Eating for Two? Are You at Risk for Gestational Diabetes?

Pregnant_woman2Eating for Two? Are You at Risk for Gestational Diabetes?

  • Do you have a family history of diabetes?
  • Were you overweight before becoming pregnant?
  • Did you gain more weight than your doctor recommended in your first trimester?

If you answered yes, talk to your doctor about monitoring your blood glucose level.

Your Diet, Your Weight and Gestational Diabetes

Eating for two may be a commonly used expression when referring to pregnancy, but this phrase can be misleading when it comes to the health and well-being of pregnant women and their unborn babies. Thinking about what you eat when you are pregnant and how much you weigh is part of being proactive when it comes to gestational diabetes.

According to the American Diabetes Association, roughly 18 percent of pregnant women develop gestational diabetes- typically around the 24th week of their pregnancy. Without enough insulin, glucose builds up in the blood instead of leaving and being changed into energy.

“A diagnosis of gestational diabetes doesn’t mean you had diabetes before you conceived, nor does it mean you will have diabetes after giving birth, although it does increase your lifetime risk of diabetes,” explains Abimbola Aina-Mumuney, M.D., a specialist in high-risk pregnancies at the Johns Hopkins Maternal Fetal Medicine Center at HCGH. “You need to talk to your doctor about your blood glucose levels to ensure you and your baby remain healthy.”

Thinking About Getting Pregnant?

According to Dr. Aina-Mumuney, taking care of yourself before getting pregnant goes a long way towards having a healthy pregnancy and delivery. She urges overweight patients to talk to their doctor prior to conceiving, so they can be properly prepared for the risks. Pregnancy risks linked to obesity include preeclampsia, diabetes, premature delivery, stillbirth and an increased rate of cesarean section delivery.

Dana Baras, M.D. an obstetrician on staff at HCGH, adds that “not only do overweight women have an increase in the likelihood they’ll have a C-section, but they have an even greater risk of complications of cesarean delivery.”

Weight Gain During Pregnancy

Many women are concerned about “normal” weight gain during pregnancy. “What is normal for one patient is not the same for another,” states Dr. Aina-Mumuney. Data suggest women who are overweight or obese should not gain as much weight as women with an ideal body weight. “A patient in her ideal body weight range could gain weight whereas overweight or obese women may not need to gain additional weight or gain very little,” explains Dr. Aina-Mumuney. “Women carrying twins or multiples may need to gain more weight, so it’s important to talk with your healthy care provider to determine what is right for you.”

According to the Institute of Medicine, a normal weight woman should gain between 25-35 pounds during pregnancy. “Women are often surprised that translates to only about 300 extra calories per day, less than three slices of bread,” says Dr. Baras.

What to do if You Have Gestational Diabetes

“We explain the importance of regularly testing blood glucose levels to women with gestational diabetes who come to HCGH’s diabetes program,” says Teresa Love, MS, RD, CDE. “We review their numbers and assess their eating style, focusing on carbohydrates. We help them develop a budget for carbs, outlining how many to eat. Just like you budget at home for other things, now these women have a budget for foods that raise their blood sugar. That is not to say they cannot eat carbs. There is a healthy middle ground in carb consumption.”

Love’s Wellness Tips for Women With Gestational Diabetes

  • The only beverage containing carbohydrates you should drink is milk.
  • Re-evaluate breakfast. Instead of cereal, choose eggs and toast or cottage cheese.
  • When it comes to diet, you are eating for 1 and ¼ – not two. A larger baby doesn’t always mean a healthier baby.
  • Incorporate exercise. You don’t have to be an athlete, but exercise moves glucose into the muscles where it belongs. It is often as effective as medication in terms of treatment.

For more information check out our entire series of videos at including:

Diabetes and Pregnancy  and Weight Gain and Pregnancy with Donna M. Neale, MD is the Director of the Center for Maternal and Fetal Medicine and Obstetrics at Howard County General Hospital, and Assistant Professor of the Gynecology/Obstetrics Division of Maternal Fetal Medicine at The Johns Hopkins University School of Medicine.