Nearly 10% of all pregnancies are affected by gestational diabetes, according to the American Diabetes Association (ADA). While doctors don’t know what causes this disorder, or why some women develop it and others don’t, they do know that gestational diabetes can pose serious complications for both mother and baby if left unchecked — including a higher birth weight for baby, increased risk of preterm birth or C-section, and high blood pressure. If you’ve recently been diagnosed with gestational diabetes or are simply worried you may develop it, here’s what you need to know, including nutrition tips (with a sample gestational diabetes meal plan) and exercise guidance — designed to help you stay healthy during and after your pregnancy. 

A note of caution: Before you make any lifestyle changes during pregnancy, consult with your doctor first. While we’ll present science-backed recommendations here, every woman’s pregnancy is different; talk to a healthcare professional before adjusting your diet or exercise routine in any way.

What is gestational diabetes?

Gestational diabetes is a condition that occurs during pregnancy in which the mother is not able to make enough insulin or use the insulin she can make effectively to pull sugar out of the blood and into the cells for energy. When this happens, it can lead to a condition called insulin resistance, which makes it harder to control blood sugar and keep levels within a healthy range. 

If you’ve never been diagnosed with diabetes and are at average risk, your doctor will typically perform the screening test for gestational diabetes during the second trimester (between 24 and 28 weeks). This test may be done earlier if you have diabetes prior to pregnancy or are considered at increased risk. Pregnant women considered to be at higher risk include those that are overweight or have a family history of gestational diabetes.

While doctors aren’t yet sure what causes gestational diabetes, researchers believe it could relate to the hormonal changes that occur during pregnancy. The good news: In women with gestational diabetes, the condition typically goes away soon after giving birth. That said, it can return with subsequent pregnancies and may put you at greater risk of developing type 2 diabetes in the future.

What are the symptoms of gestational diabetes?

Many pregnant women have no idea that they have developed gestational diabetes, until they’ve been tested, as the condition often carries no symptoms at all. That said, some women have reported feeling the following symptoms, which may be red flags for gestational diabetes:

• Increased thirst
• Blurred vision
• Extreme fatigue

How to prevent gestational diabetes 

The best ways to prevent gestational diabetes mirror the strategies recommended for preventing type 2 diabetes: a healthier diet, like our gestational diabetes meal plan below, and regular exercise. Both have been shown to help reduce diabetes risk, including during pregnancy. Recommendations:

• Fill up on fiber. A 2018 study in the British Journal of Nutrition tracked the carbohydrate intake of roughly 3,600 women over the course of 12 years, starting before they became pregnant. Stunning correlations were found between diet and the development of gestational diabetes. The group who consumed the most fiber had a 33% lower risk of developing gestational diabetes. Since fiber is a nutrient that excels at helping to stabilize blood sugar levels, it’s no wonder that a high-fiber diet makes sense.
• Choose your proteins wisely. During pregnancy, you should get a minimum of 60 grams of protein a day, which will account for approximately 20-25% of your calorie intake. Although the science is still developing on this issue, initial studies do indicate that plant protein (vs. animal protein) is associated with improvements in body composition and reductions in both body weight and insulin resistance. Thus, it is generally recommended that you combine lean animal proteins with as many plant-based sources of protein as possible. Examples of the latter include chickpeas, soy foods such as tofu and edamame beans, lentils, peanuts and almonds, quinoa, chia and hemp seeds and dark-colored, leafy greens such as kale, swiss chard and broccoli.
• Choose your fats wisely. During pregnancy, your body needs more fat. Roughly 25-35% percent of your daily calories should come from fat, depending on your carbohydrate goals, according to the UCSF Health guide on eating during pregnancy. Eating monounsaturated fat (e.g., olive oil vs. canola oil) is preferred over saturated varieties. Other good sources include avocados and nuts.
• Get enough vitamin D. A 2018 study in the Journal of Diabetes showed that habitual pre-pregnancy intake of vitamin D from diet and supplements was significantly and inversely associated with risk of developing gestational diabetes. Vitamin D may play a critical role in insulin production and sensitivity, potentially decreasing the chance mothers will develop insulin resistance.
• Get moving. Women with greater-than-average weight gain during pregnancy are at significantly increased risk of developing gestational diabetes. In women diagnosed with gestational diabetes, exercise has been shown to improve pregnancy outcomes.

Sample gestational diabetes meal plan

To help prevent gestational diabetes, or better manage the condition if you develop it, there are dozens of hearty, healthy food choices, as indicated here in our sample gestational diabetes meal plan. While there isn’t one exact diet to follow, you want to focus on keeping your blood sugar levels relatively stable; avoiding processed foods that are high in sugar (we’re looking at you, sugary sodas and desserts) should be a key goal. Instead, focus on these food groups to build a gestational diabetes meal plan:

• Choose complex carbs: Carbohydrates are naturally occurring sugars, starches, and fiber found in food. When you eat carbs, the sugars and starches get broken down into glucose, which then gets released into the bloodstream. There are simple carbs (more processed) and complex carbs (less processed). Complex carbs are the ones you want to choose for your gestational diabetes meal plan because they don’t cause your blood sugar levels to spike as much as simple carbs, and they’re also high in fiber — important for reducing the risk of gestational diabetes. Complex carbs are found in foods that are good for you, particularly from vegetables. Fruits, while also complex carbohydrates, should be eaten in moderation so that their fructose component (linked to insulin resistance) does not cause a blood sugar spike. Similarly,  oats and whole wheat bread or pasta can be eaten in moderation.
• Hit your protein goals: Your doctor or nutritionist may recommend a certain amount of protein daily during pregnancy. To hit your goals, focus on protein from lean meats as well as vegetable sources (spinach, broccoli, kale, artichokes, to name a few). Eggs, well-cooked fish (but avoid any with a high mercury count, including tuna and swordfish), nuts, and seeds are also great sources of protein that aren’t loaded with fat and sugar. A nutritionist at the Cleveland Clinic recommends not skimping on protein at breakfast to help keep your blood sugar levels stable throughout the rest of the day.
   
• Aim for healthy fats: While high-fat diets have been shown to increase the risk of type 2 diabetes, healthy fats — such as those high in heart-healthy omega-3 fatty acids — are good to consume during pregnancy. These include (in moderation): eggs, olive oil, well-cooked salmon and almonds.

To help get you started on the right track, see this healthy sample meal plan developed by Yale Health.  

Key takeaways

If you want to prevent gestational diabetes, follow the same logic you would to prevent type 2 diabetes: Focus on your gestational diabetes meal plan — eating a healthy diet rich in lean proteins, healthy fats, and high-fiber, complex carbs; and committing to a consistent exercise routine that keeps your weight in a healthy range. If you do develop gestational diabetes, your doctor can help you manage the condition throughout your pregnancy.