What is the best diet for gestational diabetes?

What is gestational diabetes?

Gestational diabetes develops during pregnancy. According to the Centers for Disease Control and Prevention (CDC), gestational diabetes affects 2–10% of pregnancies each year in the United States.

This type of diabetes occurs when the body cannot produce enough of the hormone insulin during pregnancy. The pancreas produces insulin, which helps the body’s cells use sugar from the blood as energy.

The body will produce more hormones during pregnancy, and people may gain weight. These changes can result in cells using insulin less efficiently than previously, known as insulin resistance.

Becoming resistant to insulin means the body needs more insulin to handle sugar, or glucose, in the blood. If the pancreas cannot produce enough insulin to keep up, this can lead to high blood sugar levels.

High blood sugar levels can be harmful to both the pregnant person and the unborn baby.

Insulin resistance is also related to carrying extra weight before pregnancy and physical inactivity.

The symptoms of gestational diabetes may include:

• tiredness
• nausea
• being unusually thirsty
• urinating frequently
• frequent bladder infections
• blurred vision
• sugar in the urine that is detectable with testing

Learn more about gestational diabetes here.

Foods to eat

It is important to eat a healthy diet if a person has gestational diabetes. The American Diabetes Association recommends using the diabetes plate method to help a person eat the right balance of nutritious foods.

To use this method, a person should fill half of a 9-inch plate with nonstarchy vegetables, a quarter with lean protein, and a quarter with a carbohydrate, such as a whole grain or starchy vegetable.

Examples of each of these foods are below.

Nonstarchy vegetables

• peppers
• spinach
• carrot
• broccoli
• cauliflower
• Brussels sprouts
• asparagus
• cucumber
• mushroom
• zucchini
• salad greens
• eggplant
• celery

Lean protein

• chicken
• turkey
• eggs
• salmon
• tuna
• lean cuts of red meat
• beans
• lentils
• hummus
• nuts
• nut butters
• tofu and tempeh

Carbohydrate

• brown rice
• quinoa
• bulgur wheat
• oats
• sweet potato
• parsnips
• butternut squash
• chickpeas
• fruits and dried fruit
• dairy products such as milk, yogurt, and milk substitutes

A person can consult a doctor or dietitian about a healthy diet plan during pregnancy.

Foods to avoid

Avoiding foods that cause a spike in blood sugar levels is important if a person follows a gestational diabetes diet.

Sugary foods

Blood sugar levels increase when people eat sugary foods, particularly refined or processed ones. People with gestational diabetes should avoid or limit foods with added sugar as much as possible.

Sugary foods to avoid include:

• cakes
• cookies
• candy
• desserts
• sweet pastries
• soda
• ice cream
• fruit juice or sugary drinks

Although milk and whole fruits contain natural sugars, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) still recommends that people with diabetes include them as part of a balanced diet.

High-starch foods

Starchy foods are high in carbohydrates, which can cause a rise in blood sugar. It is best to avoid or limit very starchy foods with a higher glycemic index, such as:

• white potatoes
• white bread
• white rice
• white pasta

A person may want to switch from white, refined carbohydrates to whole grains, such as brown rice, quinoa, or oats.

Hidden sugars and carbohydrates

Some foods and drinks are not obvious sources of sugar or carbohydrates. However, they may still contain high levels of both. Examples of these products include:

• highly processed foods
• some condiments, such as dressings and ketchup
• some fast foods
• sugar-sweetened soda
• french fries
• alcohol

A pregnant person should avoid drinking alcohol throughout pregnancy as there is no known safe amount. Drinking alcohol during pregnancy can cause a range of serious health problems for a baby.

Healthy eating tips

To help manage blood sugar levels and eat healthily, the CDC give the following tips:

• Eat at regular times and avoid skipping meals.
• Keep track of food, drinks, and physical exercise, to understand their effect on blood sugar levels.
• Choose foods lower in saturated fat, trans fat, sugar, salt, and calories.
• Drink water rather than juice or soda.
• Choose fruit as a sweet treat, instead of processed, sugary foods.
• Make simple swaps, such as switching foods high in saturated fats, including butter and fatty cuts of meat, to unsaturated fats, such as olive oil and fish.
• Look for foods labeled “low in sodium” and avoid processed or packaged foods such as pizzas and deli meats to help reduce salt intake.
• Add lemon, herbs, or spices to food for flavoring instead of salt.
• Steam vegetables for meals, or add half a cup of beans or peas into a salad to add extra fiber.
• Aim for colorful meals with a range of dark green and brightly colored vegetables and fruits such as berries.

