Treating and Preventing Gestational Diabetes

If you have been diagnosed with GD, you probably have a lot of questions. In this article, we will discuss what GD is, how it’s treated, what supplements may be helpful, and how to prevent it. 

By Halle Tecco, MBA, MPH

Gestational diabetes (GD), also known as gestational diabetes mellitus (GDM), is a type of diabetes that only occurs during pregnancy [1]. It affects up to 10% of all pregnancies in the United States, making it one of the most common complications of pregnancy [2].

What is gestational diabetes?

Gestational diabetes is a type of diabetes that only occurs during pregnancy [1]. Gestational diabetes is characterized by high blood sugar levels that develop during pregnancy and usually resolves after delivery [1-5].  

While gestational diabetes can be managed, if left untreated, GD can cause serious health problems for both the mother and baby [1-2]. There are pregnancy complications associated with gestational diabetes, including pre-eclamptic toxemia, preterm labor, neonatal hypoglycemia, and cesarean delivery [4]. Plus, gestational diabetes can increase the future risk of hypertension, type 2 diabetes, fatty liver disease, and cardiovascular disease in both women and their babies [4]. 

What are the symptoms of gestational diabetes?

For most people, gestational diabetes does not present any noticeable symptoms. Some have mild symptoms, such as increased thirst or frequent urination, but those are often written off as pregnancy symptoms! [1] However, some women may experience the following symptoms due to blood sugar levels being too high [3]:

• Increased thirst
• Frequent urination
• Fatigue
• Dry mouth
• Blurred eyesight
• Genital itching or thrush

Some of these symptoms are also symptoms of pregnancy, so it’s always best to get screened through your provider to see if you have gestational diabetes.

Read more in Gestational Diabetes: Risk Factors, Symptoms, and Causes

Am I at risk for gestational diabetes?

Several factors can increase your chances of developing gestational diabetes, including [1,3]:

• Being overweight. Women who have a BMI over 30 before pregnancy have a higher risk of gestational diabetes compared to those with a normal BMI.
• Having had gestational diabetes before: If you had gestational diabetes in a previous pregnancy, your risk of developing it again in subsequent pregnancies is higher.
• Family history of type 2 diabetes. If you have a parent, brother, or sister with type 2 diabetes, your risk of gestational diabetes is increased.
• Previous birth of a baby over 10 pounds. If you previously had a baby who weighed 10 pounds or more at birth, you are at higher risk for GD in subsequent pregnancies. 
• Age over 40. Pregnant women over 40 are at greater risk of gestational diabetes. 
• Prediabetes: If your blood glucose levels are higher than normal but not high enough to be diagnosed with diabetes, you have prediabetes, which increases your risk of developing gestational diabetes.
• Ethnicity: Women from certain ethnic groups are more likely to develop gestational diabetes, including African American, American Indian, Asian American, Hispanic/Latina, and Pacific Islander American.
• Polycystic ovary syndrome (PCOS): PCOS is a hormonal disorder that affects how the ovaries work. Women with PCOS are more likely to develop gestational diabetes than those without the condition.

Preventing gestational diabetes

If you think you are at risk for gestational diabetes, you may be wondering if and how you can prevent it. One of the best ways to prevent gestational diabetes is by losing weight if you’re overweight by maintaining a healthy diet and exercising regularly. [1-2] Talk to your healthcare provider before deciding to lose weight if you are already pregnant.

Your diet before conception and during pregnancy can have a significant impact on the development of gestational diabetes. A healthy diet including vegetables, fruits, whole grains, nuts, legumes, and fish can lower the risk of developing GD. Avoid consuming high amounts of red meat, processed meat, and eggs, which can increase the risk of GD. Adopting a balanced and healthy diet before conception and during pregnancy can help lower the risk of GD. [4]

The best time to prevent gestational diabetes is before you get pregnant. During pregnancy, it is important to prioritize the health of both you and your baby. It is not recommended to try to lose weight during pregnancy; in fact, it is necessary to gain a certain amount of weight to ensure a healthy pregnancy. But gaining excessive weight too rapidly can lead to an increased risk of developing gestational diabetes. [1-2]

By taking steps to reduce the risk of developing gestational diabetes, you can help increase the chances of a healthy pregnancy and delivery for you and your baby. Ask your provider how much weight gain and physical activity during pregnancy are right for you. They can provide guidance and recommendations tailored to your specific needs to support a healthy pregnancy.  

