Gestational Diabetes (GD) is so hard. It changes every facet of your pregnancy. It can feel so limiting, exhausting, and spark some real anxiety and guilt. Diabetes Mellitus or Type II Diabetes has a very negative connotation and as a result Gestational Diabetes can be the same. When you get diagnosed with GD everyone looks at you like your bad choices are what gave you this disease, when in reality that isn’t true.
The management of GD can complex, time consuming, and life consuming. Every single morsel of food you put in your mouth has to be planned or your blood sugar levels could go completely out of whack.
I have had GD with 4 of my 6 viable pregnancies. I’ve learned a few things over the past 7.5 years. I have been Gestationally Diabetic for a total of 59 weeks.
Here are 12 tips that have saved my sanity when trying to manage my Gestational Diabetes. I hope this information is helpful for you.
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The content contained in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician, go to the emergency department, or call 911 immediately.
What is Gestational Diabetes?
Gestational Diabetes (GD) is a type of diabetes that develops in pregnancy. It develops when a pregnant woman’s body struggles to produce insulin or use insulin effectively.
Usually GD is screened and tested for at 28 weeks. If you’ve had GD in the past, your provider might suggest testing earlier in pregnancy around 12 weeks.
It is also important to mention that as your pregnancy progresses towards the end of your pregnancy your insulin resistance may increase and what worked at 28 weeks for managing your GD, may not be as effective at 38 weeks.
Contributing Factors that cause Gestational Diabetes
Two factors cause GD: Insulin resistance and hormones from the placenta (neither of which you can control).
Other contributing factors are being overweight or obese, having a family history of diabetes, having GD in previous pregnancies, being older than 25, certain racial groups are more likely to get it, having PCOS, and not being physically active. Most of these factors you have very little to no control over. Bottom line: having GD is NOT your fault, so get that out of your head right now.
Tips for managing Gestational Diabetes
1. Get a good, reliable Glucometer
Remember that they do expire. This is something that I just learned. I had had my glucometer since 2017. It served me for three GD pregnancies before dying lasting month. I had no idea that they expired. My new glucometer has an expiration date in 6 years, which seems reasonable. Obviously the strips for your glucometer also expires, but the date is a lot easier to find.
I will also mention that I have used a few different types. I have some that I like their lancets more than others. The Freestyle uses a much smaller blood sample than the One Touch Ultra.
2. See a Diabetic Counselor (DC) and/or a Registered Dietitian (RD)
When I had GD the first time my OB referred me to a Registered Dietician. It was so informative. She went over portion size and what my carb counts should be for each meals. I will tell you what my numbers are, but remember that I am not a doctor or a registered dietician. You should see a specialist yourself to go over the numbers for your specific needs.
The RD told me that I should keep my carb count under 30 breakfast, 45 for lunch, 60 for dinner, and 15 carbs for each snack. I find that keeping to these numbers definitely keep my numbers relatively in check.
With my current pregnancy, which is my fourth pregnancy with GD, my OB thought that after 7.5 years it might be nice to take a refresher class in mechanics of diabetic management. She referred me to a Diabetic Counselor as a result. It has been very helpful.
3. Keeping a Food Journal
At the beginning, it may make it easier to manage your GD because you can keep a log of foods that tend to spike your sugars more than others. This will make it easier to make better choices in the future.
My Diabetic Counselor has suggested keeping a log of the meals that have resulted in high levels.
You can use anything to keep a food journal, but this one is perfect for Diabetics.
Regardless of if you decide to keep a food journal, it is so important to keep a log of your fasting and 2h postprandial levels for each main meal of the day.
4. Eat smaller, more frequent meals (typically Breakfast, snack, lunch, snack, dinner, snack.
Smaller more frequent meals can help keep your levels more stable and less likely to spike as aggressively as if you had had a large carb heavy meal. In the hospital a diabetic diet is called a Consistent Carb diet, because it is better at keeping your blood sugar levels… well… more consistent.
5. Stay hydrated.
This one may seem obvious, but it is vital to diabetic management. The less hydrated you are, the more concentrated your blood glucose levels will be.
A few weeks ago I had 3-4 days of high levels and I couldn’t figure it out why. I was eating all the same meals had been in the past, but even small amounts of carbs were making me spike. I realized that I hadn’t been drinking pretty much any water all weekend. It also was only a few weeks into the second trimester and that it is when a woman’s blood volume drops significantly. After intentionally hydrating myself, my blood glucose levels began to stabilize again.
