Gestational Diabetes: An interview with Jessica Pumple

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What do moms with gestational diabetes (or moms concerned about getting gestational diabetes) need to know? An interview with Jessica Pumple, a registered dietitian, certified diabetes and bariatric educator and pre & postnatal fitness instructor.

What do moms with gestational diabetes (or moms concerned about getting gestational diabetes) need to know? 

That they can still have a healthy pregnancy and baby. Current research has taught us a lot. Now there are excellent nutrition and exercise therapies as well as treatment options to keep baby safe and healthy. 

That it’s not their fault. Gestational diabetes occurs when the pancreas can’t produce enough insulin to overcome insulin resistance in pregnancy. Insulin resistance is caused by the hormones the placenta produces as the baby and placenta grow.

What are the risks for baby?

The increased risks to the baby mainly come from uncontrolled gestational diabetes or elevated blood sugar levels which can pass through to the baby. One of the main risks is macrosomia (a large baby over 9 lbs) caused from the extra sugar passing to the baby. Another risk for baby after birth is hypoglycemia (low blood sugar). The baby may also be at increased risk of Type 2 diabetes and obesity later in life. While these risks may sound scary, keep in mind that managing gestational diabetes and blood sugars dramatically reduce the risks.

What are the best strategies to control blood sugars? 

A meal plan from a registered dietitian who specializes in gestational diabetes: The meal plan should focus on moderate carbohydrates from low glycemic index choices. Whole and unprocessed foods, protein, healthy fats and lots of vegetables should be emphasized. The meal plan should avoid added sugars; refined bread and grains; sweetened beverages and juice; and starchy or processed snacks. 

Daily activity and exercise: Exercise has traditionally not been emphasized in the treatment of gestational diabetes. Daily exercise has the potential to help control blood sugars, especially blood sugars measured first thing in the morning (fasting blood sugars) that many moms with gestational diabetes have difficulty controlling.

Consider supplements: Research shows that those with a B-vitamin deficiency may have higher blood sugars. Talk to your doctor about any supplements that may be beneficial.

Stress reduction: Stress can raise blood sugars similar to eating a hot fudge sundae can. When someone is stressed, the liver may put out sugar into the bloodstream causing our blood sugars to be high, even if they didn’t eat carbohydrates or sugar.

Good sleep hygiene: Moms with gestational diabetes often find poor sleep may cause their blood sugars to be more elevated.  

You mentioned that exercise plays a really important role. What are the best exercises for gestational diabetes? How long should the exercise be?

In an otherwise healthy pregnancy, a combination of both pregnancy-safe cardiovascular and resistance exercise is beneficial. This could be brisk walking, a prenatal fitness class, aquafit, a prenatal dance class, a pregnancy exercise YouTube video or any other prenatal activity they find enjoyable. Of course, women with gestational diabetes should always consider their safety first. They should consult with their doctor regarding safe exercises for their pregnancy and hypoglycemia guidelines and protocols. 

Adding any amount of activity is beneficial for blood sugar control. Many women with gestational diabetes will see an improvement in their postprandial (after meal) blood sugar reading by adding just 10 minutes of exercise after a meal. The current guidelines for pregnancy are 150 min per week or about 30 min per day. However, In my clinical experience, women with gestational diabetes see an increased improvement in fasting blood sugars (blood sugar first thing in the morning) when their total exercise for the day is 45 minutes or more. With longer workouts, your muscles start to use up glycogen stores in your muscles (sugar storage). Then, over the next 24 hours, your body replaces the glycogen stores by taking sugar from your blood, lowering blood sugars. It’s OK to split up activity throughout the day or whenever moms can fit it in. For safety, the best time for activity is to start exercise is 30 – 90 minutes after a meal. 

After gestational diabetes, How likely is it they will develop Type 2 diabetes after the baby is born? 

Gestational diabetes doesn’t cause Type 2 diabetes but can be a warning sign that they are at increased risk for Type 2 diabetes later in life. While over half of moms who had gestational diabetes develop Type 2 diabetes within 11 years, research shows lifestyle changes that can dramatically reduce the risk. 

A few suggestions are to use plant-based nutrition or continue a low-moderate carbohydrate lifestyle as well as to continue with daily activity. It can be helpful to ask your healthcare provider about vitamins, supplements or herbs that reduce insulin resistance. For example, Vitamin D, Vit B-6, chromium, berberine, magnesium, turmeric, and green tea. Lastly, reducing stress and prioritizing adequate and good quality sleep is important.

Are there any other tips and tricks you recommend for moms with gestational diabetes?

Get support from other moms who have gestational diabetes. It’s an opportunity to share recipes and tips to control blood sugars, receive support when things are difficult or just to vent to others who will understand. 

Don’t give up. It takes a bit of trial and error to find meals, snacks as well as the right timing of food and activity that works for each individual. 

Lastly, don’t beat yourself up if you require insulin or treatment. Some women try all the lifestyle modifications and their sugars are still elevated. While many women are afraid of insulin, it’s made to be very similar to our natural insulin hormone and very safe for mom and baby. Most moms say it’s not nearly as bad as they thought it would be and they are surprised that it really doesn’t hurt. Be kind to yourself and try not to stress if you have a couple of elevated blood sugar readings. Your doctor is watching for trends in your sugar levels and is not concerned over one or two readings. Keep testing and sending your blood sugars to your diabetes team and they will help you manage your gestational diabetes for a healthy pregnancy and baby. 

What free resources are available for moms with gestational diabetes? 

Meal plan by a registered dietitian: www.fitaftergd.com/meal-plan 

Gestational diabetes exercise and education playlist: http://bit.ly/2TLn752 

Gestational diabetes support group with a registered dietitian and certified diabetes educator: http://bit.ly/2GVASWJ

HIIT workout to control gestational diabetes: https://youtu.be/ZCFUkkpGtlQ 

Checklist and guide for Type 2 diabetes prevention: www.fitaftergd.com/preventtype2 

Connect with Jessica:

Jessica Pumple is a registered dietitian, certified diabetes and bariatric educator and pre & postnatal fitness instructor in British Columbia, Canada. She is the founder and host of Pregnancy and Postpartum TV YouTube Channel. She supports moms all around the world to control their gestational diabetes to have healthy babies as well as manage their weight and help prevent Type 2 diabetes after. You can find pre & postnatal fitness videos and support for moms with gestational diabetes and beyond on her YouTube Channel.

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