What Is Gestational Diabetes?

Gestational diabetes is a type of diabetes that occurs during pregnancy. In the vast majority of women found to have this condition, there are no symptoms of diabetes, and the diabetes usually goes away after the baby is born.

Gestational diabetes refers to higher than normal blood glucose levels occurring during pregnancy in women who were not diabetic before becoming pregnant, e.g. >100 mg/dl.

Gestational diabetes is usually detected by discovering higher than normal glucose levels between the twenty-third and twenty-eighth weeks of pregnancy, and occurs in over five percent of pregnancies.

The body requires more insulin during pregnancy as weight is gained and as the placenta grows and produces hormones that reduce insulin sensitivity. It is normal for the pancreas to produce a higher level of insulin.

Many women have no problem producing the extra insulin needed during pregnancy, but for women with gestational diabetes, their pancreas can’t secrete the higher levels demanded, usually due to insulin resistance (IR).

Causes of Gestational Diabetes

It appears that gestational diabetes is primarily caused by the placenta’s growth. As the baby grows, the placenta grows to support the baby. But that growing placenta also releases a growth hormone called human placental lactogen (HPL) that can block the action of insulin in the mother’s body.

If the woman's body doesn’t have enough insulin to help transport the glucose in her bloodstream into her cells (to produce energy), the extra glucose remains in the bloodstream. And, this can lead to a higher than normal blood glucose level  and a diagnosis of gestational diabetes.

Gestational diabetes can also result if the woman was already prediabetic or had risk factors such as being overweight, eating a poor diet, living a sedentary lifestyle, being under a lot of stress. 

Risk Factors for Gestational Diabetes

It’s estimated that at least 9% of women will be diagnosed with gestational diabetes during their pregnancy.

Risk factors include:

  • Family history of diabetes
  • Being overweight pre-pregnancy
  • Following a poor diet and sedentary lifestyle
  • Advanced maternal age
  • High blood pressure
  • If you had gestational diabetes in a previous pregnancy
  • If you have polycystic ovarian syndrome (PCOS)
  • Race: Hispanic/Latina, African-American, Native American, Alaska Native, Asian American, or Pacific Islanders are all at a higher risk

Symptoms of Gestational Diabetes

Most women don’t have any symptoms of gestational diabetes, so it’s difficult to know if you have it without betting tested by your doctor.

Many of the symptoms are common pregnancy symptoms. But, if something feels off or you experience the following symptoms, talk to your healthcare provider.

  • Here are some symptoms that you may experience:
  • Excessive thirst
  • Frequent urination (but more than usual)
  • Extreme fatigue
  • Extreme nausea
  • Frequent vaginal, bladder, or skin infections
  • Blurred vision

Medical Test for Gestational Diabetes

Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose.

If your blood glucose level is higher than 190 mg/dL (10.6 mmol/L) after the one-hour test, you'll be diagnosed with gestational diabetes. For the three-hour test: A normal fasting blood glucose level is lower than 95 mg/dL (5.3 mmol/L).

Glucose Challenge Test

You may have the glucose challenge test first. Another name for this blood test is the glucose screening test.

In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water.

If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have Type 2 diabetes.

Please Note: Most of these sugary drinks contain ingredients that most of us try to stay away from, e.g.  artificial flavors, GMO corn syrup, glycerol ester of wood rosin, and brominated vegetable oil (BVO). So, you may want to avoid this test.  Some women opt for a consuming orange juice or dates that contain 50 grams of sugar and no healthy fats. 

Oral Glucose Tolerance Test (OGTT)

The Oral Glucose Tolerance Test (OGTT) measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes.

High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean.

Your health care professional may recommend an OGTT without first having the glucose challenge test.

Hemoglobin A1C Test

Another test that your doctor may use is the Hemoglobin A1C test, which measures the percentage of glycated hemoglobin in your blood. 

For women in the first or early second trimester, the Hemoglobin A1C test  can detect whether you’ll develop gestational diabetes later in pregnancy. Note: Results can be skewed if you’re dehydrated or have anemia.

