Our advice on gestational diabetes during pregnancy

Gestational diabetes generally develops towards the end of the second trimester and usually disappears shortly after delivery [2]. During pregnancy, the body undergoes many metabolic changes, which can affect blood glucose levels, particularly in the second and third trimesters. Scientists have shown that blood glucose is expected to be 20% lower during pregnancy [3].

During a normal pregnancy, progressive insulin resistance develops from mid-pregnancy onwards and progresses through the third trimester [4]. Normal pregnancy is characterised by a 50% reduction in insulin-mediated glucose disposal (insulin resistance) and a 200 to 250% increase in insulin secretion to maintain normal blood glucose levels in the mother [5].

For example, the increase in oestrogens, progesterone and cortisol (the stress hormone) during pregnancy contributes to a disruption of the balance between glucose and insulin [2]. Human placental lactogen (a hormone that promotes insulin release) increases thirtyfold throughout pregnancy and induces insulin release by the pancreas during pregnancy, which can cause insulin resistance [5].

To compensate for insulin resistance during pregnancy, insulin secretion by the woman's pancreas increases. Gestational diabetes develops when the woman's pancreas does not secrete enough insulin to compensate for the metabolic stress associated with insulin resistance. 

The most common risk factors associated with the development of gestational diabetes are obesity, advanced maternal age, a history of gestational diabetes, a family history of diabetes, polycystic ovary syndrome, and persistent hyperglycaemia [6].

A history of delivering a baby with a high birth weight (≥4000 g), a history of recurrent miscarriages, a history of unexplained stillbirths, and a history of hypertension are additional risk factors for gestational diabetes [7].

Furthermore, increased maternal fat deposition (body fat mass), reduced physical activity, and increased caloric intake all contribute to this condition.

There is a way to predict whether gestational diabetes may develop in the first trimester! A high haemoglobin A1c level (reflecting elevated blood sugar over several months) can predict gestational diabetes with reasonable accuracy (in 98.4% of cases) [8].

During pregnancy, the body does everything it can to maintain low blood sugar levels, as elevated blood glucose is linked to malformations and can affect development in utero, as well as lifelong metabolic health [9].

40% of women with gestational diabetes need insulin or medication to lower their blood sugar levels [15], whereas following a low glycaemic index diet reduces the likelihood of needing insulin by 50% [16]!

The goal is to maintain normal blood sugar levels in order to manage gestational diabetes. Nutrition is the cornerstone of gestational diabetes management, as it helps maintain the desired glycaemic targets in 80 to 90% of women with gestational diabetes [2].

The optimal dietary approach would be one that provides adequate nutrition to support the wellbeing of both the foetus and the mother, whilst maintaining normal blood sugar levels and allowing for appropriate weight gain during pregnancy [17].

Furthermore, even if you do not have diabetes, it is advisable to pay attention to your blood sugar levels during pregnancy. It can be helpful to monitor your blood sugar, to avoid over-stressing the pancreas, which is already under considerable demand throughout pregnancy.

Tips: carbohydrate intake should be reduced to 35–45% of total caloric intake, spread across 3 meals and 2 to 4 snacks, including an evening snack, which helps reduce post-meal blood sugar spikes whilst ensuring adequate nutrition for both the mother and the foetus [18].

Some research suggests that in some women, there are factors that may reduce the risk of developing gestational diabetes.

For example, one study found that insufficient protein intake during the first trimester may be a higher risk factor for developing gestational diabetes [22].

Women who drink large amounts of fruit juice (which provides only sugar without the beneficial effects of fibre), or who consume too many processed cereals (which are high in sugar), also have a higher risk of developing gestational diabetes. On the other hand, women who eat a lot of nuts have a lower risk [23].

Furthermore, excessive consumption of fruit, particularly those with a high glycaemic index (dates, cherries, pineapple, etc.), is associated with a higher risk of developing gestational diabetes [24].

Certain nutritional deficiencies may also contribute to the development of gestational diabetes. Deficiencies in vitamin D [25] and magnesium [26] increase insulin resistance, which raises the risk of gestational diabetes occurring. A good nutritional status in these nutrients may therefore help reduce the risk of developing this condition.

Discover our supplement magnesium pregnancy and our vitamin D pregnancy, to help you meet your needs during pregnancy.

The benefits of breastfeeding are numerous. In particular, it will lower the long-term risk of type 2 diabetes, though this impact depends on the duration of breastfeeding. 

This may also be due to the fact that, on average, women who had gestational diabetes and breastfed find it easier to return to their pre-pregnancy weight. Excess weight and obesity are risk factors for the development of type 2 diabetes.

Our cereal squares were not specifically designed for gestational diabetes, but we do not use refined sugar and only use ingredients with a low or medium glycaemic index. Some mamas have been given the green light to enjoy them, but we recommend speaking to your doctor to make sure they are right for you.

Our savoury granola ideal for pregnancy Tomato croq and our Porridge are free from added sugars and gluten, and can be an ideal option if you have gestational diabetes.

The seeded bread mix gluten-free Jolly Bread can also be consumed in cases of gestational diabetes. The bone broth Mama Poule is also a priori compatible.

Baby Bump, our pregnancy food supplement multivitamins with DHA and no added sugar.

If in doubt, it is best to seek advice from a healthcare professional. 

The onset of gestational diabetes may be linked to metabolic changes (increased insulin resistance, hyperglycaemia, hormones, etc.). 

Gestational diabetes can affect both maternal and neonatal health. To help manage it, medication or insulin injections may be prescribed, but you can also act through your diet: eating low-glycaemic-index foods, avoiding refined and processed sugars, and taking regular physical exercise.

One of the major consequences of gestational diabetes is the risk of developing type 2 diabetes after pregnancy. Studies suggest that breastfeeding may have a protective effect against diabetes.

Bear in mind that what works for you may not work for another pregnant woman, particularly when it comes to diet. You can monitor your blood sugar levels when you wake up in the morning and 1 to 2 hours after a meal, so you can adjust accordingly.