12 ways to manage diabetes during pregnancy


A healthy pregnancy is a priority for every mother-to-be, but also for women who have diabetes, including those who are diagnosed with gestational diabetes, their health care has become more complex.

Women with diabetes diagnosed before pregnancy have a higher risk of complications, including miscarriage and birth defects. As the pregnancy progresses, women with diabetes are at increased risk for high blood pressure, pre-eclampsia, eclampsia, preterm and prolonged labor, caesarean sections and associated complications.

Up to 9.2 percent of women have gestational diabetes, according to the Centers for Disease Control and Prevention (CDC), and for these women in particular, their babies have a higher risk of high birth weight and shoulder dystocia, a complication during childbirth. Babies born with low blood sugar (hypoglycemia) will probably have to be in the NICU for a few days after the birth.

The good news is that with a plan, healthy strategies and support, you can control you diabetes, a healthy pregnancy and a healthy baby.

Follow these expert tips:

1. Consult your doctor before you become pregnant.

If you have diabetes and plan to become pregnant, you should talk with your doctor to ensure that your A1C levels are normal, talk about medication if it is needed or ask for a referral to a nutritionist. Women with Type 1 diabetes should ask their doctors about a kidney function test, thyroid test and a eye test because other disorders can worsen, said Dr. Lois Jovanovic, an endocrinologist and clinical professor of medicine at the Keck School of Medicine of the University of Southern California in Los Angeles.

2. Lose weight.

One of the best ways to ensure you have a healthy pregnancy is to make sure that you are at a normal weight. If your pregnancy was not planned— 50 percent— don’t despair.

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“[Weight loss] can start from the day that they discover that they are pregnant,” said Dr. Jennifer Long, a board-certified OB-GYN in Los Angeles and author of “The Whole 9 Months: A Week-By-Week Pregnancy Nutrition Guide with Recipes for a Healthy Start.”

Eat mostly plant-based diet, avoid excessive added sugars, preservatives, processed foods, and those high in saturated fats.

3. Move more.

Exercise will help you to digest food better, control of blood glucose, and helps you control your weight during and after pregnancy, said Marina Chaparro, a spokesperson for the Academy of Nutrition and Dietetics (AND) and a certified diabetes educator in Miami who has Type 1 diabetes and recently gave birth to her first child. The CDC recommends pregnant women get the 150 minutes of moderate-intensity aerobic activity every week.

4. Carbohydrates counting.

When planning your meals, know how many carbs are in the food and limit the amount that you eat, because it will increase your blood sugar levels. This is especially important if you have Type 1 diabetes because you have to dose insulin based on carbs, Chaparro said.

5. The load on the vegetables.

Vegetables are filled with phytonutrients and fill-you-up fiber, plus they help the digestion and the prevention of overweight. They are also low in calories and low in carbohydrates, so they have no impact on your blood sugar levels. Non-starchy vegetables such as lettuce, carrots, cucumber and broccoli are all good choices.

6. Dealing with morning sickness.

Make sure you eat every two to three hours in the day to keep nausea at bay. If you take insulin or pills, eat a few saltine crackers before getting out of bed in the morning and then take your medication and make sure that you can keep food down, Chaparro said.

A small source of fast-acting carbohydrates, such as glucose tablets, honey or fruit juice can help if your blood sugar is too low. The breakfast consists of a healthy protein source such as eggs or plain Greek yogurt.

7. Food handling resistors.

If the thought of fruit makes your stomach turn— especially in the first trimester— try a fresh green vegetable juice, which is a good source of folic acid and calcium. This can control your appetite and prevent sugar cravings. Avoid fruit juice with a lot of fruit because it can spike your blood sugar.

8. Watch what you drink.

It is important to drink plenty of water to stay hydrated during the pregnancy. Be sure to avoid juice, soda, sports drinks and sweeteners in coffee and tea.

“Try to avoid them or replace them with something that has no calories and no carbohydrates, because that’s going to be the first source of the increase of the blood sugar levels,” Chaparro said.

9. Let yourself be pampered.

It is OK to enjoy a pumpkin pie or holiday cookies, but the balance of the total amount of carbohydrates you eat with dessert, and if you need to compensate with medication. If you want dessert, you may want to consider a salad instead of a sandwich as your meal, for example. Or ask for a piece of cake instead of one large piece.

10. The use of technology.

Look for apps that help you log blood sugar, food, or counting carbs, and sensors and continuous blood glucose monitors.

11. Continue with the care.

“My opinion is all the gestational diabetes is diagnosed with Type 2 diabetes,” said Jovanovic.

In fact, studies show the 35 and 60 percent of women with gestational diabetes will develop Type 2 diabetes within 5 to 10 years.

If you have gestational diabetes, it is important to talk with your doctor about monitoring your blood glucose and make lifestyle changes after your pregnancy.

12. Get support.

You might have misconceptions about diabetes, blame yourself or need advice. Go on seeking the help of a certified diabetes educator, a registered dietitian nutritionist who can help you create a realistic and a delicious meal plan or a community of pregnant mothers who have diabetes.

It is important to realize that you need a plan, make healthy lifestyle choices for you and your baby and search for information. But stick with it, you can have a healthy pregnancy and a healthy baby.

Julie Relevant, is a health journalist and a consultant who provides content marketing and copywriting services for the health care. She is also a mother of two. More information about Julie at


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