Glycated hemoglobin is created when molecules of hemoglobin (the oxygen-carrying protein in your blood) attach to molecules of glucose in your blood. The more glucose you have in your blood, the higher your percentage of glycated hemoglobin.

The American Diabetes Association recommends a target number of 4% to 6%. The American College of Obstetrics and Gynecology recommends a target number of no higher than 6%.

Pregnant women who do not have diabetes typically have A1C levels of less than 5%.

Measuring Your Own Blood Glucose

Though a bit time-consuming, you can use a glucose meter and test strips to measure your own blood glucose levels; and, keep a log of blood glucose levels at specific times of the day for one to two weeks.

This is a more accurate indicator of blood gluocse levels, especially for women who eat low carb or paleo.

Note: Most insurance companies won’t cover a glucose meter without a diabetes diagnosis, but you can purchase a meter and a pack of test strips over-the-counter at your local drugstore.

What to Expect When Measuring Your Blood Glucose

You’ll have to get used to daily blood testing. Your healthcare provider will usually have you test when you wake up in the morning, then again throughout the day.

The schedule may vary slightly, but it’s likely you’ll be taking your blood four to five times a day.

Some common testing times: after breakfast, after a mid-morning snack, after lunch, after an afternoon snack, after dinner.

You’ll also have to meet with a diabetes specialist, who will give you test strips, lancets, and a blood glucose meter about the size of your palm.

When you test your blood you insert a test strip into the meter and then prick a finger with a lancet inserted into a spring-loaded device. You then place some of the blood on the test strip and wait for results.

You may also get a booklet to record your meals, daily exercise, and blood sugar levels. In regular meetings with your specialist they’ll help you analyze trends, come up with better plan meals, and provide general encouragement to stay on track.

Natural Treatment Strategies for Gestational Diabetes

If you are diagnosed with gestational diabetes, it is not necessary that you take a drug such as metformin or insulin shots to decrease and control your blood glucose level.

It is absolutely possible to manage gestational diabetes on your own as long as you're willing to change your diet and lifestyle.

If you have gestational diabetes, the best medicine is no medicine. Who knows what subtle, long-term effects diabetes medications may have on an unborn child?

Superior nutrition is the safest and most effective choice. 

Here are some healthy strategies to use to manage and reverse your gestational diabetes:

Nutrition

Eating nutrient-dense, plant-rich foods such as green, leafy vegetables, whole fruits, raw nuts and seeds, raw juices, and healthy oils is important during pregnancy.

Gestational diabetes is a sign of nutritional inadequacy; it leads to overweight babies (macrosomia) and increases the likelihood of needing a C-section. 

The Death to Diabetes Nutritional Program is a macronutrient-balanced and nutrient-dense program that will help you to control your blood glucose and optimize your overall health.

With this program, women with gestational diabetes can reverse their disease, have a healthy pregnancy, and prevent type 2 diabetes later in life.

-- Eat foods rich in chlorophyll, fiber and protein as they help to slow digestion time and reduce insulin spikes. Try asparagus, Brussels sprouts, broccoli, cauliflower, kale, and artichokes.

-- Avoid foods that cause inflammation, e.g. refined flour, sweets and other processed foods, e.g. breads, pastas, cereals, soda, bottled fruit juices, etc. 

-- Eat healthy proteins and fats such as pasture-fed chicken breast (no skin), walnuts, almonds, flaxseed, plain yogurt, etc.

-- Use healthy oils such as extra virgin olive oil, avocado oil, coconut oil, grass-fed butter; avoid vegetable oils and margarine.

-- Drink raw green juices and green smoothies to help provide additional nutrients as well cleanse and detox your body.

Note: Refer to the Death to Diabetes Nutritional Program and Super Meal Plate for more details. This program will help to stabilize blood sugar, balance hormones, and decrease insulin resistance.

If you need help, work with a nutritionist, diabetes health coach or other nutritional therapy practitioner to create a meal plan.

