Gestational diabetes is a type of diabetes that can occur during pregnancy among women who didn’t already have diabetes.
It’s on the rise — and experts are worried.
Just last week, the Centers for Disease Control and Prevention (CDC) pointed out in a new study that there has been a 30% increase in gestational diabetes mellitus (GDM) — the official term for gestational diabetes — among women who gave birth between 2016 and 2020.
The agency noted that the gestational diabetes rate has risen with increasing maternal age, body mass index prior to pregnancy and plurality, meaning the number of live births per pregnancy (twins, triplets, etc.).
The rates of gestational diabetes ranged from 4.7% in Mississippi to as high as 12.6% in Alaska in 2020, according to the CDC study.
“About 50% of women with gestational diabetes go on to develop Type 2 diabetes,” the CDC signaled.
It also said that the rate of GDM varied by a mother’s race, with the highest rate in non-Hispanic Asians at 14.9% and lowest in non-Hispanic Black women at 6.5% among the six largest race and Hispanic-origin groups studied, according to the recent report.
“During pregnancy, the mothers’ hormones ‘compete’ with the hormones produced by the placenta and causes insulin activity to be weakened or becomes less sensitive,” said Sue-Ellen Anderson-Haynes, national spokesperson for the Academy of Nutrition and Dietetics, which is headquartered in Chicago.
“This is called insulin resistance,” she added.
“When this happens, the mother cannot keep blood sugars in a normal range and often needs medical intervention to keep it steady during pregnancy.”
There are key steps that can be taken to try to prevent it ahead of time.
Research has shown that some ways to reduce the risk of developing GDM include seeking the guidance of a registered dietician nutritionist (RDN) to help with diet and lifestyle changes to safely reduce blood sugar levels, Anderson-Haynes said.
She encourages women — before they get pregnant — to maintain a healthy weight “by eating nutritious foods and engaging in regular physical activity most days of the week,” which can “reduce the risk of development of GDM.”
Also, “be mindful of the foods you eat,” she said.
Try “limiting fried food, ultra-processed foods like potato chips, fries, refined carbohydrates like white rice, foods high in fat — particularly saturated fat — processed meats and foods high in added sugar such as sugar-sweetened beverages,” Anderson-Haynes added.
“Instead, look to eating a balanced diet of grains, fruits, vegetables, dairy/dairy alternatives and protein foods.”
She said the nutrition management of GDM is somewhat similar to that of Type 1 diabetes mellitus (caused by an autoimmune reaction in which the pancreas does not produce enough insulin) — as well as Type 2 diabetes mellitus (caused by insulin resistance due to weight gain and lifestyle factors).
The type of foods she recommends are high in fiber, healthy dietary fats, low-fat dairy (or dairy alternatives) and lean protein with an emphasis on a low glycemic index.
She also recommended eating carbohydrates that raise the blood sugar slowly — certain starchy vegetables, fruits, whole grain breads, rice pasta, etc, — as well as lots of non-starchy vegetables such as green leafy veggies, carrots, peppers and more.
“Nutrition individualization is key,” she said. “There is no exact number of carbs, fat, protein, etc. that everyone should eat. This is also true for those with diabetes or pre-diabetes.”
But if moms develop gestational diabetes mellitus during pregnancy, Anderson-Haynes says their OB-GYN can refer them to a multidisciplinary team that includes an endocrinologist, a maternal-fetal health specialist and an RDN who is also a certified diabetes care and educational specialist.
“For many women, GDM can be managed with diet and lifestyle interventions.”
Sometimes, however, insulin is needed if these modifications do not control the blood sugars, according to the American Diabetes Association Standards of Medical Care in Diabetes.
After pregnancy, those women with GDM should follow up with a diabetes health care team at their postpartum visit, which is usually 6-8 weeks after pregnancy.
The team ideally includes an endocrinologist and an RDN who specializes in women’s health and diabetes.
Treatment therapies will be individualized.
While some women may need medication to manage their high sugars, others may need only diet and lifestyle management, she noted.
The good news is Type 2 diabetes is preventable — with research showing it can go into remission with medically supervised intensive treatment, Anderson-Haynes said.
She recommends some nutrition “pearls” of wisdom to follow to stay healthy.
“Simple tips include: focus on plant foods (fruits, vegetables, nuts, seeds and whole grains), limit fried and ultra-processed foods, foods with added sugar and sugar sweetened beverages.”
And don’t forget to exercise most days of the week, have good sleep hygiene and manage stress appropriately.
Adults should aim for a daily intake of 1.5-2 cups of fruit or the equivalent, according to the 2020-2025 Dietary Guidelines of America.
And women should limit added sugar intake to 6 teaspoons (25 grams of sugar), while men should limit their intake to 9 teaspoons (36 grams of sugar) every day, according to the American Heart Association.
“Dried fruit is higher in sugar than whole fruit because the sugar is more concentrated since the water is removed,” Anderson-Haynes said.
“Fruit has natural sugar and is good for you since it provides lots of nutrients like fiber and antioxidants.”
Too much fruit, though— especially at one serving — can lead to spikes in blood sugars if not balanced with other nutrients.
“So go easy on smoothie bowls and fruit drinks,” she advised.
Lastly, she said that health care providers and patients both need to act fast when there is a diagnosis of GDM to prevent the development of type 2 diabetes.
For more information, she recommends the Academy of Nutrition and Dietetics website, the American Diabetes Association site or the “How an RDN can help with Diabetes” website when searching for the guidance of an RDN.