Gestational Diabetes in Your First Pregnancy? Learn How to Reduce Your Risk in the Future
by Tangela Kindell, MS, dietetic intern
Gestational diabetes mellitus (GDM) is a common health condition where changes in hormones lead to impaired insulin production, insulin resistance, and high blood sugar during pregnancy. In fact, GDM affects up to 9% of pregnancies in the US each year. If you’ve developed gestational diabetes before, you may have concerns about your risk of getting it again in a future pregnancy. Know that if you’re feeling a bit worried, you’re not alone!
In this blog, we’ll address your concerns by diving into what causes GDM, your risk, and how nutrition and lifestyle may help prevent its development in future pregnancies.
What Causes Gestational Diabetes?
The main cause of gestational diabetes is the way pregnancy hormones interact with insulin, the hormone that tells the body how to use blood sugar (glucose). The placenta, which grows inside the uterus during pregnancy, produces several hormones that help baby grow and develop. Some of these hormones can interfere with how your body produces and responds to insulin.
Under normal circumstances, your pancreas produces just enough insulin to use glucose for immediate energy or to store it as fat for later use, keeping blood sugar levels in check. During pregnancy the hormones human placental lactogen (hPL), cortisol, and progesterone cause the body to keep more sugar in mom’s blood so it can be directed to baby for energy. How does the body do this? By having a weaker response to insulin, a condition known as insulin resistance.
To compensate for these changes, mom’s pancreas produces a little more insulin so all the glucose isn’t sent to baby and it can still be used to give mom energy. However, if the pancreas can’t produce enough insulin to keep up with the needs of mom and baby, GDM develops.
After birth, insulin levels usually return to normal with gestational diabetes often going away in a few weeks. That said, people who have had it once are at a higher risk of developing it again in future pregnancies, a condition known as recurrent gestational diabetes. Research suggests that the rate of recurrent GDM is about30% to 84%.
Why Can Gestational Diabetes Occur Again in Future Pregnancies?
For some people, the same factors that caused gestational diabetes in the first pregnancy - like insulin resistance and impaired insulin production - can remain present in the body after pregnancy or reoccur with hormonal changes during future pregnancies. These same factors can also increase your risk of developing type 2 diabetes mellitus (T2DM), with research showing that up to 50% of people with GDM progress to T2DM within 5 years of birth.
Additionally, nutrition and lifestyle factors like difficulty with balanced meals and snacks, physical inactivity, and stress can make it harder for your body to manage blood sugar on its own. All of these are very common and understandable after bringing your first child into the world. These factors can increase your risk of developing GDM again, as they can further affect how well your body uses and produces insulin.
What Can I Do to Reduce My Risk of Developing GDM in Future Pregnancies?
Manage Blood Sugar with Protein, Fiber, and Healthy Fats:
Protein from animal and/or plant sources, healthy fats like omega-3s, and fiber-rich foods like fruits, vegetables, and whole grains can slow glucose absorption and keep blood sugar levels stable. Choose a balanced eating pattern with meals and snacks that include a combination of these foods and be sure to eat regularly throughout the day.
Move Your Body:
Regular physical activity helps your body use blood glucose more efficiently, which can reduce your risk of developing GDM. Aim for at least 30 minutes of moderate exercise - like walking, swimming, dancing, or prenatal yoga - 5 times per week, and consider strength training like yoga or weights twice per week. Always check with your healthcare provider before starting a new exercise routine to ensure you and baby stay safe.
Manage Your Stress:
Cortisol, a hormone released in response to stress, is known to raise blood sugar levels and lower insulin sensitivity. Deep breathing, meditation, yoga, and the support of a therapist or loved ones can relieve stress and support healthy blood sugar maintenance.
See a Healthcare Provider Regularly:
If you’ve had gestational diabetes, it’s important to stay on top of your health with regular check-ups. Screening, monitoring, and early intervention are the best ways to prevent GDM or keep you and baby safe if you end up developing it.
Consider Inositol:
Supplementing with inositol in pregnancy when you’ve had GDM before may reduce your risk of getting it again, or at minimum help manage it if it does occur. Read this blog to learn more about choosing an inositol supplement.
It’s important to know that whether you develop gestational diabetes or not, you can have a healthy baby and pregnancy!
Focusing on balanced meals and snacks, moderate exercise, stress management, and regular check ups not only reduces your risk of recurrent gestational diabetes, it also supports a healthier pregnancy and the overall health of you and baby.
Need personalized support for your pregnancy journey? Apply for 1:1 nutrition coaching with Feed Your Zest’s team of maternal health dietitians. You can also check out our Insulin Resistance Mini Course, an all-in-one guide to balancing your blood sugar for fertility and pregnancy.