucose.

Up to 9.2% of pregnant women suffered from this problem in 2010, according to a 2014 analysis by the Centers for Disease Control and Backention. Given its widespread prevalence, it is recommended that all pregnant women get tested for gestational diabetes at the beginning of the third trimester, or around approximately the 28th week of pregnancy.

Causes

  • The exact cause of GDM is unknown, but the hormonal changes during pregnancy play a key role. During pregnancy, the body produces larger amounts of some hormones like human placental lactogen and estrogen, which can increase the body’s resistance to insulin, the hormone responsible for regulating blood sugar. Because insulin serves the function of transferring glucose from the blood into the cells to be later utilized for energy, an increased resistance to insulin amounts to glucose buildup in the bloodstream. This high level of blood glucose can have damaging effects on the baby’s health as well.
  • Gestational diabetes typically occurs in late pregnancy after the baby’s body has been formed. It does not typically cause the kinds of birth defects that can occur in babies of mothers who had diabetes before pregnancy.
  • Risk factors of developing GDM include being older than 25, pre-existing high blood pressure, a family history of diabetes or personal history of pre-diabetes, and being overweight or obese before pregnancy.()
  • Gestational diabetes is linked to polycystic ovary syndrome (PCOS), which has similar effects on the body’s hormones and resistance to insulin.
  • Women who have previously given birth to a baby weighing more than 9 pounds or had an unexplained miscarriage or stillbirth are also at an increased risk for GDM.()

Symptoms

Gestational diabetes typically doesn’t exhibit any symptoms and is usually picked up during the routine blood sugar tests that are administered as part of every gynecologist-recommended prenatal care. Occasionally, mild symptoms appear such as:

  • Fatigue
  • Blurred vision
  • Excessive thirst
  • Excessive need to urinate.

Backention

  • Instead of eating three large meals, break your pattern by eating smaller portions of food at regular intervals throughout the day.
  • Frame a diet plan that includes a variety of foods, such that you can meet your health goals without compromising on either nutrition or taste.
  • Eat lots of green leafy vegetables.
  • Eat low-glycemic-index fruits, such as apples, guava, oranges, and watermelon.
  • Limit the amount of fat you eat, particularly saturated fat. Use healthy fats for cooking, like olive oil and polyunsaturated oils, and eat more foods like avocados and unsalted nuts, which contain plenty of such fats.
  • Eat at least two small servings of protein a day to support the growth of your baby.
  • Include two to three servings of low-fat, calcium-rich foods in your diet daily.
  • The best drink for your body is water. Plain mineral water with fresh lemon is a quick and easy way to keep your body hydrated.
  • Closely monitor the movement of your baby. If you do not feel any movement or have noticed a significant change in your baby’s movement for a couple of hours, call your healthcare provider immediately.
  • Since being overweight before becoming pregnant increases your risk of developing GDM, it is well advised to shed the extra pounds before you plan your pregnancy.

Complications

  • Developing GDM during pregnancy is not indicative that the condition will persist even after delivery. In most cases, blood sugar levels will return to normal within a few days post-delivery. It does, however, make you predisposed to developing type 2 diabetes later in life. For this reason, it is important to get screened for diabetes later than 12 weeks after the birth and then again every 3 years after that.
  • It is important to remember that untreated or poorly controlled gestational diabetes can lead to macrosomia or a large baby with high body fat. While the blood sugar travels past the placenta to reach the baby, the mother’s countering insulin does not. When the mother has high blood glucose levels, the baby’s pancreas creates extra insulin to regulate its body sugar levels. The baby’s body then stores this extra sugar as fat, making it grow to 9 pounds or more.
  • Larger babies, in turn, are difficult to deliver as they pose the risk of getting wedged in the birth canal and thus necessitating the need for a C-section or induced labor. Babies born to mothers with gestational diabetes are also at a higher risk for obesity and type 2 diabetes further down the line.
  • Furthermore, they are susceptible to developing hypoglycemia or very low blood glucose levels at birth as well as breathing problems.
  • Gestational diabetes can be controlled and treated with lifestyle and dietary changes. At times, it is necessary to get treatment with medications to keep the body’s blood glucose levels well controlled, ensuring a healthy mom, baby, and delivery.

When to see a doctor

Once you are diagnosed with gestational diabetes, you will have to work closely with your doctor who will monitor your sugar levels and weight gain and prescribe the necessary treatment. This is also true for mothers who have experienced this problem in their previous pregnancy. Even though this condition is relatively common, it can engender some pretty harmful long-term side effects for your own as well as your baby’s health. Thus, GDM is not to be taken lightly and merits professional guidance every step of the way.

