Gestational Diabetes

What is Gestational Diabetes Mellitus or GDM?

Gestational diabetes occurs when people who have never been diagnosed with diabetes have high blood glucose (blood sugar) during their pregnancy. This condition affects nearly 1 in 10 pregnancies. Women who may be at a higher risk for developing GDM include:

• Women who are overweight or obese before pregnancy
• Women who have delivered a large-for-gestational-age infant in a prior pregnancy
• Women who have had several pregnancies
• Women with a family history of diabetes or gestational diabetes

Women with GDM have higher-than-normal blood glucose levels due to insulin resistance in the second and third trimesters. This insulin resistance is caused by surges in placental hormones, in particular lactogen, prolactin, estrogen, and cortisol. Insulin is a hormone that regulates blood glucose levels. If there is not enough insulin available, then the blood glucose levels will rise. Diagnosis of gestational diabetes commonly involves administration of an oral glucose tolerance test, which provides a drinkable dose of glucose and monitors the body’s blood glucose response before the test, 1 hour after, 2 hours after, and 3 hours after. If two of those four results are high, the diagnosis of GDM is made.

Treatment for GDM

Treatment includes following a carbohydrate-controlled meal plan, incorporating physical activity, monitoring blood glucose levels, and medication in some cases. Women with GDM will need to work with a healthcare team to manage the blood glucose levels.

Each woman should work with a registered dietitian or certified diabetes educator to create a personalized meal plan. Some general tips for controlling blood glucose include the following:

1. Maximize water intake: Make water your primary source of fluids during your pregnancy. Beverages such as fruit punches, lemonades, sodas, and sweet teas contain a surplus of sugar or carbohydrate without providing any nutrition. Milk and fruit juices also contain carbohydrates, so be mindful of the portion size that you drink.
2. Eat regularly: Give yourself and your baby the nutrition to be healthy! Have a balanced breakfast, lunch, and dinner each day with 1-3 small snacks in between. Your healthcare team can give you specific advice on when to eat and how much.
3. “Eating for two” is less than you may think: Even though pregnancy does require additional nutrients, it does not mean to eat double portions of everything! Calorie requirements in the second trimester increase by about 340 calories, and by the third trimester increase by about 450 calories. Total weight gain during pregnancy should be about 25-35 pounds (for pre-pregnancy BMI 18.5-25) or about 15-25 pounds (for pre-pregnancy BMI >25).
4. Get moving: Participating in exercises such as walking, swimming, or yoga can help lower blood glucose levels and relieve stress. As long as your doctor has not restricted your activity level, try to take part in these activities daily.
5.  Keep calm and carry on: Pregnancy can be a stressful time in a woman’s life, and stress hormones can negatively impact health and quality of life. Deal with stress in a positive way, such as exercising, journal writing, or laughing. Seek the support of family, friends, or your healthcare team if you feel overwhelmed.

Healthy Mom, Healthy Baby

Maintaining a healthy lifestyle is one of the most important things you can do for both yourself and baby during pregnancy and after delivery. Join Touro dietitian Julie Fortenberry and special guest Genevieve Douglass, owner of Kindred Studios, for an informative class on nutrition and wellness for expectant and new mothers on Wednesday, August 17th from 6pm to 8pm in the Foucher Room. The class will cover basics of healthy meal planning, eating for two, healthy weight gain, important nutrients, foods to avoid, fitness during pregnancy, breastfeeding nutrition, healthy weight loss post baby, body image, meal planning for a busy lifestyle, finding time for fitness after baby and more.

This class is free of charge. Registration is required.

Complimentary parking will be available for all classes in Touro’s parking garage on Delachaise Street across from the Emergency Department.

Katie Schlemer, RD, LDN, is a Registered Dietitian and a Diabetes Educator in the Touro Diabetes Center. She received her Bachelor of Science in Nutrition and Dietetics from Saint Louis University and completed her Dietetic Internship at Tulane University. Katie has been counseling individuals with type 1 and type 2 diabetes, pre-diabetes, and gestational diabetes for the past 3 years. Her goal is to help individuals learn how to maintain a healthy lifestyle in order to live well with diabetes.