How to Manage Gestational Diabetes for a Healthy Pregnancy

From healthcare.utah.edu

When you’re pregnant, taking care of your baby’s health means taking care of your health. Learning that you have gestational diabetes mellitus (GDM) can feel overwhelming. You may even wonder if you did something to cause it. But GDM develops because of changes in how the body uses insulin during pregnancy.

According to the American Diabetes Association, about 9% of pregnancies in the U.S. are affected by GDM each year.

What Causes Gestational Diabetes?

Like other types of diabetes, GDM occurs when the body can’t make or use insulin effectively to keep blood sugar levels within a healthy range.

“Pregnancy induces physiologic insulin resistance, which helps make more glucose available to the growing baby,” says Trece Swanson, DNP, a certified nurse midwife in Maternal Fetal Medicine at University of Utah Health.

Most people can make extra insulin to keep their blood sugar in a healthy range during pregnancy. Gestational diabetes develops when the pancreas cannot produce enough insulin to meet the body’s increased needs.

You don’t need to have  Type 1 or Type 2 diabetes before pregnancy to develop GDM. However, some factors can increase your risk, including:

• Having a family history of Type 2 diabetes
• Being prediabetic
• Being over the age of 35 during pregnancy
• Having a high body mass index (BMI)
• Having polycystic ovary syndrome (PCOS)
• Being Black, Asian, Hispanic, or American Indian

Having one or more risk factors doesn’t mean you will develop GDM. The condition can also occur in people without known risk factors.

When and How Is Gestational Diabetes Diagnosed?

GDM often has no symptoms, which is why screening is an important part of prenatal care. Patients are typically tested between 24 and 28 weeks of gestation.

The first test usually involves:

1. Drinking a glucose beverage: You drink a 50-gram sugary glucose beverage.
2. Getting a blood draw: About one hour later, a clinician takes a blood draw.
3. Checking your blood sugar: The blood sample is tested to measure the amount of glucose in your blood.

What Happens If Your Blood Sugar is High?

If your blood sugar is above the screening level, the next step is a three-hour diagnostic test.

For this test: 

• You will need to fast before the appointment.
• Your blood will be drawn upon arrival. 
• You’ll drink a 100-gram glucose beverage.
• Your blood will be drawn hourly for three hours.

If two or more of the four blood sugar measurements are elevated, you will be diagnosed with gestational diabetes.  

“The one-hour test is a standard screening test, and a lot of patients wonder why we don’t just do the three-hour test on everybody,” Swanson says, “but we would end up doing a much more involved test for a large volume of people who don’t need it, because most people will pass the one-hour screening.”

Next Steps After a Gestational Diabetes Diagnosis

The good news is that most GDM cases resolve after pregnancy. For many people, a balanced diet and regular exercise can help manage gestational diabetes.

Focus meals on foods such as:

• Lean proteins
• Whole grains
• Vegetables
• Fruits

Limit foods and drinks that can cause blood sugar to rise quickly, such as:

• Sweets
• Sugary drinks
• Highly processed foods
• White bread
• Rice
• Starchy foods

Physical activity can also help manage blood sugar. Talk to your pregnancy care provider about activities that are safe for you. If your provider recommends it, aim for at least 30 minutes of exercise a day. Walking and swimming can be good options during pregnancy.

Managing Your Blood Sugar Levels

Some people may need to check their blood sugar with a simple finger prick in the morning and after meals to ensure that it’s within a healthy range. Healthy blood sugar ranges include:

• Before a meal: Less than 95 mg/dL
• One hour after eating: Less than 140 mg/dL
• Tow hours after eating: Less than 120 mg/dL

Why Treating Gestational Diabetes Is Important

Keeping blood sugar within a healthy range helps protect both you and your baby. When gestational diabetes isn’t well controlled, it can lead to dangerous complications, such as:

• Preeclampsia (very high maternal blood pressure)
• Large birth weight for baby, which increases the possibility of needing a Cesarean section
• Birth trauma due to a large baby
• Increased risk of the birthing parent developing Type 2 diabetes later in life
• Stillbirth
• Low blood sugar for baby after delivery
• Premature birth

The good news is that managing blood sugar can reduce these risks.

https://healthcare.utah.edu/healthfeed/2026/08/how-manage-gestational-diabetes-healthy-pregnancy

Diabetes prevention starts as early as conception, experts say

From kcl.ac.uk

Preventing type 2 diabetes could require action much earlier in life, according to experts calling for a new approach to protecting metabolic health 

A new perspective article in Nature Medicine, led by Andreas Birkenfeld, Medical Director of the Department of Internal Medicine IV at University Hospital Tübingen and Transcampus Professor of Diabetes at King’s College London, argues that preventing type 2 diabetes (T2D) should move beyond waiting until people develop abnormal blood glucose levels and instead focus on maintaining healthy metabolism throughout life.

