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Am Fam Physician. 2009;80(1):online

See related article on gestational diabetes mellitus.

What is gestational diabetes?

Gestational (jess-TAY-shun-ul) diabetes is a type of diabetes some women get during pregnancy if they have too much sugar in their blood. This happens because the body cannot manage glucose (blood sugar) the way it should. Your doctor can check the amount of sugar in your blood to see if you have it.

You might be able to control your blood sugar levels with exercise and a healthy diet. Some women need insulin shots or other medicines to keep their blood sugar at the right level.

How does it affect my baby and me?

Most women with gestational diabetes deliver healthy babies. Problems may develop if you do not treat it. Gestational diabetes can cause you to have a large baby, which could hurt you or the baby. It could also cause you to need a cesarean delivery (a surgical delivery) if your baby is too large to be born vaginally.

Gestational diabetes also can affect babies after they are born. For example, they might have low blood sugar levels or jaundice (JAWN-diss; yellow-colored skin). These problems need to be treated in the hospital. A baby with a low blood sugar level is given extra formula or fluids to increase his or her blood sugar. A baby with jaundice spends time under a special light or on a special lighted blanket.

After delivery, your diabetes will probably go away. However, you will be at a higher risk of getting diabetes later in life. You will need to be tested regularly for diabetes and maintain a healthy lifestyle and weight.

Why is it important to follow a healthy diet during pregnancy?

A healthy diet can help protect you and your baby from gestational diabetes. For a pregnant woman, a normal diet consists of 2,200 to 2,500 calories per day. If you are overweight before you get pregnant, you will need fewer calories than other women. It is important to pay attention to what you eat and when you eat, and to follow your doctor's instructions.

What foods should I eat?

When you choose foods, read nutrition labels and pay attention to four things: protein, carbohydrates, fiber, and fat.

Protein is found in meat, dairy products (such as milk, yogurt, cheese), fish, eggs, beans, and poultry. You should eat protein at every meal. One serving of meat is 3 oz, which is about the size of a deck of playing cards. Healthy sources of protein include baked chicken, grilled fish, bean soup, and low-fat cheese.

Carbohydrates are found in foods such as bread, pasta, and cereals. About 40 percent of your calories should come from carbohydrates. You should eat most of your daily carbohydrates at lunch. Healthy sources of carbohydrates include boiled pasta, baked potatoes, cereal, and toast.

Fiber is a type of carbohydrate. It provides nutrition and decreases constipation. Healthy fiber is found in whole-grain breads, corn tortillas, hot cereals (oatmeal and oat bran, but not the instant kinds), beans, and fresh fruits and vegetables. The American Heart Association recommends having at least 30 g of fiber each day.

Fat is found in many foods. Fat is high in calories and low in nutritional value. It can make gestational diabetes harder to control. You need some fat in your diet to help absorb certain vitamins, but you should not eat too many fatty foods. Choose low-fat or nonfat foods (for example, drink skim milk instead of whole milk). Certain fats are healthier than others, including unsaturated fats in nuts and beans, and omega-3 fats in fish such as salmon.

What foods should I avoid?

Avoid eating junk food, such as potato chips, candy, and doughnuts. Don't drink regular soda, because it is high in calories and sugar.

Try to avoid eating fast food. It's usually high in fat and not very nutritious. Don't eat fried foods, such as bacon or french fries. If you get fast food, choose healthier foods such as salads with low-fat dressing or grilled chicken sandwiches. If you eat high-fat foods, eat them only once or twice a week.

When should I eat?

It is important to eat at the same times every day. Try to eat smaller meals more often. For example, you could eat breakfast at 7:30 a.m., lunch at noon, and dinner at 5:00 p.m. Have snacks at 10:00 a.m., 2:00 p.m., and 7:30 p.m. Regular eating times will keep your blood sugar level stable throughout the day.

Where can I get more information?

Your doctor or a nutritionist

American Academy of Family Physicians

American Dietetic Association

American Diabetes Association

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