Why Gestational Diabetes is NOT Your Fault
Gestational Diabetes: What is it?
Gestational diabetes (GD) is diabetes diagnosed for the first time during pregnancy. Like other types of diabetes, gestational diabetes affects how cells use glucose (sugar). It is thought that changing hormones during pregnancy may affect the typical way the body processes blood sugar.
GD can affect both the health of the baby and the mother. For the mother, it may increase the risk of high blood pressure and preeclampsia during pregnancy, as well as the risk of preterm birth and/or need for a C-section. For the baby, it may increase the risk of breathing difficulties or low blood sugar in the baby shortly after birth, and is correlated with larger baby birth weight.[1]
What causes it?
Researchers don’t yet know why some women develop GD and some women don’t, but risk factors include previous GD and prediabetes, polycystic ovary syndrome, an immediate relative with diabetes, and age (women over 25 are at greater risk). Race is also an important factor with Black, Hispanic, American Indian and Asian American at a higher risk of developing gestational diabetes.[2]
...But I’ve heard it also has to do with weight and diet…
GD is caused by the confluence of MANY factors, several of which are out of our control. Remember that women of all shapes and sizes are affected by gestational diabetes, and it’s a relatively common condition: according to the International Diabetes Foundation, it affects 1 in 7 pregnancies.
Contrary to popular belief, eating too much sugar or too many carbs does NOT cause GD (or any form of diabetes for that matter)! In fact, most studies have found that while there may be associations between diet and development of GD, there is no certainty that any dietary factor alone causes GD.[3]
So the constant blaming of women who develop GD is - you guessed it - mostly just another sneaky form of fatphobia.
How is it diagnosed?
GD is typically diagnosed with a screening during the second trimester, though it may be done earlier if you have some of the risk factors for GD. Typically it is screened using glucose tolerance testing, similar to testing for other forms of diabetes.
How is it treated?
The good news is that even with GD, controlling blood sugar can help significantly reduce risk of complications during pregnancy and birth. This is a condition that you can manage by finding the right treatment for you!
There are a few options for treatment, including behavior changes and medication. Remember that behavior changes do not equate to weight loss interventions, and that in fact weight loss interventions for diabetes generally have not been shown to be effective in improving cardiovascular complications down the line.[4]
In terms of behavior changes, several things can help control blood sugar in mothers-to-be with GD, including:
● Sleep: it is well-studied that poor sleep quality can increase risk of developing diabetes. Getting 7-9 hours of sleep a night can help with insulin resistance and GD management.[5]
● Meal frequency and consistent carbohydrate intake: eating more frequent meals that contain carbs throughout the day can help even out blood sugar and prevent large spikes or dips.
● Food pairing: pairing carbs with fat and/or protein can also help keep blood sugar more consistent. For example, having crackers with cheese, or an apple with peanut butter, rather than just the crackers or apple alone.
● Fiber: fiber helps slow absorption of food, including carbohydrates, as you digest, which can help avoid swings in blood sugar after eating.
● Movement: studies have found that even moderate-intensity exercise like walking or light cycling can have a blood-sugar-lowering effect. Resistance exercise can also be beneficial. The important thing is to find movement that is accessible and enjoyable to you.[6]
One thing to remember: moms-to-be with GD should NOT stop eating carbohydrates! While the research is limited, studies have shown that low-carbohydrate diets in pregnant women with GD had little to no effect on fasting blood glucose or on pregnancy outcomes.[7]
In some cases, medication may also be used, typically in combination with behavioral changes. Typically insulin injections are used, although some oral medications (Metformin) are also approved for use.
All in all, developing gestational diabetes is never your fault. Women with GD can and do have healthy pregnancies and give birth to healthy babies. By finding treatment that works for you and your lifestyle, you can make sure you and your baby stay healthy! If you think an intuitive eating-certified, anti-diet registered dietitian might be helpful to you during your pregnancy journey, be sure to reach out Tory for more info.
Sources:
[1] https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
[2] https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
[3] https://link.springer.com/content/pdf/10.1186/s12884-019-2185-y.pdf
[4] https://haeshealthsheets.com/type-2-diabetes/
[5] https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2632-9