Pregnancy changes not only your body but also the way it works.
Some of these changes are clearly seen, but others may not be as noticeable
such as your changing blood sugar levels in pregnancy. Sometimes this can
lead to gestational diabetes.
Let’s talk about that today.
In your first trimester your blood sugar level is lower than
before you were pregnant.
Why? Because your body changes how it produces and
uses insulin. These changes start early around 6 weeks and can last until
about 20 weeks.
Insulin is a hormone that helps the sugar in your bloodstream enter your
cells to be used as fuel. Your body becomes more sensitive to insulin
during this early time so more sugar is entering cells, leading to lower
blood sugar levels. This happens so that both placenta and baby can grow.
Yup, that’s why you may feel symptoms of low sugar between meals such as
shakiness, dizziness, headache, sweating and extreme hunger in between
meals or overnight!
Your blood sugar level increases slightly in the 2nd and 3rd
Hormones produced by the placenta start to trigger insulin
resistance, which means that insulin isn't as efficient at
getting sugar into your cells. As your placenta keeps growing, your body
gets more and more insulin resistant so that by the third trimester you may
be half as sensitive to insulin as before ( basically you need double the
amount of insulin to do the same work it was doing before).
This makes the blood sugar levels rise, especially after a meal. This is a
normal change in how your body works during pregnancy so you can supply
your developing baby with a stable supply of fuel and nutrients.
Okay, you may be wondering if this is a normal change then why do
some women get gestational diabetes?
Usually, your body can ramp up production of insulin (again thanks to
hormones by the placenta!) to counter this insulin resistance and keep
blood sugar levels increased enough for what baby needs but not too high as
to be damaging.
But in some women, the body cannot make enough insulin during pregnancy or
they start pregnancy already with some insulin resistance, and so blood
sugar levels go way up.
This is called gestational diabetes.
Remember if you have gestational diabetes, your body passes more sugar to
your baby than he/she needs. With too much sugar, your baby can gain a lot
of weight. A large baby (weighing 9 pounds or more) is
more likely to experience birth trauma, including damage to their
shoulders, during delivery and higher need of C-section for you.
Other possible issues with having high sugar levels
Baby with breathing issues and jaundice at birth
Baby with low blood sugar at birth
Still birth (usually if very uncontrolled sugars)
Having high blood pressure
Increase in your risk for type 2 diabetes later in life
Increase chance of diabetes and obesity in adulthood for baby
Some risk factors for developing gestational diabetes
Being overweight or obese
Being physically inactive
Age greater than 35
Gestational diabetes in a previous pregnancy
Very large baby (9 pounds or more) in a previous pregnancy
High blood pressure
A history of heart disease
Having polycystic ovary syndrome (PCOS)
Prediabetes (some insulin resistance)
Family history of diabetes
If you are Hispanic, African-American, Native American, Asian
American, or Pacific Islander
Gestational Diabetes can also develop in women who have no risk
At 24-28 weeks you will be screened for gestational
diabetes by testing your blood sugar level one hour after given a
sugary beverage. This is called the glucose challenge test.
You do not need to fast for this test.
Screening simply is a proactive testing to see if you COULD have
This does not diagnose gestational diabetes.
If your screening testing is positive. You will be asked to take a 3 hour
fasting glucose tolerance test which will actually tell you if you have or
do not have gestational diabetes.
Although many women who get diabetes while pregnant have the gestational
type, it is possible to establish other types of diabetes while you're
pregnant. Your healthcare provider might recommend early testing for you
based on your risk factors.
If diabetes is detected during the first trimester of pregnancy, it is
probably type 2 diabetes. You may need to take a test 4-6 weeks after
delivery to really know.
If you have risk factors consider being proactive:
Eat better: You can talk to a nutritionist for more
specifics for you. In general, eat a balanced diet with plenty of whole
fruits and vegetables, moderate amounts of lean proteins and healthy fats,
moderate amounts of whole grains and fewer foods that have a lot of sugar,
such as soft drinks, fruit juices, and pastries. Keep your carbohydrate
intake to less than 50% of your calories and limit simple carbohydrates
while increasing complex carbohydrates.
Exercise: One study in overweight and obese women
showed that exercising for three to four times per week for 30- to
60-minute sessions starting early in pregnancy and continued until delivery
lowered the chance of getting gestational diabetes. It is always advised to
talk to a healthcare provider before starting something new. If you can’t
do the above just start small! Try adding a 15-minute walk after meals.
Weight gain: Be mindful of the specific weight gain
recommendations for you during pregnancy. More than the recommended weight
gain can add to your risk of getting gestational diabetes.
Remember, even if you do all of the above you may still get
These changes in how your body uses insulin begins when you start your
Stay proactive to ensure your best health!
If you do have gestational diabetes, Be easy on yourself!
You and your baby will be okay!
It is not your fault and you can make a change now. With a change in diet
and exercising, most women can control their blood sugar levels and have a
very healthy pregnancy and baby!
Reach out to MaternalWell text support if you have any general questions.
If you need personalized nutrition advice please contact your healthcare
provider or schedule an appointment with our maternal nutrition specialist.