Around 90–95% of people living with diabetes have type 2 diabetes, which develops through a complex combination of genetic, biological, environmental and lifestyle factors. While current prevention approaches often focus on people who have already developed prediabetes, the authors argue that this may miss opportunities to intervene earlier.

The researchers propose a life-course approach that recognises T2D as a gradual process, with metabolic changes accumulating over many years before the disease develops. They suggest that prevention should focus on identifying periods when people are more metabolically vulnerable and providing targeted support to preserve or restore metabolic health.

The paper brings together an international group of experts who identified ten priorities for improving diabetes prevention. These include redesigning screening approaches across the life course, recognising differences between individuals, developing clearer stages of disease progression and ensuring prevention strategies are accessible across different socioeconomic settings.

The authors argue that, rather than focusing only on preventing progression to diabetes, a key goal should be prediabetes remission, which means restoring and maintaining normal blood glucose levels (normoglycaemia).

The researchers also highlight that diabetes risk is not constant throughout life. Instead, there are periods when people may be more susceptible to metabolic changes. The first opportunity for prevention may begin before conception. Evidence suggests that the metabolic health of both parents, including factors such as obesity, may influence a child’s future metabolic health.

Pregnancy is another important window. During pregnancy, the body naturally becomes more resistant to insulin to support the developing baby. Some women are unable to compensate for this increased demand and develop gestational diabetes. Women who experience gestational diabetes have a substantially increased risk of developing type 2 diabetes later in life, making the period after pregnancy an important opportunity to monitor metabolic health.

The authors also highlight childhood and adolescence as important stages for protecting metabolic health. Increasing sedentary behaviours, including prolonged screen time, alongside changes in diet and activity levels, may contribute to future diabetes risk.

Later life stages, including midlife and menopause, represent further periods of increased vulnerability. For women, changes in hormone levels during menopause can contribute to changes in body composition and metabolism, which may increase diabetes risk.

We think it is no longer sufficient to wait until someone has prediabetes or diabetes before taking action. We need to recognise the stages of life when people are more metabolically vulnerable and use these as opportunities to tailor prevention and protect metabolic health.

Professor Andreas Birkenfeld, Medical Director at University Hospital Tübingen and Transcampus Professor of Diabetes at King’s College London

The article suggests that prevention should become more personalised, using information such as family history, changes in weight over time, pregnancy-related diabetes and emerging biomarkers to better understand an individual’s risk. The authors also call for future prevention research to look beyond blood glucose measurements alone and consider wider health outcomes, including cardiovascular and kidney health.

https://www.kcl.ac.uk/news/diabetes-prevention-starts-as-early-as-conception-experts-say

Gestational Diabetes Diet: What To Eat (and Limit) During Pregnancy

From health.clevelandclinic.org

Make meals with lean proteins, non-starchy vegetables and complex carbohydrates 

Gestational diabetes isn’t your fault. Pregnancy hormones can make it harder for your body to use insulin. But the foods you choose to eat can help keep your blood sugar in a healthy range to keep complications at bay.

Registered dietitian Tegan Bissell, RD, LDN, CDCES, along with diabetes educator and registered nurse Megan Asterino-McGeean, BSN, RN, CDCES, explain what healthy eating with gestational diabetes looks like.

What is a gestational diabetes diet?

A gestational diabetes diet balances complex carbohydrates with lean proteins and healthy fats to keep your blood sugar levels steady, Asterino-McGeean explains.

“It also has the nutrients needed to support a healthy pregnancy for both you and the foetus,” she says.

Why diet matters when you have gestational diabetes

“During pregnancy, the placenta makes hormones that make it harder for insulin to do its job,” explains Asterino-McGeean. “As a result, your blood sugar can rise more easily, especially after carbohydrate-heavy meals and snacks.”

