To learn more about Type I diabetes, and Type II diabetes, visit our Health articles and Pharmacy news section today! Identify your HbA1c test score, mean blood and glucose level to know if your blood glucose is in the optimum level. If you or someone you know is looking for information on managing GD with real food, I highly recommend it!Gestational diabetes is never part of any mom’s plan . Yet there are many misconceptions about this diagnosis, both in conventional health care and the integrative medicine world.
Ia€™ll also be sharing why the typicalA gestational diabetes diet fails and why a real food, nutrient-dense, lower carbohydrate approach is ideal for managing gestational diabetes.What is Gestational Diabetes?Gestational diabetes is usually defined as diabetes that develops or is first diagnosed during pregnancy. However, it can also be defined as a€?insulin resistancea€? or a€?carbohydrate intolerancea€? during pregnancy.I prefer to rely on the latter description because, at the end of the day, gestational diabetes is the result of insulin resistance, which means a woman is unable to tolerate large amounts of carbohydrates without experiencing high blood sugar.
However, in our modern world where food is rarely scarce and refined carbohydrates are everywhere, this adaptation can work against us.
This is especially true if a woman already has some level of insulin resistance before becoming pregnant, which is becoming more common.[2]Why Early Screening for Gestational Diabetes is HelpfulIn years past, it was thought that the elevated blood sugar levels seen with gestational diabetes only begin to occur in the second and third trimester, when placental hormones are at their peak and insulin resistance spikes. This is why gestational diabetes is classically screened for around 24-28 weeks of pregnancy.However, researchers have now found that gestational diabetes can be predicted earlier, by relying on a blood test called hemoglobin A1c (for short, A1c). As their pregnancies progressed, their insulin resistance got more severe, as a natural result of placental hormones and weight gain, resulting in elevated blood sugar.Moreover, gestational diabetes is increasingly believed to be an early indicator for the later development of diabetes, which means a womana€™s insulin resistance continues or worsens years after they give birth.
Women who have gestational diabetes have a 7-fold higher risk of developing type 2 diabetes later in life.[4]Can Gestational Diabetes be Prevented?Not all women with gestational diabetes have preexisting issues with glucose tolerance or insulin resistance, but research does show that wise preconception practices may prevent some cases of gestational diabetes. For women with a body mass index (BMI) greater than 35, the risk of gestational diabetes is five times greater than a woman at a healthy weight, most likely because insulin resistance tends to go up at higher body weight.[8]Vitamin D deficiency has also been associated with gestational diabetes (and, not surprisingly, insulin resistance). When those two arena€™t enough to bring the blood sugar levels down to normal, a woman may need insulin or medication.Many women would rather make dietary changes to control their gestational diabetes, than jump right to medicine (and most doctors feel the same way). Often, much to their disappointment, my patients had to start medication or insulin in order to control their blood sugar. Carbohydrates are the primary macronutrient that raises the blood sugar, so why are we suggesting they eat lots of carbohydrates?The primary reason clinicians are afraid to endorse a lower carbohydrate diet for pregnancy is that theya€™ve been given outdated information regarding ketosis.


This topic is so complex that I devote an entire chapter to in my book,A Real Food for Gestational Diabetes.
But the short answer is that low-level nutritional ketosis is common during pregnancy, does not carry the same risks as starvation ketosis or diabetic ketoacidosis, and does not negatively impact the brain development of a baby.[19]What Level of Carbohydrates is Best?There will likely always be controversy around the ideal level of carbohydrates a woman should consume during pregnancy and frankly, I believe it will vary woman-to-woman based on her blood sugar control. But, in general, I find most women with gestational diabetes benefit from a diet that has less than 175g of carbohydrates per day.My approach is to have a woman monitor her blood sugar while eating her usual diet (using a home glucose monitor) to get a baseline of how food affects her blood sugar. Below are some simple tips you can implement.Request getting your HbA1c (hemoglobin A1c) measured with your first trimester labs to get a better idea of your baseline blood sugar control. That way, you can take action earlier in your pregnancy if you need to.Ask to have your vitamin D levels measured (25-hydroxy vitamin D), so you can correct deficiency if ita€™s present. Depending on where you live, time of year, and time spent outdoors in sunlight, you may need to add a vitamin D supplement to meet target levels.[22]If you have gestational diabetes, monitor your blood sugar in the morning (fasting) and after each meal to learn your bodya€™s unique pattern and response to different foods (and combinations of food). Adjust your diet and exercise levels accordingly, knowing that carbohydrates tend to raise your blood sugar the most, fat and protein tend to stabilize your blood sugar, and exercise tends to lower your blood sugar.Emphasize foods with plenty of fat and protein, both of which stabilize, rather than directly raise, the blood sugar.
Pasture-raised meat (including organ meat), poultry, eggs, wild-caught fish, full-fat cheese, heavy cream, nuts, seeds, avocados, olives, butter, and some coconut products fit into this category.Embrace low-glycemic sources of carbohydrates, like non-starchy vegetables (lots of these!), nuts, seeds, and low-sugar fruit (like berries). For example, ita€™s better for your blood sugar levels to have a servings of sweet potatoes alongside grass-fed beef, sauteed spinach, and butter rather than by itself.Avoid large portions of carbohydrates at one time to prevent blood sugar spikes.
Ita€™s far better to have fruit as a snack twice per day than to have a large fruit salad in one sitting.Exercise regularly. A real food approach is ideal for gestational diabetes, because it emphasizes nutrient-dense foods that provide a baby with all the critical nutrients for growth, while also minimizing blood sugar spikes.Knowledge is power.
2Real Food On A Budget Pregnancy 10 Comments About Lily Nichols, RDN, CDE, CLTLily Nichols, RDN, CDE, CLT is one of the countrya€™s most sought after a€?real food for pregnancya€™ experts whose approach to nutrition embraces real food, integrative medicine, and mindful eating.She is a regular speaker at medical conferences on gestational diabetes and prenatal nutrition. I had gestational diabetes during my pregnancy and it was one of the most frustrating and depressing seasons of my life.
I had no traditional risk factors other than maternal age over 30, although since then I’ve done a lot of research and discovered there is a link between autoimmune disease and gestational diabetes. I could talk on and on about my experience, what I learned, what I will do differently next time, etc (supplements, exercise, diet).


I felt like the focus was on birthing a baby of a certain size rather than on our day-to-day health and well-being. In the end my son was born healthy at 39 weeks with barely any sign that his mom had gestational diabetes. Our great frustration is that he is now allergic to all the foods I was required to eat in large quantities for that diet- dairy, eggs, chicken, blueberries. Brewer’s Pregnancy Diet is an excellent resource that eliminates many pregnancy complications. The whole diagnosis of gestational diabetes can be a real pain to deal with without the right kind of help.
Protein, vegetables, a little fruit (low on the glycemic index), higher fat dairy…Thanks for this post!
Instead of hearing snarky comments like, “You do know that *half* a banana is one serving, right?” Yeah, maybe not eating bananas at all would have been easier! I have been gluten free for several years and I feel that I should have been gluten free when I was pregnant.
My fasting levels are checked every year or so because of my high risk of developing Type 2 diabetes. I was able to get my blood sugars under tight control basically how you suggested- monitoring and adjusting my diet accordingly. I’m so nauseous and all I can tolerate (barely) is crackers, bread, rice, and watered down juice or broth. On the other hand, I think I am actually glad I was diagnosed with GD, because it certainly gave me a huge kick in the butt down the path of healthy living, good nutrition, and label reading!



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Comments

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