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What is Gestational Diabetes and How Can You Manage It?
What is gestational diabetes?
Due to its rising prevalence worldwide, many people are aware of the phrase and meaning of diabetes; nevertheless, the term gestational diabetes and its causes may be less well known. Gestational diabetes mellitus (GDM) is a form of diabetes that first manifests during pregnancy. It is characterised by abnormally high blood sugar levels. It often presents between the 24-28th week of pregnancy and is detected with an OGTT (Oral glucose tolerance test). It affects approximately 15% of women.
What causes GDM?
Following a meal, when sugar (glucose) is absorbed into the bloodstream, the pancreas releases the hormone insulin. Insulin’s role is to transport the glucose from the bloodstream into your cells so energy can be utilised. During pregnancy, the body is required to produce 2-3 times more insulin than usual as the placenta produces hormones that inhibit insulin from removing glucose from your bloodstream. GDM therefore develops is you body lacks the ability to create or react to the additional insulin required.
What is gestational diabetes?
Due to its rising prevalence worldwide, many people are aware of the phrase and meaning of diabetes; nevertheless, the term gestational diabetes and its causes may be less well known. Gestational diabetes mellitus (GDM) is a form of diabetes that first manifests during pregnancy. It is characterised by abnormally high blood sugar levels, which can have major health consequences for both you and your unborn child. It often presents between the 24-28th week of pregnancy and is detected with an OGTT (Oral glucose tolerance test). It affects approximately 15% of women.
The risk factors:
You are more likely of developing GDM if you fall under one or more of the following:
- Over 40 years of age
- Hyperglycaemia in a previous pregnancy
- Asian, Aboriginal or Torres Strait Islander, Maori, Middle Eastern, Indian subcontinent, Pacific Islander or non-white African
- Increased blood glucose levels
- A relative who diabetes or who has experienced hyperglycaemia during pregnancy
- A BMI greater than 30
- PCOS
- Macrosomia
- Taking corticosteroid or antipsychotic medication
Diet:
Diet plays a large role in treating gestational diabetes as a well-balanced diet regulates blood sugar levels within a healthy range. Protein, fat, and carbohydrates are the three primary macronutrients that are required to optimally function. Carbohydrates are the primary nutrient that affects blood glucose levels. Carbohydrates are commonly known as breads and pastas; however, other grains like rice and cereals, fruit, starchy vegetables, milk, and yoghurt all come under this category. Additionally, frequently recognised items like cookies, cakes, sugar, chocolate, lollipops, soft drinks, and ice cream are also included as carbohydrates. Although carbohydrates are often misjudged and perceived as ‘unhealthy’, it is crucial to emphasise that carbs are a crucial source of energy, particularly when you are pregnant. According to available research, consuming less than 175g of carbohydrates per day is harmful, hence the amount of carbohydrates should not be limited.
In summary, the two key takeaways from this article are that the type and amount of carbohydrates are crucial for regulating blood sugar.
TYPE:
Glycaemic index (GI) is a crucial element when considering type of carbohydrates to consume. Glycaemic Index is a ranking of how a certain food's carbohydrate impacts blood sugar levels. It has to do with how rapidly food is broken down, absorbed, and metabolised in order to alter and affect blood sugar levels. Low GI foods participate in these processes more gradually and cause blood glucose levels to rise over a longer period of time. This gives insulin more time to work to get glucose into cells and lower blood glucose levels. On the other hand, high GI foods are broken down rapidly therefore causing blood sugar levels to spike.
AMOUNT:
Foods high in carbohydrates must be consumed throughout the day in a reasonably even dispersion to maintain blood glucose levels that remain within a safe range. For breakfast, lunch, and dinner, it is advised to eat 2-3 servings (exchanges) of carbohydrates. As for morning tea, afternoon tea, and supper, 1-2 exchanges are recommended.
What is a carbohydrate exchange?
About 15g of carbohydrates is considered to comprise one exchange of carbohydrates. Below is a list of foods that contain this quantity.
For example, a medium apple and 1/3 cup of oats could be included in the three exchanges of carbohydrates that are consumed at breakfast. It would be equivalent to about 45g of carbohydrates (15g x 3).
| Carbohydrate Type | One exchange (15g) | Low GI Option (≤55) | High GI Option (≥70) |
|---|---|---|---|
| Bread/Cereals/Grains | 1 slice of bread ½ cup cooked pasta ½ cup cooked rice 1/3 cup rolled oats ½ wrap/pita bread ½ bread roll | Multigrain bread Wholemeal pita bread Fruit/raisin bread Long grain white/ brown/basmati rice | White bread Crumpets White pita bread Bagels Jasmine/arborio rice |
| Fruit | 1 medium apple or orange 1 small banana 3 small apricots 1 cup berries/canned fruit | Apple/Pear/Orange Apricot Berries Banana | Cantaloupe Raisins/Sultanas Watermelon Lychee |
| Starchy Vegetables | 1 small potato (70g) ½ cup mashed potato/sweet potato | Sweet Potato | White Potato |
| Legumes | ½ cup cooked/canned chickpeas, kidney beans, baked beans ¾ cup cooked/canned lentils | Kidney beans Chickpeas Lentils | Broad beans |
| Milk/Milk Products | 250ml low fat milk 200ml natural yoghurt 100g low fat fruit yoghurt ½ cup low fat custard | Milk Yoghurt Custard | Rice milk |
| Biscuits | 9 rice crackers 2 plain sweet biscuits 2-3 crispbreads | Vita wheat crispbread | Water crackers Cruskits Rice crackers |
Tips:
- The more processed a product is, the easier it is to digest, and the more it will raise your blood sugar than the less processed one.
- Add a protein source, such as meat, eggs, or lentils, to a meal to reduce its GI.
- It is crucial to eat often throughout the day, to have three meals and three snacks, and to incorporate a source of carbohydrates at each meal.
- Choose foods low in saturated fat and high in fibre (wholegrains, fruit, and vegetables) (ice-cream, chocolate).
- Controlling blood glucose levels requires moderate exercise, or exercise that only slightly raises heart rate and respiration.
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