If you’re going into your glucose test, you may be nervously wondering: Could I have gestational diabetes? If you failed your glucose test, you may be wondering: what now?
First, a bit of good news: Gestational diabetes is a manageable condition. But there are a few things you need to know. Here you’ll find:
- What causes gestational diabetes?
- How are women tested for gestational diabetes?
- What can you expect if you’re diagnosed with gestational diabetes?
- Are there natural treatments for gestational diabetes?
- What potential complications should you be aware of?
What is Gestational Diabetes?
Gestational diabetes is when a pregnant woman develops high blood glucose (sugar) levels during pregnancy.
Our bodies take the food we eat and turn it into glucose (sugar) that enters our bloodstream. In response, insulin is produced by our pancreas to help move that glucose from our blood to our cells where it’s used as energy. Without adequate insulin, blood sugar levels can build up in our blood, which is a problem.
What Causes Gestational Diabetes?
No one knows for sure, but the medical community’s best guess is that it could be caused by the placenta’s growth. As the baby grows, the placenta grows to support him. But that growing placenta also releases a growth hormone called human placental lactogen (HPL) that can block the action of insulin in the mother’s body. If your body doesn’t have enough insulin to change the glucose in your blood to energy, it can build up to high levels, which leads to a failed glucose test and a diagnosis of gestational diabetes.
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How Common is Gestational Diabetes?
It’s estimated that 9.2% of women will be diagnosed with gestational diabetes during their pregnancy. Risk factors include:
- Family history of diabetes
- Being overweight pre-pregnancy
- Advanced maternal age
- High blood pressure
- If you had gestational diabetes in a previous pregnancy
- If you have polycystic ovarian syndrome (PCOS)
- Race: Hispanic/Latina, African-American, Native American, Alaska Native, Asian American, or Pacific Islanders are all at a higher risk
- Even a Paleo or low-carb diet!
What Are the Signs of Gestational Diabetes During Pregnancy?
Most women don’t have any symptoms of gestational diabetes, so it’s difficult to know if you have it without testing. Many of the symptoms are common pregnancy symptoms, so you may just chalk it up to that. You know your body best. If something feels off or you experience the following symptoms, talk to your healthcare provider. Here are some things you may experience:
- Excessive thirst
- Frequent urination (yes even more than usual!)
- Extreme fatigue
- Extreme nausea
- Frequent vaginal, bladder, or skin infections
- Blurred vision
How to Test for Gestational Diabetes
There are no standardized screening guidelines for gestational diabetes, but most doctor’s offices follow a general procedure called a glucola test between weeks 24-28 of pregnancy. If you’re at high risk for developing it, your doctor may test earlier.
Since there are usually no symptoms, a screening test is the only way to determine if you have gestational diabetes. Here’s what you can expect:
- At the doctor’s office they’ll have you drink a syrupy solution containing 50 grams of sugar, usually on an empty stomach. (Some doctors will give you the drink at a previous appointment, so you can consume it at home and then come in. This limits in-office wait time. Additionally, some doctors or midwives will let you drink with a protein like eggs or meat.)
- An hour later you’ll have a blood test to measure your blood sugar level.
What if you fail the glucola test?
If you fail the test, it could just indicate that you’re at higher risk for gestational diabetes, so you’ll have to come back for a fasting test. Here’s what you can expect:
- Your doctor will schedule a morning appointment and ask you to fast for 12 hours.
- When you arrive the doctor will check your fasting blood sugar level and then give you a syrupy drink with a higher concentration of glucose than the first test’s drink.
- After that, they test your blood sugar every hour for the next three hours (Bring a book, you’re going to be there for a while.?)
- If at least two of your blood sugar readings are too high, you’ll be diagnosed with gestational diabetes.
The problem with gulcola
There are a lot of problems with glucola. Some versions of the drink are “cleaner” than others, however they all contain ingredients most of us try to stay away from. This drink contains artificial flavors, GMO corn syrup, glycerol ester of wood rosin, and brominated vegetable oil (BVO). Yikes!
