Gestational Diabetes Written by nutrition student Millie Rose Introduction Diabetes week is here bringing awareness to the chronic health condition. There are 3 types of diabetes, including Type 1, Type 2 and Gestational. However, this blog will focus on gestational diabetes and how diet can help manage your blood sugar levels. Read until the end for recipes for women with Gestational Diabetes. Why is this relevant? Gestational Diabetes affects 1 in 20 pregnancies in the UK (Diabetes, 2023). Gestational diabetes can make it difficult to manage blood sugar levels, which may lead to symptoms such as increased thirst and urination, a dry mouth, and tiredness (NHS, 2022). It is important that you learn to manage your blood sugar levels if you have gestational diabetes, for the health of you and your baby. What is gestational diabetes? Gestational diabetes is when blood sugar levels are high during pregnancy. It occurs because the body cannot produce enough insulin to reduce blood sugar levels after eating, leading to spikes in blood sugar that don’t settle. Blood sugar levels usually level out after birth. Who is more likely to get gestational diabetes? (NHS, 2022) Why? These risk factors have a correlation with insulin resistance. A healthy individual will produce insulin when blood sugar rises after eating. The insulin will be responded to, and the blood sugar levels will reduce to a pre-eating level. Insulin resistance is where insulin is produced when blood sugar rises after eating. However, the insulin is not responded to, and the blood sugar levels remain high. Often in gestational diabetes, insulin is produced in response to increasing blood sugar levels; however, it is not responded to, so blood sugar levels remain high. This can be due to placental hormones making insulin less efficient. How is gestational diabetes diagnosed? If you have one or more risk factors for Gestational Diabetes (see list above), you will be screened for Gestational Diabetes earlier in your pregnancy. This is done by an oral glucose test, where a blood test is taken in a fasted state and 2 hours after a glucose drink. However, some women may have high blood sugar levels, which are indicated by symptoms including increased thirst, increased urination, a dry mouth, tiredness or blurred eyesight, which may also prompt earlier testing (NHS, 2022). Gestational Diabetes may also be detected later in your pregnancy. What happens after diagnosis, during pregnancy? You will be given a blood sugar testing kit to measure your blood sugar levels throughout the day, especially after eating. This requires a small finger prick for a drop of blood, allowing you to get a blood sugar reading. Controlling blood sugar levels is vital to reduce the effects of Gestational Diabetes, meaning diet is an important factor to monitor. Continue reading to learn how to manage your blood glucose through your diet. Additionally, being more active can help reduce blood sugar levels. Walking, swimming, and prenatal yoga may be more suitable options during your pregnancy. However, in severe cases insulin injections may be necessary to reduce blood glucose. Additionally, your midwife will talk to you about monitoring what is needed throughout pregnancy and birth. It is recommended to give birth before 41 weeks with gestational diabetes to reduce the risk of complications to you and your baby, so an induction or caesarean section may be considered. (NHS, 2022) What can I do? 1. Swap to wholegrain options How to apply this: 2. Reduce refined sugar How to apply this: 3. Check portion sizes How to apply this: 4. Choose and plan healthier snacks How to apply this: 5. Opt for lower Glycaemic Index foods How to apply this: (Diabetes UK) (Diabetes UK, 2023) Exemplar Meal Guide Breakfast: Overnight oats with figs and honey Lunch: Tahini goddess lunch bowl Dinner: Chorizo and bean stew Snack option 1: Crunchy chocolate quinoa bites Snack option 2: Creamy smooth hummus with cucumber or carrot sticks Snack option 3: Dark chocolate dipped strawberries/fruit What is the impact of Gestational Diabetes after birth? Having Gestational Diabetes during your pregnancy increases the risk of having Type 2 Diabetes, which is lifelong. Women who have had gestational diabetes have their blood sugar levels tested every year to detect whether they are pre-diabetic or diabetic. It is especially important that women who have had gestational diabetes maintain a healthy weight by eating a balanced diet and exercising regularly to prevent development of type 2 diabetes after pregnancy. Continuing the habits in the ‘What Can I do?’ section after birth will also reduce the risk of type 2 diabetes, in which mothers who have had Gestational Diabetes are at a greater risk of developing. References: Buchanan, T.A., Xiang, A.H., & Page, K.A. (2019). Gestational diabetes mellitus. Nature Reviews Disease Primers, 5, Article 47. https://doi.org/10.1038/s41572-019-0098-8 Diabetes UK. Glycaemic Index and Diabetes. [online] Available at: https://www.diabetes.org.uk/living-with-diabetes/eating/carbohydrates-and-diabetes/glycaemic-index-and-diabetes Diabetes UK (2023). Causes of Gestational Diabetes. [online] Diabetes UK. Available at: https://www.diabetes.org.uk/about-diabetes/gestational-diabetes/causes. Diabetes UK (2023). What can I eat with Gestational Diabetes? [online] Diabetes UK. Available at: https://www.diabetes.org.uk/living-with-diabetes/eating/gestational-diabetes Hillier, T.A., Pedula, K.L., Ogasawara, K.K., et al. (2021). A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening. New England Journal of Medicine, 384(10), 895–904. doi:10.1056/NEJMoa2026028. NHS (2022). Gestational Diabetes. [online] NHS. Available at: https://www.nhs.uk/conditions/gestational-diabetes/. Simmons, D., Immanuel, J., Hague, W.M., et al. (2023). Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. New England Journal of Medicine, 388(22), 2132–2144. doi:10.1056/NEJMoa2214956. Zhang, C., Rawal, S., & Chong, Y.S. (2016). Risk factors for gestational diabetes: is prevention possible? Diabetologia, 59(7), 1385–1390. https://doi.org/10.1007/s00125-016-3979-3 Zhu, Y., & Zhang, C. (2016). Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective. Current Diabetes Reports, 16(7), 7. https://doi.org/10.1007/s11892-015-0699-x