Dos and Don'ts of Managing Diabetes During Pregnancy

• Apr. 30, 2012
• Topic: Pregnancy and Parenting

Ah, pregnancy, a time when “Let them eat cake!” can be a woman’s mantra, right? Not exactly, particularly when it comes to women at risk for developing gestational diabetes.

High blood sugar in pregnant women that starts or is diagnosed during pregnancy is known as gestational diabetes. Women are more likely to develop this condition if they are over 25 years old, start their pregnancies with a body mass index of 25 or higher, have a family history of gestational diabetes, or if they are African-American, Asian-American, Hispanic/Latino or Native American, explains Virtua registered dietitian Barb Darcy-Castorina.

“As the baby grows, the mother's insulin production may not keep up with insulin needs,” says Darcy-Castorina. “This leaves too much blood sugar available for transport to the baby via the placenta. The baby uses this extra nutrition to put down fat stores, and this can cause problems at the time of delivery.” A mom’s symptoms are usually minimal, but this can result in big babies. (Translation: ouch!)

Gestational diabetes can be diagnosed through a blood test and luckily ends when the pregnancy ends. But, if you have this condition or think you might be at risk, diet and exercise can help to keep your blood sugar within normal limits. “Inappropriate intake of sweets such as candy, juices, soda, and other high-sugar foods may allow more glucose to build a bigger than healthy baby if the mother has the predisposition to gestational diabetes,” Darcy-Castorina explains.

She recommends limiting your intake of such concentrated sweets and instead opting for fruits and vegetables, which provide extra vitamin C and folic acid. Other diet recommendations include low-fat milk, whole grain breads and cereals, and lean proteins such as poultry and fish.

Like any soon-to-be mom, Tamar O. has gestational diabetes on her too-long mental list of potential pregnancy complications – despite her lack of risk factors or family history of the condition. However, she tries not to worry about it too much. “The further I get in my pregnancy though, the more I have been aware of it, and even more aware of what I'm eating,” she says. “I have been trying to stay active, and eat healthy. I practice yoga four to five times a week, walk as much as I can, and try to get to the gym a few times a week. I carry food with me all the time to avoid the emergency buys and the crazy, I-need-to-eat-now, pregnancy hunger. I have a stash in my office, in the car, and a bag of almonds in every one of my bags. I'm pretty aware of the choices I make about food, and try to fill up with as much nutritionally dense food as possible.”

This combination of exercise along with meals or snacks spaced two to three hours apart is the exact regimen Darcy-Castorina recommends for all pregnant women, including those with gestational diabetes.

A woman with gestational diabetes often follows a meal plan and may need to monitor her blood sugar throughout the day. A day's plan would look something like this:

Breakfast: one or two slices of whole grain toast paired with an egg or some cheese

Mid-morning snack: high-fiber crackers with peanut butter and milk 

Lunch: a high-fiber sandwich with lean meat and cheese, veggies or salad, soup, and fruit or milk

Afternoon snack: nuts and yogurt 

Dinner: fish or lean meat paired with rice and non-starchy veggies, soup, fruit or milk