As pregnant women approach their third trimester, it is standard protocol to test for Gestational Diabetes (GD). This is a form of diabetes that is developed and/or first diagnosed during pregnancy. Those with GD run the risk of increased medical emergencies at birth and birthing larger babies who have a higher risk of birth injury, the need for C-sections, hypoglycemia at birth, jaundice, and permanent metabolic changes they must tolerate for life. Now, I'm not sharing any of this information to scare you, though I do feel it's important to be informed that the foundation of your child's health is determined in utero.
In pregnancy, it is normal for certain metabolic adaptations to occur that make it difficult for the pregnant woman to regulate her blood sugar. If a woman previously had some level of insulin resistance, it is possible for it to progress into GD once she becomes pregnant.
One common misconception is that because it develops during pregnancy, we assume it goes away after pregnancy.
We know that those diagnosed with GD have a higher chance of developing prediabetes or Type 2 Diabetes later in life. Actually, within 5 years of giving birth, 70% of women with GD will develop Type 2 Diabetes. So, we can conclude that pregnancy didn't CAUSE the diabetes, rather it shed light on the fact that the woman was already insulin resistant to begin with and if she doesn't make any changes, it will likely progress into Type 2 Diabetes after birth.
How do I find out if I have Gestational Diabetes?
I recommend working with a provider who is encouraging and takes the time to help you through all of your pregnancy concerns. Both OBs and Midwives are qualified to assist you in your prenatal visits. Some providers will require you to take a 2-hour Oral Glucose Tolerance Test (OGTT) which entails drinking a 75g sugar/glucose solution and measuring your blood glucose 2 hours afterward. This tells us your body's ability to remove that sugar from your bloodstream . For someone who has sufficient insulin sensitivity, her levels should be below 140 mg/dL at the 2-hour mark.
If you feel like you have a healthy diet and lifestyle and that your risk for Gestational Diabetes is rather low, you can ask your provider if you can observe your blood sugars using an alternative method. This can not be used to diagnose GD, but it can quite clearly confirm that you don't have it. Personally, I wouldn't volunteer to drink 75g of pure sugar if I didn't absolutely have to.
For myself, I chose the alternative option. Though I have family members who do have diabetes (Type 1 and Type 2), my blood sugar has been quite well-regulated for several years and I know that I was not insulin resistant going into my pregnancy (lifestyle > genetics). My midwife was on-board with having my use the alternative method. For one week, I chose to measure my fasting blood glucose (FBG) upon waking and to measure my blood sugar before and 2-hours after meals. My FBG was 86 mg/dL most days and averaged around 90 mg/dL 2-hours after meals. The highest measurement I had after a meal during the week I measured was 123 mg/dL.
To give some context, the meal that showed the highest 2-hour post-meal BG was right after a 5 mile hike and looked like this:
- 2 sprouted corn tortillas
- 2 eggs
- 1 tbsp butter
- 1/4 cup lobster mushroom
- 1 tbsp goat cheese
- 1/4 cup eggplant with garlic
- 1 cup grapes
- 3 figs
As you can see, they were all real, whole foods but still had significantly raised my blood sugar after the meal. Thankfully, I was able to quickly shuttle away that glucose to help me recover from the hike. I'm showing this because it's very easy to throw your blood sugar off, especially if you are consistently eating foods like bread, pasta, sugary drinks (including juice), etc.
So what can I do if I have Gestational Diabetes?
The beautiful thing is that a diagnosis of Gestational Diabetes is not a life sentence! Through making the proper dietary and lifestyle changes, you can control your blood sugar during pregnancy and birth a perfectly healthy baby! I highly recommend enrolling in one of my 21-Day Sugar Detox Coaching groups and/or working with me 1-On-1 to prevent GD or get yours under control. The 21-Day Sugar Detox Program is the ideal program, filled with whole, nourishing foods, to help you manage blood sugar in a way that will help you develop a metabolically healthy child.