Gestational Diabetes: 10 Ways to Lower Your Risk

Cut your odds for high blood sugar that develops only in pregnancy. Part 2 in a series

expectant couple holding a onesieIt's important to understand that HALF of all women who develop gestation diabetes don't have known risk factors. Talk to your doctor and take steps before you conceive to lower your risk. (Photo: Unsplash, MonPetit Chou)

Gestational diabetes (GD)—high blood pressure that develops just during your pregnancy—doesn’t have to happen. These steps can help you lower your risk.

Before You Conceive

#1. Talk to your doctor about your risk for GD
A wide variety of factors can increase your chances for developing GD during pregnancy.  These include a history of GD in a past pregnancy; being an “older” mom age 25+; being of African-American, Hispanic, Asian, Native American or Pacific Islander descent, having a health condition such as Polycystic Ovary Syndrome (PCOS), high blood pressure or heart disease; a family history of diabetes and being overweight or inactive. Your doctor can help you assess your risk, decide if earlier testing during pregnancy is a good idea for you, make a plan for reducing your risk—and for tracking your health during pregnancy.

#2. Understand that half of all women who develop GD don’t have known risk factors.
Low risk doesn’t mean no risk. Fifty percent of women who have GD don’t have a known risk factor. That’s why the American Diabetes Association and other health groups recommend all women get screened during pregnancy.

#3. Get active.
Women who were physically-fit before becoming pregnant were 21% less likely to develop gestational diabetes than women at low levels of fitness in a recent University of Iowa study1. Researchers tracked 1,333 women for 25 years—checking their fitness level at the start of the study and keeping tabs on their health before, during and after pregnancy. Lead researcher Kara Whitaker, PhD, MPH, assistant professor of Health and Human Physiology at the University of Iowa, told On Track Diabetes, that you don’t have to train like an elite athlete to get this protection.

“If you increase your fitness from a fair to a good level, you can lower your risk,” Whitaker says. “It’s hard to say how much exercise that would take, but getting thirty minutes of brisk walking at least five days a week could be enough. Doing that for about six months before you start trying to conceive can help protect you during pregnancy.”

#4. Aim for a healthy weight.
Carrying extra pounds before pregnancy boosts your odds for developing GD. Being overweight can double your risk and obesity can increase your risk even more, a recent Brazilian study has found2. Carrying extra pounds from a previous pregnancy can also double or even quadruple your risk.3. So in addition to exercise, Whitaker recommends women “work to bring your body weight down into a healthy range with a healthy diet that’s low in saturated fat and full of fruit and vegetables.”

#5. Eat less processed meat, red meat and animal fat.
Opt for olive and canola oil, nuts and nut butters, beans and tofu instead of butter, cheese, big servings of fatty meats, red meat and processed meats like bacon, hot dogs and most lunch meats. In a 2012 studyfrom the National Institutes of Health and Harvard University that tracked 13,475 women for 20 years, those who ate the most animal fat and cholesterol were nearly twice as likely to develop GD as those who ate the least.

The researchers say swapping some of the animal fat in your diet for plant-based fats could lower GD risk by 7%. Animal fat and cholesterol may interfere with healthy blood sugar processing by contributing to insulin resistance (when cells don’t obey insulin’s command to absorb blood sugar) and possibly by harming cells in the pancreas that produce insulin.

Other studies suggest red meat and processed meats in general raise risk—and that getting some of your protein from nuts instead of red meat could cut GD risk by as much as 51%.5

#6. Focus on fiber. 
Savor whole grains—such as whole-wheat bread, brown rice, oatmeal and grains like quinoa, barley and bulgur—instead of refined types. And bump up your intake of beans and produce. Research suggests a low-fiber diet before pregnancy could double GD risk. Adding just 10 grams a day (the amount in two slices of whole-grain bread and a cup of blueberries) could lower GD risk 26%. 6

#7. Say ‘no thanks’ to sugary sips. 
Drinking five or more servings of sugar-sweetened cola per week before pregnancy raised risk for gestational diabetes by 22%, compared to women who had less than one cola per week in a 2009 Louisiana State University Health Science Center study of 13,475 pregnant women.7 Other research has linked sugar-sweetened drinks of all types to higher GD risk.8

#8. Establish great sleep habits now.
A 2017 University of Illinois at Chicago review found that skimping on sleep during pregnancy could increase GD risk. Researchers analyzed eight studies involving 17,308 pregnant women and found that getting less than six hours of shut-eye per night raised odds 70%9. Not getting enough sleep may boost blood sugar levels by increasing inflammation and by making your body less sensitive to insulin.

During Pregnancy

#9. Ask your doctor about the best healthy eating plan and exercise routine for you. 
Follow your healthcare practitioner’s advice. In a 2017 review of 23 well-designed GD-prevention studies involving 8918 pregnant women, researchers from Australia’s The University of Adelaide found that programs combining a healthy diet with safe exercise program during pregnancy reduced GD risk by 15%.10

Talk with your doctor about what’s right for you. Some experts recommend working with a registered dietitian to create an eating plan to make sure the nutritional needs of your baby and you are met during pregnancy. “The general recommendations for physical activity for pregnant women are to get 150 minutes a week—such as 30 minutes of walking, five times a week,” Whitaker says. “It’s wise to talk with your doctor.”

#10. Ask if an early test for GD is right for you.
Women are usually screened for GD between the 24th and 28th weeks of pregnancy. That’s because the insulin resistance that can lead to GD develops during the 2nd trimester and early in the 3rd trimester. But medical organizations like the American College of Obstetricians and Gynecologists11 and the American Diabetes Association suggest that doctors may screen women at high risk for GD earlier. This could pick up blood sugar changes sooner, giving you and your doctor a chance to change your eating and exercise plan or even start medication if needed. Your doctor can determine when in pregnancy an early test is a good idea. If your blood sugar’s fine, you’ll still need a routine GD check later on.

Updated on: March 28, 2019
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Gestational Diabetes: 5 Surprising Facts