What’s more, some women report nausea, vomiting, dizziness, fatigue, and other symptoms after a glucola test. Natural mama’s who avoid processed food and refined sugar are more likely to react negatively, since their bodies aren’t used to all that junk (and that much sugar!).
False positives are also fairly common. In fact, 1 in every 4 women who test positive for gestational diabetes with glucola don’t actually have the condition. Similarly, many women who DO have gestational diabetes won’t test positive with glucola.
Alternatives to Glucola
- Try other sugary food: Some women opt for a dye-free version of the drink or consume orange juice, dates, jellybeans, or other sugary substances instead with doctor’s approval. To mimic the effect of the drink, you should consume something with 50 grams of sugar and no healthy fats. Talk to your provider to come up with a plan of action. (Note: Some providers contend that jellybeans won’t cut it, however a study of 136 pregnant women demonstrated their effectiveness.)
- Hemoglobin A1C screening: For women in the first or early second trimester, this can detect whether you’ll develop gestational diabetes later in pregnancy. Note: results can be skewed if you’re dehydrated or have anemia.
- Log blood sugar levels: Though a bit time-consuming, it’s possible to keep a log of blood sugar levels at specific times of the day for one to two weeks. This is a more accurate indicator of blood sugar levels, especially for women who eat low carb or paleo. Note: Most insurance companies won’t cover a glucose meter without a diabetes diagnosis, but you can purchase a meter and a pack of test strips over-the-counter.
False Positives Are Possible, Especially for Natural Mamas
Remember: False positives with the glucola test are pretty common—1 in 4 women without gestational diabetes test positive.
If you follow a paleo, low-carb diet, or just aren’t used to eating large quantities of refined sugar and processed food, your body may be more sensitive to the glucola test. This can cause your body to react negatively—your insulin can spike, causing a false positive.
Low-carb, high-fat diets transiently increase insulin resistance. This isn’t a flaw, it’s a feature to ensure you keep burning fat in the tissues that can and preserve precious glucose for the sections of the brain that must burn glucose. But this also means that taking a gestational diabetes test while low-carb can give a false diagnosis. (Source.)
If you suspect you might wind up with a false positive, talk to your healthcare provider about some of the alternative testing methods outlined above.
What to Expect if You Are Diagnosed With Gestational Diabetes
You’ll have to get used to daily blood testing. Your healthcare provider will usually have you test when you wake up in the morning, then again throughout the day. The schedule may vary slightly, but it’s likely you’ll be taking your blood four to five times a day. Some common testing times: after breakfast, after a mid-morning snack, after lunch, after an afternoon snack, after dinner.
You’ll also have to meet with a diabetes specialist, who will give you test strips, lancets, and a blood glucose meter about the size of your palm. When you test your blood you insert a test strip into the meter and then prick a finger with a lancet inserted into a spring-loaded device. You then place some of the blood on the test strip and wait for results.
You may also get a booklet to record your meals, daily exercise, and blood sugar levels. In regular meetings with your specialist they’ll help you analyze trends, come up with better plan meals, and provide general encouragement to stay on track.
Natural Treatments for Gestational Diabetes
You may wonder if you’ll have to give yourself shots. The good news: not necessarily. It is absolutely possible to manage gestational diabetes through a specially tailored diet and exercise. Here are some healthy changes that can make a big difference:
1. Cut back on carbs
Carbs are going to be strictly monitored. Not just breads, pastas, and cereals, but also healthy carbs like fruit, dairy, beans, and squashes. Adopting a low-carb diet rich in healthy fats and proteins helps to stabilize blood sugar, balance hormones, and decrease insulin resistance.
Primal or Paleo diets may work well for this. It’s helpful to work with a nutritionist or nutritional therapy practitioner to create a meal plan.
2. Focus on foods that reduce inflammation
Some of the foods that have been associated with an increased risk for chronic diseases such as type 2 diabetes and heart disease are also associated with excess inflammation,” says Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health
Choose healthy fats, like nuts/seeds, olive oil, fatty fish, and grass-fed butter, as well as green leafy vegetables.