It is very important to drink as much water you can. It can be helpful to also add in electrolytes as well, so that you don’t because hyponatremic which can also be serious in pregnancy as well. I do like to use Liquid IV packets in my water to help me be more hydrated as well, especially when I’m under the weather.
6. Move your body, better yet get some light exercise in after each meal.
Exercise can help manage GD by improving insulin sensitivity and lowering blood sugar levels.
Going for a short 10-15minute walk after each meal is highly effective. I also like to do some strength or resistance training 2-3 times a week as well. My favorite way of moving my body, especially during the cold winter months (I live in Central New York) is to jump on my stationary bike for 10-15 minutes after each meal. It doesn’t take a lot of time, but it makes me feel amazing.
Definitely talk to your healthcare provider if you are concerned about working out while pregnant. There are obviously some conditions and situations that make working out in pregnancy dangerous.
The general recommendation is 150 minutes of exercise a week, but it doesn’t need to be crazy.
7. Sleep
Adequate sleep in pregnancy, especially for women with GD, can help with blood sugar control.
Anecdotally, the nights that my sleep is short or vastly interrupted, because I’m pregnant and have 5 other kids, my sugar levels are almost amazing harder to control throughout the day.
Obviously this isn’t always easy to fix, but it is something to at least consider.
8. Importance of Protein, especially at night.
Protein is vital for helping with the management of GD. It has five major benefits:
-Blood sugar control
-Satiety by keeping you full for longer
-It helps to increase blood supply, which is vital to pregnancy.
-Protein contributes to breast and tissue growth.
-It also is fundamental in fetal growth and development.
I try and get at least 30grams of protein in every meal and 5-10grams in my snacks. My evening snack, before bed, almost always includes a Fairlife Protein Shake. They are a quite expensive, but by far the best tasting with pretty good ingredients. I also enjoy these Quest protein bars as well.
I like to get most of my protein through whole clean foods, but this pregnancy has been brutal with the protein aversions I’ve had, so I get the protein in where I can.
9. Fiber is your best friend.
Fiber helps to slow digestion which in turn helps control blood sugar. It is also magic when it comes to constipation as well.
Fiber sources can include: fruits and vegetables (blueberries are life for me right now), whole grains. brown rice, carrots, legumes, and cucumbers.
Most daily recommendations I have found are between 25-35 grams of fiber a day.
My favorite fiber sources are blueberries, cucumbers, celery, Olipop prebiotic sodas, and quest protein bars.
10. Whole wheat and whole grains are a lot better at keeping your sugars leveled compared to the white alternatives like white bread or rice.
Whole wheat and whole grains serves a few purposes in helping to manage GD. Firstly, whole grains contain complex carbs and fiber which slows the absorption of glucose and digestion as a whole, thus maintaining steady blood glucose levels longer
Secondly, they also make you feel more full for longer, which can help you consume fewer carbs overall.
Thirdly, they contain necessary nutrients that are vital for overall fetal development and maternal health, like iron, vitamins, and magnesium.
Whole grains include: quinoa, farro, whole wheat bread, oats, barley, bulgur, and brown rice.
11. Food timing
I have been advised that I shouldn’t go more than 8-10 hours between my last meal (or snack) of the night and my breakfast in the morning. This is for multiple reasons; it reduces the risk of hypoglycemia (low sugar levels), it promotes better health of your baby by keeping your glucose supple to your baby more consistent, and it also aids in maintaining a stable blood sugar level.
Anecdotally, I find that the longer I go without eating, the higher my fasting sugar level is, but this is because I take long acting insulin and my blood glucose level will rebound after the 6-8 hour insulin peak.
12. Insulin doesn’t make you a failure
Insulin doesn’t mean you failed. It doesn’t mean that your body failed. All it means is that you needed help in managing your GD and keeping your baby safe and healthy. I have needed insulin with all of my GD pregnancies, but I have been so blessed and fortunate to have been able to birth beautiful, healthy babies.
My first GD pregnancy needed a lot of insulin. I was taking it five times a day. He was my healthiest newborn. He never had blood glucose regulation issues at all. All of this is just to say that if your body needs the insulin to keep you and your baby safe, take it and let go of the guilt.
Risks that come with GD
While pregnant there are a few risks that come with GD that you should definitely discuss with your provider. These can include: hypoglycemia in the baby immediately or within the first 12-48 hours of birth, high blood sugar during labor (you may need an insulin drip), preeclampsia (which high blood pressure in late pregnancy, labor, or even up to 6weeks postpartum).
Having GD also puts you at risk for developing Type 2 Diabetes after birth or even later in life. It can also increase the risk of Type 2 Diabetes in your child when they grow up as well.
