Pregnancy: Gestational Diabetes and Dietary Guidelines
Guest: Abby Van der Veer – Dietetic Services
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I’m Dr. Linda Austin. I’m talking with Abby Van der Veer, Registered Dietician, here, at the Medical University of South Carolina. Abby, let’s talk about an area of special interest for you, the woman with gestational diabetes, that is, a pregnant woman who is showing early signs and symptoms of diabetes. What advice do you have for women in that condition?
Abby Van der Veer: Well, women that are diagnosed with gestational diabetes are typically in the 24th to 28th week already, so they’re almost done with their pregnancy. I would recommend that they start carb counting and checking their blood sugars, because it’s important to keep their blood sugars very tightly controlled for the rest of the pregnancy. It’s best to check your blood sugars about four times a day. You can get set up with somebody who can give you a glucometer.
Dr. Linda Austin: Why is that important?
Abby Van der Veer: It’s important to control the after-meal blood sugars, because if the blood sugars run too high, the glucose, or the sugar, crosses the placenta and it makes the baby bigger. So, the baby is at risk for what we call macrosomia, or a baby that’s bigger than nine pounds at birth. And the baby is also at risk for diabetes and obesity if you let your blood sugars run too high.
Dr. Linda Austin: Why is macrosomia a problem?
Abby Van der Veer: Macrosomia would be a problem because it would cause the mother to have a C-section or, also, if the baby gets too big, it may have what we call shoulder dystocia, when their shoulders are too big for the body and it causes a traumatic birth.
Dr. Linda Austin: And, additionally, of course, it can be dangerous for the mother to be running high blood sugars throughout pregnancy.
Abby Van der Veer: Exactly. High blood sugars in anybody can cause complications like kidney disease, eye disease, nerve damage.
Dr. Linda Austin: Vascular disease.
Abby Van der Veer: Vascular disease. Yes.
Dr. Linda Austin: And so forth. How often is gestational diabetes, or diabetes in pregnancy, a warning sign that the mother will go on to develop diabetes in life?
Abby Van der Veer: They say there’s about a 30 to 50 percent chance of getting type 2 diabetes if you’ve had gestational diabetes. And it’s about a 50 percent chance of getting gestational diabetes in the next pregnancy.
Dr. Linda Austin: So, the two often go hand in hand?
Abby Van der Veer: Exactly.
Dr. Linda Austin: What other guidelines or suggestions do you have for women with diabetes? How radically do they have to change their dietary habits?
Abby Van der Veer: The good thing is that it’s not a diet per se, but they do have to learn carb counting. They have to learn about all the foods that contain carbohydrates and how to count the grams of carbohydrates. Typically, I recommend about three meals and three snacks a day, for women with gestational diabetes. And each of the meals should contain carbohydrates, but only a limited amount, to keep their blood sugar from spiking.
Dr. Linda Austin: Any other recommendations that you give?
Abby Van der Veer: I also, very highly, recommend avoiding juice and regular sodas, Sweet Tea, Kool Aid, because all of those sugary drinks will spike the blood sugar more than most foods do.
Dr. Linda Austin: So, what are some good things to drink, then?
Abby Van der Veer: Well, most women actually don’t know, but they can have diet drinks, like diet sodas, because the aspartame and the Splenda, all that stuff, does not cross the placenta. So, those diet sodas and Crystal Light, all those, are fine to drink.
Dr. Linda Austin: As well as milk?
Abby Van der Veer: As well as milk, and water.
Dr. Linda Austin: But not beer?
Abby Van der Veer: No beer.
Dr. Linda Austin: And not wine?
Abby Van der Veer: No alcohol.
Dr. Linda Austin: Okay. Abby, thanks so much for talking with us today.
Abby Van der Veer: Thank you.
If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection: (843) 792-1414.