Can you really prevent gestational diabetes?

What Is Gestational Diabetes exactly?

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GD is a temporary form of diabetes that develops during pregnancy, where a hormone produced by the placenta prevents your body from using insulin effectively. This type of insulin resistance results in your body struggling to process sugar, which leads to elevated blood sugar levels. It typically occurs in the second or third trimester when the body’s insulin needs increase. The good news is that many women with GD go on to have healthy pregnancies and babies. In most cases, GD also resolves shortly after childbirth and your blood sugar levels usually return to normal.

While GD can be quite sneaky and asymptomatic, some possible symptoms you may experience include dry mouth, unusual thirst, frequent urination, constant fatigue, blurred vision, genital itching or thrush, and vaginal, bladder or skin infections.

Many mums’ main concerns about GD are about its effects on the baby. GD may lead to Macrosomia (having a large baby over 4kg, which can make delivery more difficult), premature birth (delivering too early which can cause respiratory and other issues in baby), and Hypoglycaemia (baby experiencing low blood sugar levels immediately after birth, requiring glucose intravenously).

What’s your risk of getting GD?

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The big question then: can GD be prevented? The frustrating answer is both no and yes. Here’s why.

While the exact cause of GD is not fully understood, factors like genetics, weight, and hormonal changes may contribute. It is noteworthy that these appear more correlative than causative though. Also, some mummies who had GD in previous pregnancies may not have it in later pregnancies.

Hence, it is impossible to predict who will have GD. Do know that Asians are naturally predisposed to the condition, and your chances go up if you:

Were overweight before your pregnancy, with a body mass index (BMI) of 25 or greater
Have a family member with diabetes or high blood pressure
Are aged above 35
Had gestational diabetes, a large baby (over 4kg) or an unexplained stillbirth in an earlier pregnancy
Gain an unusually large amount of weight during pregnancy
Have had polycystic ovarian syndrome (PCOS)
Have had abnormal blood sugar tests before

You may be able to prevent GD – before getting pregnant – by losing weight if you are overweight, getting regular exercise and having a healthy fibre-rich diet. However, if you’re already pregnant, it is not advisable to go on a weight loss regimen.

What happens if you get GD?

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If you’re diagnosed with GD, fear not! It is a completely manageable condition, and many mummies have survived this. Depending on how high your blood sugar levels are, your healthcare team will prescribe medication or more commonly advise dietary changes and regular exercise such as walking. You will most likely need to use a glucose-monitoring device to monitor your blood sugar levels. The goal is to keep blood sugar levels within a healthy range so as to ensure the well-being of both your baby and you.

Recommended foods for managing GD

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One of the best ways to manage your blood sugar levels is through proper nutrition. Contrary to what some believe, it is not advisable to completely cut carbohydrates out of your diet. Instead, focus on the proportion of carbohydrates, proteins and fats in each meal. One study suggests the recommended ratio to be 33 to 40 per cent  complex carbohydrates, 35 to 40 per cent fat and 20 per cent proteins. It is also important not to miss any meals or snacks, because your body tends to compensate by producing glucose when you do this, leading to even higher blood sugar levels.

Consider the following foods to include in your diet:
1. Whole grains
Fibre-rich complex carbohydrates help control blood sugar levels by slowing down the absorption of carbohydrates. Choose whole grains like quinoa, oats, sorghum, spelt, rye and barley over refined or simple carbs like white bread, white rice, potatoes or white pasta. Cakes, candy, soda and boxed cereals are, needless to say, off the table.
2. Lean proteins
Healthy protein choices include chicken, eggs, fish and other seafood with low mercury content, and lean cuts of beef, veal or pork. Trim away visible fat from your meats, and choose to bake, roast, grill or boil instead of frying.
3. Healthy fats
Your fatty food intake should be generally limited, but since fat is necessary for growth and baby’s brain development, you should choose healthy oils – olive and avocado oils are great options – and include seeds and nuts in your diet. You may also consider boosting your limited consumption of fatty fish by taking prenatal DHA supplements.
4. Healthy dairy
Low-fat or non-fat milk or yogurt are good dairy options. Choose natural Greek yogurt instead of those with added sugar or artificial sweeteners. Hard cheeses also make great snacks. It is important to consume some dairy products since they’re a great source of protein, calcium, and phosphorus.
5. Leafy greens and non-starchy vegetables
Dark green leafy vegetables like spinach, kale, rocket and collard greens are nutritious, rich in fibre and low in sugar and carbohydrates. Broccoli, cauliflower, and bell peppers are also excellent choices as they have a low glycaemic index.
6. Citrus fruit and berries
Although fruit juices, canned fruit, dried fruit and incredibly sweet fruits like overripe bananas and durian are not recommended for GD mums, not all fruits are bad for those with GD. Citrus fruits like oranges, grapefruit and tangerine, as well as berries like blueberries, strawberries, and raspberries are low in sugar and packed with vitamins and antioxidants.
7. Keto dessert options
For a sweet treat, consider keto-friendly desserts made with almond flour or coconut flour and natural sweeteners like monkfruit (luo han guo). Since science and research on the safety of artificial sweeteners and sugar substitutes in pregnancy continue to evolve, it is best to consume such treats in moderation. If you’re really craving a sweet treat and enjoy baking, you could experiment with your own sugar-free recipes.



This article was originally published in Singapore Women's Weekly.