Gestational diabetes

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Gestational diabetes

Gestational diabetes (GD) is a condition in which a pregnant woman, who before pregnancy did not have diabetes, develops diabetes at any time during her pregnancy. Up to 10% of pregnant women develop GD. One of the hormones in pregnancy, placental lactogen, causes the body to be less sensitive to insulin so that more glucose is available to help grow the developing baby. Other hormones cortisol, progesterone, prolactin and estrogen also influence blood sugar regulation. However, for some women, these hormones may cause blood glucose levels to be too high, resulting in gestational diabetes.

Naturopathic medicine can help with proactive prevention of gestational diabetes and can help with managing active gestational diabetes through diet and supplements that are safe during pregnancy. The goal with treatment is to normalize blood glucose levels or at least prevent GD from becoming more severe as the pregnancy progresses.

Seeing a naturopathic doctor during your pregnancy can also help reduce the risk of other pregnancy associated conditions.

Who is more likely to develop gestation diabetes?

  • Women with PCOS (Polycystic Ovarian Syndrome)

  • Previous diagnosis of GD, prediabetes, impaired glucose tolerance or impaired fasting glycemia

  • Family history of type 2 (non-insulin dependent) diabetes

  • Increased maternal age (risk increases with increasing age over 35 years old)

  • Ethnicity (African-American, Caribbean, Native American, Hispanic, Pacific islander, South East Asian)

  • Being overweight, obese, severely obese

  • Previous pregnancy where the baby’s birth weight was greater than 4000g (8lbs 12.8 oz)

  • Smokers

  • Other genetic risk factors (polymorphisms)

GD in the pregnant woman increases the following risks to her baby:

  • Abnormal blood glucose levels. During pregnancy, the baby of a mother with GD receives higher levels of glucose, but after birth the baby no longer receives the excess glucose and very low blood glucose can result.

  • Large for gestational age. The size and weight distribution of the baby born to a GD mother can contribute to shoulder dystocia (shoulder becomes stuck during birthing).

  • Growth restrictions. Abnormal blood glucose levels can affect the health of the placenta which in turn can affect the growth and development of the baby, including small for gestational age.

  • Respiratory difficulties

  • Jaundice

  • Increased risk of still birth.

  • Lower rate of breastfeeding. This can be a result of the extra medical procedures that may be required during and after birth which can decrease the opportunities for immediate skin-to-skin bonding and breastfeeding.

  • Increased life-time risk of developing type 2 (non-insulin dependent) diabetes.

For the pregnant woman, GD can increase the risk of having high blood pressure during pregnancy which can lead to pre-eclampsia. Diabetes during pregnancy increases the mother’s lifetime risk of developing type 2 (non-insulin dependent) diabetes, even if her GD resolves after childbirth.

GD can also impact how her pregnancy, labour and birthing is managed:

  • GD increases the number of ultrasound and additional medical assessments used to monitor the baby’s growth and well-being.

  • GD may increase her need of being artificially induced as the pregnancy length is usually restricted to 40 weeks or shorter.  Interventions used during labour increases the chance of more interventions used.

  • Increased chance of using forceps or vacuum to help birth the baby.

  • GD may increase the chance of having a C-section.

  • Rates of breastfeeding may be lower.

How is gestational diabetes diagnosed?

Around 26 – 28 weeks of pregnancy, your healthcare provider will offer an oral glucose tolerance test. This test involves arriving at the clinic, typically in the morning after an overnight fast, to drink a glucose drink (something like a very sweet orange drink). A baseline blood sample is usually taken before the drink and taken at 1 and 2 hours after ingestion.

If abnormal levels are detected, then a blood test is performed to confirm the results. If the blood test shows abnormal blood glucose levels, the woman is then referred to an endocrinologist and dietician at a diabetic clinic.

Method of screening for gestational diabetes may vary from region to region.

How is gestational diabetes managed?

The initial approach is to control GD through diet and exercise (if appropriate for the pregnant woman). The woman is instructed on how to monitor her blood sugar levels several times a day using a glucometer. Based on her glucometer readings, if the blood glucose levels become too high then she may be required to start injectable insulin. It is important that the blood sugar levels are kept consistently within normal levels for her health and the health of her baby.

Dietary management of GD is different than dietary management for diabetes in the non-pregnant. Low carbohydrate diets are not recommended and can pose risks to the developing baby.

Naturopathic medicine can help with proactive prevention of gestational diabetes and can help with managing active gestational diabetes through diet and supplements that are safe during pregnancy. The goal with treatment is to normalize blood glucose levels or at least prevent GD from becoming more severe as the pregnancy progresses.

Seeing a naturopathic doctor during your pregnancy can also help reduce the risk of other pregnancy associated conditions.

To inquire further about naturopathic medicine email or

Photo credit: Merrion Square, sculpture of a pregnant woman, by Danny Osborne, William Murphy, 7 July 2007, 17:09:21

Jonah Arnold