The doctor-recommended or approved dietary and lifestyle choices can provide effective safeguards against future complications. Some women might even need medications or insulin injections to manage this condition. Trust your doctor’s discretion and expert knowledge in chalking out the best course of action for you, to effectively combat gestational diabetes.

Here are the top 10 ways to deal with gestational diabetes during pregnancy.

1. Monitor Blood Sugar Level Regularly

In order to reduce the risk of complications from gestational diabetes, it is important to keep a close tab on your blood sugar level and address the results with your doctor-prescribed treatment.

It is highly likely that you will be required to check your fasting and postprandial (post-meal) blood sugar levels frequently throughout the day. To that end, you’ll need a diabetes kit that includes needles to prick your finger, test strips, and a little machine called a glucose meter that reads your blood sugar.

Typically, after pricking your finger, you are supposed to squeeze a drop of the blood onto a test strip that has been inserted into the meter. Within a few seconds, the machine will display your sugar level. Because different brands of glucose meters work a little differently, be sure to follow the instructions that come with the apparatus.

Check with your health insurance company to see if it will bear the partial or complete cost of the kit, as it is an indispensable tool for ensuring a healthy pregnancy.

To get the holistic and accurate picture, you may be required to check your blood sugar first thing in the morning before eating to get your fasting rate and then one or two hours after eating each meal. Depending on your results and the severity of the condition, your healthcare provider will delineate the appropriate schedule for administering these sugar tests that will enable you to monitor your glucose levels and subsequently report them back to your doctor.

The optimum fasting (before eating) blood sugar level should be less than 95 milligrams per deciliter (mg/dL), while a one-hour post-meal blood sugar goal should be less than 140 mg/dL, and a two-hour goal is less than 120 mg/dL.

If the sugar levels escalate beyond the proposed result, it is important to report the results to your doctor or midwife immediately, so that proper treatment can start as soon as possible.

2. Include Breakfast in Your Eating Plan

A healthy diet is always an important part of maintaining a healthy pregnancy and is essential for controlling your blood sugars with GDM. Moreover, of all the meals you have in a day, breakfast has long been touted as the most important. In fact, getting something to eat soon after waking is considered to be essential for maintaining a stable blood sugar level. Conversely, an erratic eating pattern that skips out on breakfast often causes glucose levels to spike or dwindle.

A breakfast that consists of low glycemic index foods containing a healthy mix of complex carbohydrates, protein, and fat is ideal for women with GDM.

An ideal breakfast spread includes porridge, oatmeal, or whole-grain cereal, with eggs along with some healthy fat avocado to round out your meal. Adding a glass of spinach juice or some other vegetable smoothie can further supplement your breakfast with some much-needed vitamins.

To keep your blood sugar well regulated, it is important to continue to eat small meals and snacks throughout the day. Be sure to talk to your healthcare provider about a diet plan that works best for you.

3. Eat the Right Carbohydrates

Carbohydrates are an important part of any kind of diabetes diet, including GDM. This essential diet component provides the fuel that sustains your body as well as the baby growing inside you.

However, before loading up your plate with carbohydrate-rich foods, it is important to know that not all carbohydrates are beneficial. Complex carbohydrates rather simple ones are the preferred choice because they provide more nutrients and their fibrous nature ensures that they are digested more slowly. Complex carbohydrates, if consumed at proper intervals, can help manage post-meal blood sugar spikes.

Foods like peas, legumes, beans, and lentils as well as whole-grain bread, pasta and cereals, brown or wild rice, oats, and quinoa are replete with healthy carbohydrates. Some vegetable sources of complex carbohydrates include okra, carrots, yams, and sweet potatoes.

Avoid simple carbohydrates found in foods, such as white bread, cake, cookies, donuts, soda, and other sweets. Not only do they account for zero nutrition, but the effects of these empty calories can also be detrimental to keeping your blood glucose levels in check.

Include the right kind of carbohydrates in your meals and snacks throughout the day, complementing them with healthy fats and proteins to support a healthy diet.

4. Eat High-Fiber Foods

Increasing your dietary fiber intake can help you better regulate your blood sugar levels. Dietary fiber reduces postprandial (after-meal) glucose responses after a carbohydrate-rich meal. This action can help to balance the blood sugar level throughout the day, keeping it better controlled.

Furthermore, a woman’s pre-pregnancy diet that is low in fiber and has a high glycemic load has been associated with an increased risk for gestational diabetes. This extends further support to the recommendation of incorporating more fiber-rich foods into your diets as they tend to have a low glycemic index.