It can help to space meals and snacks evenly throughout the day. The American College of Obstetricians and Gynecologists recommends that people with gestational diabetes consume three meals and two to three snacks per day. Doing this can reduce high blood sugar spikes after eating.

A person with gestational diabetes can monitor and log their blood sugar levels at different points during the day and keep a food and activity diary. This can show them how foods and activity affect their blood sugar levels.

Learn more about blood glucose levels here.

Staying healthy during pregnancy

The NIDDK recommends the following tips for staying healthy during pregnancy:

• Consume foods and drinks that are high in iron, folate, calcium, and protein.
• Talk with a healthcare professional about taking prenatal vitamin supplements.
• Eat breakfast every day and meals or snacks as necessary throughout the day.
• Drink plenty of water and eat foods high in fiber to help prevent constipation.
• Avoid food and drink that could be harmful to a growing fetus, such as alcohol, raw or undercooked fish and seafood, fish containing high levels of mercury, undercooked meat or poultry, and soft cheeses.
• Exercise regularly with moderate levels of aerobic exercise for at least 150 minutes each week.
• After giving birth, slowly reintroduce regular, moderate-intensity aerobic exercise to gradually regain a healthy weight.

Gaining weight during pregnancy is normal, but gaining too much or too little can pose health risks for a pregnant person and the unborn baby. A healthcare professional can give a person advice about ideal weight through pregnancy stages.

Treatment

Following a healthy diet and exercising can help a person control their blood sugar levels and manage gestational diabetes. However, this may not be enough to control the condition in some cases.

Some people with gestational diabetes may need medication, such as insulin or metformin, to lower their blood sugar levels.

Learn more about using metformin during pregnancy here.

Complications

Gestational diabetes increases the risk of complications for both the pregnant person and the baby. Risks affecting the pregnant person include:

• difficulties during labor
• cesarean delivery
• heavy bleeding after delivery
• in a vaginal delivery, severe tears in or around the vagina

According to the CDC, the babies of people who have gestational diabetes have a higher risk of:

• weighing more than 9 pounds (lbs), making delivery harder
• premature birth
• having low blood sugar
• developing type 2 diabetes in later life

Around half of all people with gestational diabetes go on to develop type 2 diabetes after pregnancy. After giving birth, maintaining a healthy body weight and controlling blood sugar levels can reduce this risk.

Risk factors

Gestational diabetes can affect anyone during pregnancy, but risk factors for developing the condition include:

• being overweight or obese
• having a family history of diabetes
• having high blood pressure or heart disease
• having polycystic ovary syndrome
• having prediabetes, or impaired glucose tolerance
• previously giving birth to a baby weighing more than 9 lbs
• being older than 25
• being of African American, Native American, Asian, Hispanic, or Pacific Islander heritage

When to see a doctor

Gestational diabetes typically develops around the 24th week of pregnancy. A doctor will usually test for the condition at around 15 weeks.

If a person notices any symptoms of gestational diabetes before testing, they will need to speak with a healthcare professional as soon as possible.

Once a doctor diagnoses gestational diabetes, they may refer the pregnant person to a dietitian. A dietitian can help create a diet plan that is appropriate for a person’s blood sugar levels and nutritional needs.

Summary

Gestational diabetes happens when pregnancy hormones make the body resistant to insulin. Sometimes, the pancreas can produce enough extra insulin to handle the glucose in the blood, but sometimes it cannot. This leads to high blood sugar levels, which can be harmful to a pregnant person and the unborn baby.

To regulate blood sugar levels, a person can choose a combination of nonstarchy vegetables, lean protein, and grains or starchy vegetables, as set out in the diabetes plate method.

Gestational diabetes can lead to complications during birth and health risks for the pregnant person and the unborn baby if a person does not get treatment.

People at higher risk of developing gestational diabetes include those who are obese or overweight, people with a family history of diabetes, and those who have previously given birth to a baby weighing more than 9 lbs.