High blood sugar levels during pregnancy can be dangerous, bringing possible risks, like a larger-than-average baby and the need for a C-section.

That’s why what you eat can play such a big role in managing gestational diabetes.

Foods to eat with gestational diabetes

Let’s take a closer look at the types of foods to opt for.

Lean proteins

Protein helps you feel full, and it slows digestion. It’s also an essential building block for foetal growth.

“Lean” means the protein is lower in total fat compared to other types of protein. Examples include chicken, eggs, fish and tofu.

“It’s especially important to eat protein at breakfast for more stable hunger levels throughout the day,” Bissell says. “This may also help lessen morning sickness.”

Non-starchy vegetables

Non-starchy vegetables are packed with important vitamins, minerals and fibre for both you and the foetus.

“They’re so low in carbs that you can consider them ‘freebie’ foods,” Bissell notes.

Non-starchy vegetables include:

• Broccoli
• Cucumbers
• Green beans
• Peppers
• Salad greens

Healthy fats

Healthy fats help you feel full and are beneficial for heart health. They include avocado, seeds, nuts and nut butters, and olive oil.

Complex carbohydrates

Carbs are a key source of energy, fibre and certain nutrients.

“Complex carbohydrates digest more slowly than simple and refined carbs, like sugar,” explains Bissell. “So, they tend to cause smaller blood sugar spikes”

Complex carbs include:

• Beans
• Berries
• Brown rice
• Sweet potatoes
• Whole-wheat bread

Sample gestational diabetes meal ideas

So, what does this balance of food look like? Here’s just one day’s worth of gestational diabetes meal ideas.

Breakfast

• 6 ounces of low-fat Greek yogurt
• 12 almonds
• Handful of berries

Lunch

• 1 slice of 100% whole-wheat bread
• 3 ounces of grilled chicken
• 1 slice of cheese
• Broccoli
• Berries

Dinner

• 6 ounces of cooked salmon
• 1/2 cup of cooked brown rice
• 1/2 plate of green beans
• 1 tablespoon of butter or oil

Three snack ideas

• 1/2 cup of 2% cottage cheese
• Carrot sticks with light ranch dressing
• 1 ounce of mixed nuts

Foods to limit

Some foods are more likely to cause blood sugar spikes. If you have gestational diabetes, Bissell says it’s best to limit or avoid:

• Ultra-processed foods, like sugary cereals, candy and packaged snacks
• Deep-fried foods, like French fries, fried chicken and onion rings
• Sugary drinks, including juices, sodas and sweetened teas

Seeing some of your pregnancy cravings on this list may feel discouraging. But you don’t have to be perfect.

“It’s about balance and moderation,” Asterino-McGeean encourages. “Aim for healthy eating patterns most of the time."

And keep in mind that gestational diabetes won’t last forever. Once your baby is here, it’ll be safer to indulge your salty-sweet favourites.

Gestational diabetes diet tips

You may know which foods are most helpful to eat. But putting that knowledge into action can be challenging, especially while you’re balancing all the other ups and downs of pregnancy.

Here are some tips to keep in mind as you manage gestational diabetes:

• Eat regularly. Skipping meals can make cravings harder to manage. Asterino-McGeean advises eating three small- to moderate-sized meals and one or more snacks each day.
• Drink plenty of water. Hydration is important for all pregnancies, but it’s extra important when you have gestational diabetes.
• Try, and try again. “A meal that works for someone else may not be best for you,” says Bissell. “Keep track of your meals and post-meal blood sugar levels to learn your ideal food combinations.”
• Stay consistent. Eat at the same time each day and try to eat the same types of food. “This routine may get boring, but repetition keeps blood sugar more stable,” adds Asterino-McGeean.
• Work with a dietitian. A registered dietitian can help take the guesswork out of this new-to-you eating plan, especially if you have other dietary needs or preferences, Bissell says.
• Try not to compare your pregnancy to others. Each body and pregnancy is completely unique. Try to stay focused on yourself to prevent unnecessary stress.

It’s not easy doing the work of a body system that’s usually automatic. Be kind to yourself and celebrate each small win. If you feel like you’re fighting an uphill battle, ask your healthcare provider for help.

“In some cases, diet alone isn’t enough to manage gestational diabetes,” Asterino-McGeean recognizes. “Your healthcare team may suggest medication to help your body get what it needs.”

https://health.clevelandclinic.org/gestational-diabetes-diet