Fresh fruits and vegetables, whole-grain bread and cereals, and dried peas and beans can add this necessary fiber to your diet while supporting your body’s need for a low-glycemic-index food.

5. Do Some Exercise

Regular exercise during pregnancy keeps both the mother and the baby healthy and is especially important when you have gestational diabetes.

Keeping your body active not only saves you from piling on the pregnancy-induced pounds, but it also helps the body maintain a better glycemic control by lowering glucose levels while also decreasing the body’s resistance to insulin. This is a crucial step in maintaining your blood sugar at a steady level, avoiding the spikes and dips that can happen without this added support.

By relieving some of the common discomforts associated with pregnancy, including back pain, muscle cramps, swelling, constipation, and trouble sleeping, exercise can prove to be a gift that keeps on giving. There are reports that exercising during mid-pregnancy decreases the incidence of lower back and pelvic pain as well as depression in late pregnancy. Moreover, you can do well to get used to a bit of exercise and mentally and physically prepare yourself for what’s to come once the baby’s born.

Walking is a low-impact exercise that pregnant women can incorporate into their daily lives. It is, however, important not to overexert yourself or go overboard with regards to the distance covered or the speed of walking. The pace should be such that you can easily converse when exercising and not run out of breath. You can try walking to the local shops instead of driving, walking in an open garden or park, or simply pacing around while you’re on the phone. It is also advisable to break your exercise routine into short sessions spread throughout the day, rather than do it all in one go.

Note: Before starting or continuing any form of physical activity during pregnancy, always consult with your obstetrician or midwife.

6. Opt for a Sugar-Free Diet

Sugary foods are futile calories that can be detrimental to maintaining a healthy GDM pregnancy. It is imperative to keep your sweet tooth in check to ensure that your blood glucose levels remain normal.

Swear off all kinds of sugary products: high-sugar desserts, ice cream, cookies, candies, and baked confectioneries. Even sweet fruits like mangoes or bananas can be too sugary for your condition and should be limited.

Additionally, avoid all regular sodas and sugar-sweetened beverages like packaged fruit juices. These items often contain large amounts of sugar and calories but offer very little in terms of nutrition.

There are healthier sweet options to quell your sugar cravings, such as eating foods with non-sugar sweeteners instead of added sugars. Aspartame and sucralose are artificial sweeteners that have been approved as safe to eat during pregnancy. Sugar alcohols like sorbitol and xylitol, however, are not recommended. Thus, be sure to go through the list of ingredients before consuming any product in order to avoid eating anything with artificial sweeteners in it.

7. Drink Cinnamon Tea

There are benefits of consuming the common spice cinnamon for those struggling to control their blood glucose levels.

It has been shown that cinnamon may help lower blood sugar levels by imitating the effects of insulin. It also increases insulin sensitivity, which may help your body to better respond to sugar spikes in your blood. It can help reduce your fasting blood sugar levels and may help to control your long-term sugar levels.()

This spice is safe to use during pregnancy in the recommended amounts. You can use up to 1.2 teaspoons of Cassia cinnamon per day or up to 5 times more if using Ceylon cinnamon.

  • Drink cinnamon tea at least once daily. To make the tea, steep a medium-sized cinnamon stick in hot water for 10 minutes and then drink the refreshing tea.
  • You can also sprinkle some cinnamon powder in your oatmeal, smoothies, and yogurt or add it to some meat dishes like chicken or fish.
Note: Do not take cinnamon in excess as it may cause involuntary contractions. There are certain compounds in this spice that may be toxic for your baby when taken in excess. Check with your doctor or midwife before taking this herb medicinally.

8. Sleep Well

During pregnancy, it is common to feel fatigued due to hormonal changes in the body. Managing gestational diabetes can further add to this general feeling of exhaustion.

To help your body handle fatigue and tiredness, always listen to your body and get adequate rest and sleep. Proper sleep will help in the development of the unborn baby and restore your energy that tends to deplete faster when you have a life growing inside you.

When pregnant, try to sleep on your left side with your knees bent. This will reduce the strain on your back, which is often the cause of disturbed sleep. It is also the recommended sleeping posture as it helps to stimulate blood circulation in your body, which is beneficial both for you and your fetus.

Naps can be truly helpful in fighting fatigue. Thirty-minutes lumber breaks few times a day can go a long way in keeping you energized. Moreover, studies have correlated sleep deprivation with increased blood sugar levels, so it is especially important to get enough rest if you have GDM.

