Rebecca Ditkoff, a registered dietician, talks about misconceptions around gestational diabetes and how people can ensure their health during pregnancy.
Rebecca Ditkoff
Registered Dietician
What are some common misconceptions about gestational diabetes?
Diet misconceptions:
- “You need to avoid carbohydrates.” Carbohydrates are still an important part of a healthy diet for you if you’ve been diagnosed with GDM; however, monitoring how much and what you pair carbohydrates with is key for maintaining healthy blood sugars.
- “Fruit (such as bananas) are too high in sugar to eat.” Pair fruit with a protein.
- “You need to stay away from sweets.” You can enjoy dessert mindfully and can try to pay attention to additional fat and protein content to help balance blood sugars.
General gestational diabetes (GDM) misconceptions:
- “Having GDM means you will have a large baby.” There is an increased risk of having a large baby (known as macrosomia) with gestational diabetes. However, it is important to note that just because someone is diagnosed with GDM does not mean they will automatically have a large baby. The chances of having a large baby correlates very strongly to blood sugar control during pregnancy. Therefore, if changes are made to control the blood sugar, whether through lifestyle or medication, this can help lower the risk.
- “Having GDM means there will automatically be delivery complications.” Ignorance is not bliss when it comes to GDM. Getting the diagnosis is helpful because then you can take strides to make dietary and lifestyle changes to improve your glucose levels. Something important to note is that a woman with GDM is at no higher risk than a woman without an “official” gestational diabetes (and probably a way lower risk than someone who had a false negative on their glucose screening and is eating whatever they want without any consideration for their blood sugar). If proper diet, lifestyle, and medications are implemented and blood sugar levels are well controlled, the risk for complications should be lowered.
What are a few key foods that pregnant women should be incorporating into their diet whether they are living with gestational diabetes or not?
- Eggs: Eggs are not only a convenient source of protein, which helps balance blood sugar if one is diagnosed with GDM, but also an excellent source of many nutrients commonly lacking in a prenatal diet. An important and often overlooked nutrient found in eggs is choline, which is extremely vital to a baby’s brain development and in the prevention of birth defects. Whole eggs are also a good source of vitamin A, B-vitamins, vitamin D, vitamin E, and omega-3 fatty acids. All of these nutrients are found in the yolk, and therefore it is important to eat the whole egg and not to skip it.
- Foods rich in folate.
- Vegetables: Incorporating vegetables is an important part of any healthy diet. For GDM especially, it is important to incorporate more of the non-starchy vegetables that provide vitamins, minerals, and antioxidants while being low in carbohydrates. Dark leafy greens are especially important and provide a good source of folate.
- Foods rich in fiber: Dietary fiber is a carbohydrate substance of plants that is not digestible, meaning it doesn’t get absorbed in the body. But that doesn’t mean it’s useless. Fiber helps to keep your bowels running smoothly, lowers cholesterol, helps you feel fuller longer, and is also crucial for maintaining optimal blood sugar levels. Fiber can be found in lentils, popcorn, almonds, pears, apples, and strawberries.
- Fatty fish such as salmon. Omega-3 fatty acid is critical for optimal brain and vision development.
How will a woman know if she has gestational diabetes? Are there any warning signs to be aware of?
For most women, gestational diabetes doesn’t cause noticeable signs or symptoms. Increased thirst and more-frequent urination are possible symptoms. Since signs and symptoms are not always evident, GDM screening is a standard test provided during routine prenatal doctor visits. Most pregnant women have a glucose screening test between 24 and 28 weeks of pregnancy. The test may be done earlier if you have a high glucose level in your urine during your routine prenatal visits or if you have a high risk for diabetes.
Being diagnosed with gestational diabetes can be scary for women. Beyond diet, how can women care for themselves physically, mentally, and emotionally after this diagnosis?
Without adequate support, the wrong information, or no information at all, the diagnosis of gestational diabetes can feel overwhelming and scary. One may feel especially confused about what and how to eat after the diagnosis. Therefore, seeking professional help from a registered dietitian or certified diabetes educator is an important first step in order to help one stay calm and feel supported with their food choices.
Additionally, if you have been diagnosed with gestational diabetes, the most important thing is to be gentle with yourself and not beat yourself up. You can’t change family medical history or dietary and lifestyle habits prior to the time of the diagnosis. However, you can focus on how you eat and care for you and your baby now. For both physical and mental health, it is important to think about ways outside of diet to care for yourself that can impact your blood sugar control such as sleep hygiene, activity levels, and stress management.
Having a mindset that focuses on what to add into your routine versus what to limit or take away can be very helpful.
Last, research has shown us that moms who maintain overall normal blood sugar levels, despite a GDM diagnosis, have no higher risk than women without the diagnosis. With the right information and support, GDM isn’t so deleterious after all.