Exercise

Exercise plays an important role in lowering your blood’s glucose level. When you exercise, your muscles can more efficiently use insulin to process blood sugar and use it for energy. In the long term, regular exercise can lower your A1C—your body’s average blood glucose level over a period of 2-3 months. (source)

One study found that taking just three short walks each day after meals was enough to help reduce blood sugar levels. In fact, those walks were just as effective over the span of 24 hours as a single 45-minute walk.

Nutritional Supplements

Take your vitamins, but, avoid synthetic vitamins. Studies suggest that women who are deficient in vitamin D are more likely to develop gestational diabetes.

Getting some sunshine and supplementing with virgin cod liver oil can help boost vitamin D levels.

Supplementing with chromium, a necessary mineral that helps metabolize carbohydrates, may also be beneficial.

Take a magnesium supplement and/or eat foods with magnesium, e.g. green leafy vegetables (e.g. spinach and kale); fruit (figs, avocado, banana, raspberries); nuts and seeds; legumes (black beans, chickpeas, kidney beans); other vegetables (broccoli, cabbage, green beans, artichokes, asparagus, Brussels sprouts); seafood (wild salmon, mackerel, tuna).

In one study, pregnant women with gestational diabetes were given 250 mg of magnesium daily for 6 weeks.

Magnesium significantly improved blood sugar levels significantly and reduced markers of inflammation and cell damage. Their babies also saw a 20.6% reduction in excess bilirubin, which can cause jaundice.

Reduce Stress

Studies show that reducing the stress in your life is good for you and the baby.

Make sure that you get enough quality sleep. Easier said than done, but try to make quality sleep a priority. Sleep deprivation raises the stress hormone cortisol, contributing to unhealthy belly fat. Insulin sensitivity decreases rapidly and raises the risk for diabetes when we’re not getting enough quality sleep.

Impact of Other Health Problems

There are other health problems that can affect your blood glucose control, including high blood pressure, obesity, thyroid dysfunction, immune system dysfunction, gastrointestinal problems, gut-brain axis, etc.

The following diagram shows you how other areas of the body can have an effect on your blood glucose control.

Gut-Brain Axis GBA Death to Diabetes

Note:For more details about how other areas can impact your diabetes, refer to the Impact of Diabetes web page.

Can Gestational Diabetes Harm the Baby?

It’s very important to work with your healthcare providers to manage your gestational diabetes and reduce problems for both you and the baby.

If not controlled, gestational diabetes can cause the following in babies:

Shoulder dystocia: This occurs when a baby’s head is delivered through the vagina, but his shoulders get stuck inside the mother’s body. It can cause serious complications for both mama and baby.

Macrosomia: A fancy way of saying your baby can get too big. Since high birth weight can lead to delivery complications (bleeding or uterine rupture in mama; abnormal blood sugar levels in baby), your baby’s weight will be regularly monitored. (This could mean more ultrasounds.)

Respiratory problems

Jaundice

Higher risk for obesity and type 2 diabetes as an adult

If not controlled, gestational diabetes can also cause the following problems for mothers:

  • High blood pressure or preeclampsia
  • Pre-term delivery
  • Higher risk of stillbirth
  • Higher risk of c-section, particularly if your healthcare provider estimates your baby weighs more than 9 pounds

Can You Still Have a Home Birth if You Have Gestational Diabetes?

If you were planning on a home birth or birthing center, it may no longer be an option due to some of the delivery risks of gestational diabetes. Post-birth your baby will be closely monitored for a drop in blood sugar, which can damage the baby’s brain and lead to developmental delays.

Talk to your doctor or midwife to determine what’s right for you and your baby.

Gestational Diabetes IS Manageable

Is diabetes during pregnancy serious? Absolutely! But it’s a manageable condition.

In most cases, women with gestational diabetes have a little extra work to do, but they’ll go on to have a healthy pregnancy and a healthy baby.

Follow the tips above and listen to your caregivers. And always get extra support if you need it.

Next Steps to Wellness

If you want to reverse or prevent the onset of gestational diabetes, obtain one or more of the following author's books, which address diabetes, high blood pressure, inflammation, obesity, fatigue, etc.:

Note: For more information about diabetes and other diseases, click on the (black) menu or use the search box at the top of this web page; or contact our office.

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