9. Manage Stress

There is already so much weight on your mind when you are expecting that an additional concern like gestational diabetes is the last thing you need. The mounting level of stress increases cortisol levels in the body, which can have a bearing on the health of the unborn baby. High levels of stress can even induce premature labor as it can lead to the release of contraction-triggering hormones. To add to that, the constant and overbearing anxiety or stress can keep you up at night and make it impossible for your body and mind to properly rest, which is ultimately detrimental to your own well-being. It is, therefore, very important to seek your healthcare provider’s guidance for the appropriate management of stress.

Furthermore, stress reduction programs have been shown to reduce overall glucose levels in type 2 diabetics, which makes stress management all the more beneficial for expectant mothers with GDM. Stress management techniques can range from meditation and using slow, deep breathing and imagery to something as commonplace as talking with your friends or loved ones about your fears or anxiety.

10. Take Prescribed Medicine as Directed

In some cases, diet and lifestyle changes alone are insufficient to manage gestational diabetes. If your doctor feels that your GDM condition necessitates medication, it is important to take it as directed by your health care provider. There are some oral medications that are safe to be used during your pregnancy to control your blood sugar levels. In fact, as many as 50% of women with gestational diabetes need insulin injections to keep their blood sugar under control.

It is important not to forget taking any prescribed medication. Missing even a single dose can have a severe effect on your blood sugar level. When your blood sugar levels fluctuate too much during pregnancy, it increases the risk of complications for both you and your baby.

Along with any diabetes medication, you should also take your iron and calcium supplements as directed by your doctor.

Resources:

  1. DeSisto CL, Kim SY, Sharma AJ. Backenting Chronic Disease | Backalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010 – CDC. Backenting Chronic Disease. . Published June 19, 2014.
  2. What is Gestational Diabetes? American Diabetes Association. .
  3. Lin P- C, Lin K- C, Hung C- H, Chan T- F. The risk factors for gestational diabetes mellitus: A retrospective study. Midwifery. . Published November 2016.
  4. Ali AD, Mehrass AA-KO, Adhroey AHA-. Backalence and risk factors of gestational diabetes mellitus in Yemen. International Journal of Women’s Health. . Published 2016.
  5. Symptoms & Causes of Gestational Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. . Published May 1, 2017.
  6. Farahvar S, Walfisch A, Sheiner E. Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review. Expert Review of Endocrinology and Metabolism. ?journalCode=iere20. Published May 15, 2018.
  7. Basic meal planning. Allina Health. . Published January 20, 2014.
  8. Hernandez TL, Pelt REV, Anderson MA, et al. A Higher-Complex Carbohydrate Diet in Gestational Diabetes Mellitus Achieves Glucose Targets and Lowers Postprandial Lipids: A Randomized Crossover Study. Diabetes Care. . Published May 1, 2014.
  9. Weickert MO, Pfeiffer AFH. Metabolic Effects of Dietary Fiber Consumption and Backention of Diabetes. The Journal of nutrition. . Published March 1, 2008.
  10. Zhang C, Liu S, Solomon CG, Hu FB. Dietary Fiber Intake, Dietary Glycemic Load, and the Risk for Gestational Diabetes Mellitus. Diabetes Care. . Published October 1, 2006.
  11. Colberg SR, Castorino K, Jovanovič L. Prescribing physical activity to prevent and manage gestational diabetes. World Journal of Diabetes. . Published December 2013.
  12. Gjestland K, Bø K, Owe KM, Eberhard-Gran M. Do pregnant women follow exercise guidelines? Backalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. British Journal of Sports Medicine. . Published May 1, 2013.
  13. Pope E, Koren G, Bozzo P. Sugar substitutes during pregnancy. Canadian Family Physician. . Published November 2014.
  14. Bernardo MA, Silva ML, Santos E, Moncada MM. Effect of Cinnamon Tea on Postprandial Glucose Concentration. Journal of Diabetes Research. . Published July 14, 2015.
  15. Twedt R, Bradley M, Deiseroth D, Althouse A, Facco F. Sleep Duration and Blood Glucose Control in Women With Gestational Diabetes Mellitus. Obstetrics and Gynecology. . Published August 2015.
  16. Lockwood CJ. Stress-associated preterm delivery: The role of corticotropin-releasing hormone. American Journal of Obstetrics and Gynecology. . Published November 30, 2005.
  17. Surwit RS, Zucker N, McCaskill CC, et al. Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes. Diabetes Care. . Published January 1, 2002.
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Published by
Brenda Montoya, RN, RNC-OB

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