3. Get your greens and veggies
Foods rich in fiber and protein are also important to help manage gestational diabetes as they slow digestion time (and reduce insulin spikes!). Try asparagus, Brussels sprouts, broccoli, cauliflower, and artichokes.
4. Take your vitamins
Studies suggest that women who are deficient in vitamin D are more likely to develop gestational diabetes. Getting some sunshine and supplementing with cod liver oil can help boost vitamin D levels. Supplementing with chromium, a necessary mineral that helps metabolize carbohydrates, may also be beneficial.
5. Boost magnesium levels
In one study, pregnant women with gestational diabetes were given 250 mg of magnesium daily for 6 weeks. Magnesium significantly improved blood sugar levels significantly and reduced markers of inflammation and cell damage. Their babies also saw a 20.6% reduction in excess bilirubin, which can cause jaundice. Regularly include high magnesium foods into your diet.
6. Get some sleep
Easier said than done, but try to make quality sleep a priority. Sleep deprivation raises the stress hormone cortisol, contributing to unhealthy belly fat. Insulin sensitivity decreases rapidly and raises the risk for diabetes when we’re not getting enough quality sleep.
7. Get moving
Exercise plays an important role in lowering your blood’s glucose level. When you exercise, your muscles can more efficiently use insulin to process blood sugar and use it for energy. In the long term, regular exercise can lower your A1C—your body’s average blood glucose level over a period of 2-3 months. (source)
One study found that taking just three short walks each day after meals was enough to help reduce blood sugar levels. In fact, those walks were just as effective over the span of 24 hours as a single 45-minute walk.
When Natural Treatments Aren’t Working
In some cases, you may be doing everything you can to no avail. Don’t beat yourself up, mama. It happens.
If you’re taking steps to manage your gestational diabetes and it’s still out of control, then you may have to take medicine or give yourself insulin injections. If untreated, gestational diabetes can be serious for both you and your baby. Always follow your doctor’s recommendations. And reach out for support if you find yourself struggling.
Remember: This is only temporary. Your blood sugar levels will most likely resolve themselves after baby’s birth.
Can Gestational Diabetes Harm the Baby?
It’s very important to work with your care providers to manage your gestational diabetes and reduce problems for both mama and baby.
If not controlled, gestational diabetes can cause the following in babies:
- Shoulder dystocia: This occurs when a baby’s head is delivered through the vagina, but his shoulders get stuck inside the mother’s body. It can cause serious complications for both mama and baby.
- Macrosomia: A fancy way of saying your baby can get too big. Since high birth weight can lead to delivery complications (bleeding or uterine rupture in mama; abnormal blood sugar levels in baby), your baby’s weight will be regularly monitored. (This could mean more ultrasounds.)
- Respiratory problems
- Low blood sugar
- Higher risk for obesity and type 2 diabetes as an adult
If not controlled, gestational diabetes can also cause the following problems for mamas:
- High blood pressure or preeclampsia
- Pre-term delivery
- Higher risk of stillbirth
- Higher risk of c-section, particularly if your healthcare provider estimates your baby weighs more than 9 pounds
Can You Still Have a Home Birth if You Have Gestational Diabetes?
If you were planning on a home birth or birthing center, it may no longer be an option due to some of the delivery risks of gestational diabetes. Post-birth your baby will be closely monitored for a drop in blood sugar, which can damage the baby’s brain and lead to developmental delays.
Talk to your doctor or midwife to determine what’s right for you and your baby.
Gestational Diabetes IS Manageable
Is diabetes during pregnancy serious? Absolutely! But it’s a manageable condition. In most cases, mamas with gestational diabetes have a little extra work to do, but they’ll go on to have a healthy pregnancy and a healthy baby. Follow the tips above and listen to your caregivers. And always get extra support if you need it.
How about you?
We want to hear from you! Do you plan to take the glucola test? For mamas already diagnosed with gestational diabetes: What steps are you taking to manage the condition?