There is controversy in obstetrics about the diagnosis of gestational diabetes and the testing that is done to ascertain which women are at greatest risk. Dr. Michel Odent has written an article GESTATIONAL DIABETES: A DIAGNOSIS STILL LOOKING FOR A DISEASE? which can be viewed online at http://www.gentlebirth.org/archives/gdmodent.html
Pregnant woman testing blood sugar levels
Until all the controversy is resolved and a more scientific test can be offered, we are stuck with the glucose tolerance test at 28 weeks gestational age. The mother can look at the list of who is at greatest risk and decide to decline the test if her risk is low.
Women at risk:
– maternal age over 25
– – obese woman prior to pregnancy
– – previous birth of baby weighing over 10# at birth
– – previous unexplained stillbirth at term
– – family history of diabetes (esp. close relatives who became diabetic at a young age
i.e. juvenile onset diabetes)
–previous history of recurrent miscarriages
–extremes of heaviness or thinness
–history of alcohol abuse
–history of anorexia or bulimia
This risk factor screening will only pick up 50% of women who are GD. Therefore, we would be wise to treat everybody “as if” they are GD because the diet and lifestyle changes are good for everyone (preventive health care).
If your client has any of the above factors, urge her to follow a GD diet and exercise program as early as possible and then, if she does take the 28 week test, she will usually sail through it with flying colors.
This doesn’t mean that she can start eating junk food though. I tell my clients that ice cream and chocolate are toxic to unborn babies–there is way too much fat, salt, sugar and caffeine in these products for a baby in utero to cope with.
Whole, organic foods, fresh water, and love are the ingredients to grow a healthy baby.
How can we best serve the health interests of mother and baby?
If you meet your client prior to the 28 week test, you can let her know that she can improve her chances of passing the test by eating healthy, unrefined food for the week preceding the test and exercising every day (a 20 minute brisk walk that elevates her heart rate). You can explain to her that some healthy women who just ate badly (lots of sweet desserts and junk food) prior to the 28 week test have tested positive for risk of GD and then had to undergo the more unpleasant fasting 3 hour blood tests.
If you meet your client after she has been diagnosed as GDM (gestational diabetic mother), I would encourage you to attend with your client at the diabetic clinic where a nurse will give her counseling and nutrition advice. Usually, the woman will be asked to maintain a food diary and daily ‘exercise after meals’ regimen. She will be shown how to test her own blood and may be asked to count the number of times her baby kicks in a 12 hour period.
The philosophy behind the diet is that the GDM needs to control her blood sugar levels at an even rate (also known as staying in the Zone–not getting stuffed or starved) and can do so by “grazing” on small amounts of wholesome food, eaten often.
What foods should your clients avoid?
*sugar (white or brown)
*honey, molasses, syrup, jams, jellies, marmalade
*chocolate, candy
*puddings, Jell-O, fruit yogurts
*desserts—cakes, pies, pastries, iced cookies, etc.
*soft drinks, tonic water
*sweetened condensed milk
*sweet sauces—oyster sauce, teriyaki, plum, sweet & sour, ketchup
Caffeine has been shown to make the body more resistant to the effects of insulin so tea, coffee and all soda pop should be avoided.
Fruit sugar should only be consumed in small portions. ½ a banana, 10 grapes, a small apple are the serving sizes. Milk products are also high in sugar and should be used in moderation according to the advice of a diabetic nutritionist.
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Update: June 16, 2015
Nice compilation of articles about Gestational Diabetes by an Australian doula http://www.themoderndoula.com.au/g-is-for-gestational-diabetes/
I follow the lead of my body. I know that eating anything with sugar first thing in the morning makes me feel terrible all day, so I avoid yogurt, fruit and cereal for breakfast.
however, I think it’s fine to have a little chocolate. chocolate makes me happy. I dont consume any type of caffeine other than that, so I think a little chocolate once in a while is not going to be TOXIC :eyeroll:
didnt the first paragraph of your post say that GD is not a real disease? real diabetes IS a problem, but GD is a diagnosis looking for a disease. why are we putting people on super restrictive diets? do you think that anyone who’s used to eating normally is going to be able to suddenly eliminate all sugar from their diet? that’s crazy.
eat sugary food less often, and eat it in moderation. why do we have to make women feel bad about EVERYTHING they eat? cant we trust them to be smart enough to follow their body’s lead without making up restrictive diet charts? that’s just as bad as any other kind of “healthcare” that disregards women’s bodies and wisdom.
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I agree that restrictive diets often do more harm than good…. I usually love everything you write, Gloria, and I am a huge fan, but this was the first article that I have to say, I disagree with. I really agree with Odent’s article, and also would suggest looking into Ray Peat’s diabetes research, which suggests that sugar is not the problem…. there is alot of misinformation out there about diabetes, especially gestational diabetes. I do understand though, that is article is written for birth professionals about how to help patients do well on the test… but still…
Gloria, your link to Michel Odent’s article is broken. 🙁
I did find a valid link for the article here: http://www.gentlebirth.org/archives/gdmodent.html
Thank you, Vachi, I’ll correct it in the body of the article. Gloria
Sadly…I didn’t have ANY of the risk factors with my first baby…so my GD went undetected and she stopped breathing after birth and I lost consciousness. We are both okay, but it could have been much different. Turns out I have a weird situation where my insulin kicks in too fast and drops my glucose levels too quickly…and so my GD can only be detected with a three hour test. HOWEVER..with all subsequent pregnancies….my GD was diet controlled by eating good, wholesome foods and just being aware of making the BEST choices for myself and baby.
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Pregnancy is a great time to start a lifetime of healthy eating and exercise, both for yourself and for the lifetime of your family. If you think of the GDM food preferences as above, you get your head out of the ‘diet, deprivation mode’.
If you have a sweet tooth as I do, eat a small portion and go walk around the block and/or do 2-3 flights of stairs to burn up that additional glucose. I can tell such a difference in the way I feel with additional simple sugars hanging around.
We have all had a lifetime of brain washing about food. Snack food, processed food, “treats”, out of season foods, soda pop, juices, on and on. Our bodies are not evolved for the junk that is available. We also aren’t meant to eat 5 times a day. Look at the men on any city street. Those big guts are a sign that something is very wrong. I know that people don’t like change. I know that sugar is an addictive substance, as is chocolate. Coming off those things takes 3 days of suffering. Those 3 days will pay big dividends on the day of the birth. All this political correctness and fear of triggering is not doing any fetus or woman a favour. We need to speak up about what a healthy diet really looks like in pregnancy.