My Experiences with GD
My First GD Pregnancy
Having GD with my second pregnancy was a blessing in disguise. I was 28 weeks when I was diagnosed and as a result of this diagnosis I risked out of care from my midwife. I am so grateful for this seven years later. My midwives were very nice and caring, but my first pregnancy, delivery, and immediate postpartum period were very difficult and complicated. I do believe that if I had had an OB the complications I experienced would have been caught earlier and wouldn’t have caused me and my son so much trauma.
I started being seen by the OB, who I still see seven years later and she is amazing. My blood glucose levels were very high based off of the 3 Hour Glucose Tolerance Test, so she warned me before hand that insulin was most likely going to be needed. She referred me to a Registered Dietician and gave me 2 weeks to try and manage my levels with dietary modification. That didn’t work.
I was put on long acting insulin twice a day (in the morning and at night) and short acting insulin with each meal. For those counting, that insulin 5 times a day. It was brutal, time consuming, and mentally exhausting. I was working nights as a Cardiac nurse at the time and I had to go on early unpaid leave because it was too difficult to work while managing my blood sugar and dietary needs.
My son’s birth
My son was born at 37 weeks via c-section because my placental function was 20%, he had stopped growing, and he was breech. We tried the External Cephalic Version, but it was unsuccessful and we weren’t sure if he would last much longer with placental insufficiency. The placenta provides nutrients and oxygen, both of which are needed for sustaining life. So my OB sat me down, went through the options, and we agreed to take him while he was healthy.
He was a happy, healthy 6lb 3oz. baby boy. We had no issues or complications with his blood sugar regulation and he is now a happy, crazy seven year old.
My second GD Pregnancy
I was diagnosed with GD at 28 weeks with my fourth pregnancy. My OB gave me 2 weeks to control my levels with dietary changes and they were pretty successful, but my fasting sugar levels were still higher than my OB liked. I was put on small dose long-acting insulin at night, just to help with my fasting numbers. We increased it a few times, but otherwise my GD was well controlled throughout the remainder of my pregnancy. My son was a spontaneous VBAC at 38 weeks. He weighed 7lb and was a healthy, wonderful baby and an even more wonderful almost four year old. He had one low blood sugar level in the first 12 hours, but it came right back up after breastfeeding and we needed no interventions.
My third GD Pregnancy
*I had a miscarriage before this pregnancy, which caused me to have a lot of hormonal/weight problems that I do believe contributed to making this GD a little more aggressive than the previous one.*
I was diagnosed with Gd at 16 weeks with my fifth (viable) pregnancy. Usually they would have tested me earlier because of my previous GD pregnancies, but had to use a different OB for the first 16weeks of my pregnancy because my OB was on maternity leave herself. So we tested at 16 weeks and it came back with high levels. I tried to change with diet, but this pregnancy was not having it. I started out with just long-acting insulin at night, but at about 24-28weeks my insulin resistance became worse and my OB had to start me on long-acting in the morning as well. When I was 32weeks my levels were once again increasing so my OB was increasing my long-acting insulin each week. I ended up only needing long-acting, but had increased to high levels due to the increase in my insulin resistance.
My son was an induced VBAC at 38 weeks. His induction got a little hairy at one point, but we were so blessed that he was born healthy. He had three pretty low blood glucose levels in the first 12 hours, we had to use the glucose gel twice to help raise his levels. My little man was perfectly healthy after that and is now a thriving, fun-loving 18 month old.
My fourth/current GD pregnancy
I didn’t have to take the Glucose Tolerance Test with my current pregnancy. Symptom of diabetes started at 6 weeks for me. I went into my first appointment at 9 weeks after checking my sugar for 3 weeks and told my OB I was diabetic. It was relatively mild, but unfortunate. GD makes your pregnancies feel eons long. Also having GD when you’re fighting the nausea and fatigue of first trimester is nothing like I have ever felt before. I was put on insulin around 16 weeks. I’m currently 24 weeks and I’m still on the same dose of long-acting insulin due to my high fasting levels. I am anticipating that my insulin needs will need to be increased towards the end of my pregnancy, but I just take it one day at a time.
Gestational Diabetes can be rough to manage and exhausting, but we do what we need to do to keep our babies and ourselves happy and healthy. You are doing an amazing job and I am sending you so much love and support.
I hope this information has helped you in your Gestational Diabetes journey. Save it for later, send it to a friend, and please leave a comment if you liked this post and/or have any comments, questions, or concerns.
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