What To Do For Gestational Diabetes

Chad Birt

Written by Chad Birt on Tue Aug 22 2023.

Checking blood sugar.

Gestational diabetes is one of the most common pregnancy-related complications, affecting 2%-10% of all U.S. pregnancies, according to the CDC. During pregnancy, the placenta releases hormones that affect the way the body uses insulin –– a hormone that helps regulate blood sugar.

“This mild insulin resistance keeps sugar in the blood to be delivered to the growing placenta and fetus,” explains Jessica L. Tomasello, MSHCA, RDN, CDN, CSCS, a Registered Dietitian Nutritionist, Certified Dietitian Nutritionist, and the president of Mom’s Good Taste™. “Gestational diabetes develops when the pancreas is unable to produce enough insulin to overcome the insulin-resistant effects of rising placental hormones and too much sugar remains in the bloodstream.”

Gestational diabetes can make an already challenging time even more so. But there are plenty of things you can do to help keep your blood sugar in check. 

What You’ll Need

If you’ve been diagnosed with gestational diabetes, consider working with a registered dietitian nutritionist (RDN) who specializes in perinatal care. “An RDN can help you personalize your diet to manage and control your diagnosis, while including foods and flavors you love,” Tomasello says.

Steps For Managing Gestational Diabetes During Pregnancy

Step 1: Be Mindful of Nutrient Load and Insulin Sensitivity

The best way to balance your blood sugar during pregnancy is to pay attention to two things:

Nutrient load

“Nutrient load is the amount, timing, and quality of food you eat at each meal,” Tomasello explains. Try to eat three small meals and two to three small snacks each day, balancing your carbohydrate intake throughout.”

Some pregnant women don’t tolerate carbs very well in the morning. Even so, try to eat at least 15-30 grams of healthy carbs to start the day. Options include a small banana, ⅔ cup of plain yogurt, or ½ cup of cooked oatmeal.

Insulin sensitivity

“Insulin sensitivity refers to the body’s ability to ‘accept’ sugar into the muscle, fat, and organ tissue, clearing that sugar from the bloodstream,” says Tomasello. “Improving insulin sensitivity improves blood glucose control.”

Exercise can help. In fact, a 10-15 minute walk after eating a meal can boost insulin sensitivity and regulate blood sugar levels

Step 2: Avoid Foods and Drinks that Cause Blood Sugar to Spike

“When it comes to the prenatal diet, it can be challenging to balance side-effects like cravings, aversions, morning sickness, constipation, fatigue, and a medical diagnosis like gestational diabetes,” Tomasello says. Still, it’s important to avoid foods and drinks that could make things worse, including:

  • Sugar-sweetened beverages like soda, lemonade, and energy drinks

  • Highly-processed foods, like pastries, cookies, cakes, and donuts

  • Breaded and fried meats

  • Fast food

  • Fruit juices

  • Candy

Giving up your favorite foods and drinks isn’t easy. Your obstetrician or dietitian can recommend healthy food substitutes so you can still enjoy a delicious and healthy pregnancy.

Step 3: Portion Snacks and Meals

When it comes to food, we’re often taught that bigger is better. But that isn’t necessarily the case.

“Sometimes it’s not the food itself that’s the problem, but the amount of food you eat,” says Tomasello. “If you’re having cravings or want to enjoy a treat, opt for a small portion size that fits your dietary needs. Your registered dietitian nutritionist may use a gentle approach, like ‘carbohydrate exchanges’ to help you swap foods and portion sizes to meet your needs.”

Step 4: Use Herbs and Spices to Enhance Flavor

Cutting back on high-calorie foods can feel like a punishment, particularly when you’re dealing with symptoms like morning sickness and back pain. 

“A gestational diabetes diagnosis doesn’t require you to abandon your cultural preferences or traditions, especially flavor,” Tomasello says. “Creating healthy dishes with flavorful herbs and spices can help promote a diverse palate and healthy metabolic outcomes for you and your baby.”

You might need to eat less salt and sugar, but there are plenty of flavorful alternatives to help you cope.

Step 5: Exercise Several Times a Week

Remember how we said that taking a short walk after meals can help boost insulin production? Exercise can also improve blood glucose control, manage stress hormones, and support a healthy pelvic floor.

“I encourage all pregnant women to exercise at least 30 minutes a day, five days per week (or a total of 150 minutes weekly),” Tomasello says. 

You might not be able to perform your normal workouts during the second and third trimesters, but there are plenty of low-impact exercises that are safe during pregnancy. These physical activities include:

  • Strength training

  • Yoga

  • Pilates

  • Walking

  • Low-impact aerobics

  • Water aerobics

Step 6: Take Any Medications as Prescribed

Most people with gestational diabetes are able to lower their blood sugar within a few weeks of changing their diet and beginning exercise. But this isn’t always the case. 

Your obstetrician might prescribe insulin injections or metformin if your blood sugar remains high. Having to take medication during your pregnancy doesn’t necessarily mean it’s something you’ll have to do forever. Blood sugar levels usually return to normal after giving birth.

Step 7: Regularly Monitor Your Blood Sugar Levels 

The only way to know if your blood sugar is within the healthy range is through regular testing. Most obstetricians recommend checking blood sugar four times daily –– once in the morning after waking up and one or two hours after each meal (breakfast, lunch, and dinner).

Keep track of your blood sugar levels by writing them down in a notebook. Or, if you prefer download an app like Diabetes in Pregnancy - Gestational Diabetes Logbook and Manager.

What To Do For Gestational Diabetes - Commonly Asked Questions

1) Does gestational diabetes increase the risk of pregnancy complications?

About 50% of women diagnosed with gestational diabetes end up developing type 2 diabetes later in life. Studies also show that children born to women with uncontrolled gestational diabetes are at a higher risk of developing type 2 diabetes as they grow.

These statistics are sobering, but “there is no evidence to say these will be the outcomes if you are diagnosed with gestational diabetes during pregnancy,” Tomasello says. “The most important thing is to manage and control the diagnosis during pregnancy. After giving birth, develop a sustainable, enjoyable, and balanced diet to prevent future complications.”

2) Do certain medical conditions increase my risk of gestational diabetes?

Gestational diabetes is a complex metabolic disorder. Researchers aren’t sure why some women develop it and others don’t, but several medical conditions may increase your risk, including:

  • Prediabetes

  • Polycystic ovarian syndrome (PCOS)

  • High blood pressure

  • A family history of diabetes

Lifestyle factors can also increase your risk, according to Tomasello, including smoking, living a sedentary lifestyle, and being overweight. 

3) Will gestational diabetes harm my baby?

Gestational diabetes can cause pregnancy complications, but most babies are born healthy. There’s little to worry about if you follow the steps mentioned above and listen to your doctor or healthcare provider and dietitian’s advice.

Have Pregnancy Questions? We’re Here to Help!

Pregnancy is exciting and scary. You probably have lots of questions if you’re pregnant for the first time. Our Care Specialists regularly help expecting mothers with everything from diaper recommendations to feeding tips. Call (800) 696-CARE or send an email to support@carewell.com. We’re standing by 24/7 and here to make your life easier!

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Chad Birt
Chad Birt

Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.