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Many women come into pregnancy primed for Gestational Diabetes. This is a disease process which exists on a continuum and with support, guidance, and effort, pregnancy can be a leverage into optimal health. This is a very exciting option compared to the standard expectation that one will move from at-risk all the way into a full blown disease which requires multiple finger pokes a day, medication to control, and affects nearly every organ system in both mom and baby as well as their long term health outcomes. Additionally, nutrition and exercise interventions during pregnancy reduce the likelihood of cesarean section (and you know how I feel about avoiding the primary cesarean and VBACs).
Do not be fooled by common recommendations which allow for a great deal of carbs per meal. The single most important dietary intervention is the elimination of sugars and carbs with the exception of fresh fruit which is loaded in fiber that provides benefits which far exceed the effects of fructose. Choose low glycemic load fruits. Increase levels of lean protein and low glycemic load vegetables for filling alternatives to sugars. Look for glycemic load which represents glucose in a normal serving (the index represents portions much greater than one person can eat). Expect the first 3 days to be the hardest as you teach your body that it can get energy from sources other than sugar-heavy foods. Cravings will be very strong but can be helped by keeping nourished throughout the day.
During pregnancy it is especially important to provide families with support for these changes until they can take them on as their own. Failure due to “non-compliance” is usually blamed on the patient but is actually the failure of the provider to work on education and support that is meaningful to the individual and their family in a personalized way. It is a huge investment of time with dividends in multitudes: short and long term health for the pregnancy, mother, baby, and family. If the provider cannot spend the kind of time needed, and does not have a health coach on staff who can–switch providers.
For those diagnosed already with Gestational Diabetes, take a look at lifestyle changes which have been shown to improve outcomes even over medication. Work with your midwife or doctor to increase lifestyle changes and decrease medication. If you are at the end of your pregnancy or a new parent–it’s not too late to start. Breastfeeding longer than six months can also help regulate your insulin resistance and improve outcomes for you.
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