Supplements for preventing gestational diabetes 

Nutritional supplements can be a safe way to supplement your diet and help prevent GD, but many of the studies on specific supplements are small and conflicting [4]. 

A 2022 study reviewed systematic reviews and meta-analyses of studies on supplementation during pregnancy and the impact on gestational diabetes. Let’s take a look at their findings for each supplement [4]:

Vitamin D

The authors concluded that vitamin D supplements may be beneficial in preventing GD for women with vitamin D deficiency.

Inositol

Myo-Inositol may be beneficial in helping prevent GD in obese or overweight women, women with PCOS, or women with a family history of type 2 diabetes. However, the authors point out that large, randomized controlled trials need to be conducted in different ethnic groups. 

Magnesium

Magnesium supplementation has been shown to improve glucose metabolism in people with diabetes and improve insulin sensitivity parameters in those at high risk of diabetes.

Iron

There is no conclusive evidence linking routine iron supplementation in non-anemic women to an increased risk of GD.

Fish oil

The authors looked at several studies of omega-3 and concluded that the current evidence is insufficient to recommend for or against taking it for gestational diabetes. However, the authors did point out that there are multiple potential benefits in pregnant women with or without GD that should be studied further.

Another meta-analysis of 698 patients from 12 randomized controlled trials found that vitamin and mineral supplementation– specifically magnesium, zinc, selenium, calcium, vitamin D, and vitamin E – significantly improved glycemic control, and attenuated inflammation and oxidative stress in women with GD. [5]

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Medication and treatment for GD

While many pregnant women with gestational diabetes can manage their blood glucose levels by following a healthy diet and being physically active, some women also need diabetes medication (insulin) [1]. 

If this is the case for you, your healthcare provider will guide you on how to self-administer insulin injections. Insulin is a safe and effective treatment for gestational diabetes and is often the first choice. While researchers are studying the safety of diabetes pills such as metformin and glyburide during pregnancy, there is still a need for more long-term studies to determine their effectiveness. Always consult with your healthcare provider to determine the best treatment plan for you and your baby. [1]

Monitoring your blood glucose during pregnancy

How do you know if your diabetes is in control? Some providers will ask you to use a blood glucose meter to check your blood glucose levels at home. This device uses a small drop of blood from a finger prick to measure your blood glucose levels [1]. The recommended daily target blood glucose levels for most women with gestational diabetes are [1]:

• Before meals, at bedtime, and overnight: <95 
• 1 hour after eating: <140 
• 2 hours after eating: <120 

If you’re given a blood glucose monitor, your provider will tell you what targets are right for you.

Summing it up

Gestational diabetes is a common complication of pregnancy that can have serious health implications for both the mother and baby. Although some women with gestational diabetes may experience mild symptoms, most do not exhibit any symptoms, making it important to get screened through a healthcare provider (especially if you are at increased risk!). 

A healthy diet and regular exercise can help reduce the risk of developing gestational diabetes, as can maintaining a healthy weight before pregnancy. Nutritional supplements may also be beneficial in preventing gestational diabetes, but larger studies are needed to make a definitive call. By taking steps to prevent gestational diabetes, you can increase the chances of a healthy pregnancy and delivery for yourself and your baby.

Sources: 

1. “Gestational Diabetes.” National Institutes of Health. URL. Accessed May 2023.
2. “Gestational Diabetes.” Centers for Disease Control and Prevention. URL. Accessed May 2023.
3. “Overview: Gestational Diabetes.” National Health Service. URL. Accessed May 2023.
4. Ibrahim I, Bashir M, Singh P, Al Khodor S, Abdullahi H. The Impact of Nutritional Supplementation During Pregnancy on the Incidence of Gestational Diabetes and Glycaemia Control. Front Nutr. 2022;9:867099. Published 2022 Apr 8. doi:10.3389/fnut.2022.867099
5. Li, D., Cai, Z., Pan, Z. et al. The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus. BMC Endocr Disord 21, 106 (2021). https://doi.org/10.1186/s12902-021-00712-x