By: Jennifer Jolorte Doro

MS in Clinical Nutrition, Certified Breastfeeding Counselor, Birth Doula and Pre/Postnatal Yoga Instructor.

What is Gestational Diabetes? 

Gestational Diabetes is diabetes developed during pregnancy. It is a condition diagnosed by a blood test and a OBGYN or Midwife. 

Diabetes in pregnancy occurs when there is any degree of abnormal glucose intolerance. The American Diabetes Association (ADA) then defines Gestational Diabetes as the chronic glucose intolerance as it corresponds to insulin sensitivity with pregnancy. 

But first… 

What is glucose? 

Glucose is a sugar, it derives from carbohydrates in food that you consume. Once the food is broken down, the carbohydrates (sugar and starch) become glucose. It is the main source of energy for the body. Your blood carries glucose to the body’s cells to use for energy. 

What are carbohydrates? 

Carbohydrates are a macronutrient, one of the three (including protein and fat) main ways the body obtains energy aka calories. Carbohydrates are found in many foods including fruits, vegetables, beans, nuts seeds, dairy products and grains. Carbohydrates are made of fiber, starch and sugar. It is vital to eat the right type of carbs and not avoid them completely. Without carbohydrates, the body is unable to properly regulate its energy. 

Simple versus complex carbohydrates 

Simple carbohydrates are refined sources of carbohydrates which typically include processed or packaged foods, candy, soda, cereals or simple sugars like honey or table sugar. They are broken down quickly and only have a couple of sugar molecules. These typically contain limited to no nutritional value. These may provide a quick boost of energy but also provide a post sugar crash. 

Complex carbohydrates are sugar molecules but that are linked together in longer complex chains. Since the molecule structure is larger, it takes the body more time to break down and typically contain higher amounts of fiber. Fiber takes the body longer to process and digest and keeps you fuller longer. These carbohydrates also contain vitamins and minerals so naturally have more nutritional value. 

What is insulin? 

Insulin is a hormone made by the pancreas. When food is consumed, the pancreas releases insulin into the bloodstream to be used for energy or to be stored for later use. Without insulin, glucose may stay in the bloodstream which in turn causes blood sugar levels to rise. 

Putting it all together

With diabetes, insulin loses the ability to be the gatekeeper or regulator. It can lead to dysfunction including elevated blood glucose levels. Glucose remains in the blood stream otherwise known as insulin resistance. When the body fails to respond to insulin the way it typically should, it prevents glucose from being used for energy. This can lead to fatigue, frequent urination, nausea or vaginal yeast infections. 

Testing + Diagnosis

All pregnant people will undergo an oral glucose screening test typically between 24-28 weeks of pregnancy. It is a very sweet flavored drink, to drink in full and an hour later, blood will be drawn to determine if insulin is working properly. If the first test ‘fails’ you will be asked to test again for a glucose tolerance test. Your OBGYN or Midwife will determine the results and confirm diagnosis. 

Interventions

Exercise 

A recent study found that resistance exercise had a larger effect on blood glucose levels two hours after exercise than aerobic exercise.[1] Resistance exercise is defined as exercising muscles using opposing force. Pregnancy safe resistance exercises can include squats, lunges, leg raises and utilizing resistance bands. 

Diet + Nutrition

Folate, a water soluble B Vitamin can be found in foods such as beef liver, leafy greens like spinach and kale, oranges and peanuts. Choline is an essential nutrient found in meat, eggs, poultry and fish. Both of these nutrients have been shown to improve insulin sensitivity and prevent fetal overgrowth. Other ingredients to have improved outcomes include capsaicin, soy, ginger and turmeric which prevents glucose and insulin dysfunction, reduce fasting plasma glucose, insulin resistance as well as suppressing fasting blood sugar and insulin. [2] 

Carbohydrates on their own can spike blood glucose, but carbohydrates paired with protein and/or fat can help mitigate a spike. We always make sure of this! Our snacks, like our Moringa Cashew Bites include natural sugar from dates, protein and fat from organic cashews and antioxidant rich Moringa. 

Distribute your foods between the day

Eating too much at one time, or skipping meals (e.g. intermittent fasting) can cause your blood sugar to spike. We recommend eating frequently, choosing gestational diabetes friendly snacks and continuing to monitor what foods and what time of day some trends occur. 

Limit sweets & added sugars

Cakes, cookies, candies and pastries are simple carbohydrates. These foods often offer very little in terms of nutrition. Limit adding sugar, honey or syrup to your foods. We utilize natural sugars in fruits, vegetables as well as those on the lower glycemic index including coconut sugar, honey and real maple syrup. Sauces and syrups are served on the side.  

All of these key nutrients and foods are found in each day of Chiyo’s meals. We curate our program with an eye on preventing and managing gestational diabetes. Everything is gluten-free, dairy-free, low sodium and follows the low glycemic index - balanced with a variety of complex carbs, lean proteins and healthy fats.

References

1. Xie, Y., Zhao, H., Zhao, M., Huang, H., Liu, C., Huang, F & Wu, J.(2022) Effects of resistance exercise on blood glucose level and pregnancy outcome in patients with gestational diabetes mellitus: a randomized controlled trial. BMJ Open Diabetes Res Care. Published online 2022 Apr 4. doi: 10.1136/bmjdrc-2021-002622 
2. Bankole, T., Winn, H. & Li, Y. (2022) Dietary Impacts on Gestational Diabetes: Connection between Gut Microbiome and Epigenetic Mechanisms. Nutrients. Published online 2022 Dec 10. doi: 10.3390/nu14245269
3. Choline. (NIH) Updated June 2, 2022. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
4. Folate. (NIH) Updated November 30, 2022. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/