Sweet Solutions: Expert Insights on Managing Gestational Diabetes with WakeMed Dietitian Gissela Banegas

Medically Reviewed by Gissela Banegas, RD

Nothing could be sweeter than a pregnancy with zero problems. Yet, up to 10 percent of pregnant women get a bit of deceptively unhealthy sweetness packaged as gestational diabetes.

Gestational diabetes is a temporary condition that arises during pregnancy. It is characterized by elevated blood sugar levels. This condition typically emerges around the second trimester and affects how a woman's body processes glucose. Often asymptomatic, it can pose risks for both mother and baby if not managed properly, leading to complications, such as excessive fetal growth or preterm birth. Regular monitoring and dietary adjustments are crucial, as they can help regulate blood sugar and ensure a healthier pregnancy journey for both mother and child. Early nutrition and lifestyle changes can help manage glucose levels and promote a healthier pregnancy.

What to Eat with Gestational Diabetes

In general, various foods are suitable for a diet designed for those with gestational diabetes. Ideally, it is best to eat regular, balanced meals and snacks.

• Aim for about five to six smaller meals each day.
• Source the majority of foods from whole foods — including fruits, vegetables, proteins and healthy fats.
• Eat high quality complex carbohydrates that are high in quality, rich fiber and have a low glycemic index. Also, always pair carbohydrates with protein and healthy, non-starchy vegetables.
• Limit refined, processed foods, such as cookies and pastries.
• Consider the timing, portion size and quality of the carbohydrates.

Food Cravings with Gestational Diabetes

Often, expectant mothers think that when they have cravings for particular foods, their bodies are signaling a need for a certain nutrient contained in those items. However, in gestational diabetes, blood sugar fluctuations may cause a cycle of cravings, especially for sweets. When blood sugar levels dip below the normal range, at that moment, the body may indicate a desire for something sweet, such as cake or candy. Cravings can feel intense and sudden, like riding a roller coaster.

Some women with a strong craving for sugary foods may wonder if it’s related to the baby. Sometimes individuals crave sweets because it’s what they eat out of habit or for comfort. Choosing more satisfying foods or pairing carbohydrates with fiber-rich, protein-rich or healthy fat foods can help manage these cravings. Reading nutrition labels and limiting added sugars in processed snacks, such as ice cream can also help support better blood sugar control. 

Symptoms of Low or High Blood Sugar in Women with Gestational Diabetes

Signs that a woman may struggle with blood sugar regulation can manifest as symptoms connected to low blood sugar, called hypoglycemia, or as symptoms related to excessively high blood sugar, known as hyperglycemia.

Typical symptoms of low blood sugar can include the following: 

• Shakiness
• Dizziness
• Blurry vision
• Weakness
• Severe fatigue

High blood sugar may lead to different symptoms:

• Increased urination
• Excessive thirst
• Heightened and intense hunger

Diagnostic Indicators of Gestational Diabetes

Typically, doctors assess whether a woman has gestational diabetes between the 24 to 28-week mark, using a glucose tolerance test. They use a diagnostic glucose tolerance test. If insulin resistance is suspected earlier based on symptoms or risk factors, testing may occur earlier. 

While A1C can be helpful in early pregnancy to assess baseline glucose control, it is not used beyond the first or second trimester. In early pregnancy, an A1C ranging from 5.7 percent to 6.4 percent suggests prediabetes, while an A1C of 6.5 percent or above signifies pre-existing diabetes. A1C is typically not used to monitor blood sugar after the first or second trimester because changes in red blood cell turnover in pregnancy can make this value less accurate.  

The Impact of Untreated Gestational Diabetes on Babies

Babies can be greatly impacted by uncontrolled blood sugars in their birth mothers, so it is critical to take diagnosis and treatment seriously. Here are some potential impacts for babies exposed to gestational diabetes: 

• Large gestational-aged baby
• Hypoglycemia at the delivery, causing the blood sugar to drop
• Birth trauma which is called shoulder dystocia, which is an injury around their shoulder, related to birth size
• Jaundice
• Still birth
• Restrictive growth

Diabetes Risks Following Pregnancy

For the majority of women, once the placenta is delivered, their blood sugar levels typically normalize. Although gestational diabetes often resolves after pregnancy, women should undergo another glucose tolerance test following delivery to confirm this is, indeed, the case.

For women with gestational diabetes, the likelihood of developing type 2 diabetes is significantly elevated. Therefore, it is important for women who had gestational diabetes to keep up good habits after delivery. They should continue to engage in healthy habits, such as 150 minutes of physical activity each week and a nutritious, balanced diet that includes plenty of whole foods, such as fruits and vegetables.

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About WakeMed's Pregnancy & Diabetes Program

The WakeMed Pregnancy & Diabetes Program is a great resource for women who have developed diabetes at any stage of pregnancy — or who have diabetes prior to conception. The program offers education and support to help mothers-to-be manage diabetes for a healthy pregnancy and a healthy baby. Our dedicated nurses and dietitians partner with you and your physician to help monitor glucose levels and plan meals for the rest of your pregnancy. The program includes an assessment, nutritional counseling and individualized meal plans as well as post-partum care to help reduce your risk for developing Type 2 diabetes.

See locations where the program is offered.