dos and donts of managing diabetes

Managing Gestational Diabetes During Pregnancy

By Bryony Crane, RD, CDE, Registered Dietitian and Certified Diabetes Educator
Virtua Diabetes Care

Pregnancy is a time when “Let them eat cake!” can be a woman’s mantra, right?

Well, not exactly—particularly when it comes to women at risk for developing a condition called gestational diabetes.

What is gestational diabetes?

Gestational diabetes mellitus (GDM) is high blood sugar in pregnant women that starts or is diagnosed during pregnancy. The following factors put a woman at higher risk for developing GDM:

  • Age 25 or older
  • A body mass index of 25 or higher at the beginning of pregnancy
  • A personal history of polycystic ovary syndrome (PCOS)
  • Given birth to a baby weighing more than 9 pounds
  • A family history of gestational diabetes
  • African-American, Asian-American, Hispanic/Latino or Native American ethnicity

What causes gestational diabetes?

As the baby grows, the mother's insulin production may not keep up with insulin needs. This is called insulin resistance. It leaves too much blood sugar available for transport to the baby via the placenta. This extra blood sugar (or glucose) causes the baby to get more energy than he or she needs to grow, and that extra energy is stored as fat, making a bigger baby. This, in turn, can cause problems at delivery.

A mom’s symptoms are usually minimal. Good blood sugar control can decrease the risk of having a bigger baby, and decrease the need for a cesarean delivery.

How is gestational diabetes diagnosed?

GDM is diagnosed through a blood test during the second trimester at 24 to 28 weeks, and it ends when the pregnancy ends. 

If you have this condition or think you might be at risk, diet and exercise can help keep your blood sugar within normal limits.

How to have a healthy pregnancy

Being mindful of your intake of sweets such as candy, juices, soda, and other high-sugar foods, and making healthier choices most of the time helps with glucose control.

Here are recommendations to maintain a healthy pregnancy:

  • Plan on eating 3 meals and healthy snacks in between to avoid getting hungry.
  • Eat a variety of fruits and vegetables during the day for extra vitamin C and folic acid.
  • Choose whole-grain breads, cereals, pasta, and brown rice.  
  • Balance each meal and snack with protein such as egg, low-fat cheese, milk, yogurt, beans, nuts or nut butters, lean meats, poultry or fish.
  • Instead of drinking sugary beverages, drink plenty of water or non-calorie liquids.
  • Exercise 30 minutes daily (after discussing with your ob/gyn) with pregnancy-friendly activities like walking, yoga and Pilates.

If you’re risk for developing gestational diabetes, pre-conception counseling with a Virtua registered dietitian can help. A moderate weight loss and increase in physical activity may help prevent gestational diabetes and type-2 diabetes in the future.

Updated December 29, 2017


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Virtua offers a variety of expert-led maternity classes and support groups for moms, dads and grandparents. Topics include childbirth preparation, prenatal yoga, labor basics, breastfeeding, postpartum depression support and more.

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