Photo by Flickr user cafenut (CC BY-NC-SA 2.0)

The number of women diagnosed with gestational diabetes could soon rise, and possibly even double or triple, if doctors adopt the stricter standards advocated by the American Diabetes Association.

The proposed standards are based on findings from the Hyperglycemia and Adverse Pregnancy Outcomes study, which showed that as a mother’s blood glucose levels go up, so do her risks of a Caesarean section and a host of other complications, including pre-eclampsia, preterm delivery, and giving birth to an infant who weighs more than 9 pounds or requires intensive care. Women with borderline blood glucose levels are at higher risk than those with low levels, even if they fell below the threshold of gestational diabetes.

Some experts have also pointed out that while diabetes dramatically increases the mother’s risk of having a baby born too large, the majority of babies weighing more than 9 pounds are actually born to mothers who do not have gestational diabetes. Many of the outcomes typically associated with gestational diabetes are also the result of maternal obesity and/or excessive weight gain during pregnancy.

Although experts are still debating the new guidelines, they agree on the importance of physical activity and a healthy diet. The best approach for all pregnant women is to cut back on the simple carbohydrates found in sugar, white bread and white rice, and get more whole grains, vegetables, beans, nuts, and lean proteins (think the Atkins, Mediterranean, or South Beach diets). These foods have a low glycemic index, which means they do not cause spikes in blood sugar.

Eating smaller, more frequent meals also helps to control blood glucose levels. Women should try to keep their weight gain within the recommended range of 25 to 35 pounds (less for women who begin pregnancy overweight).

For more tips on nutrition in pregnancy, see the USDA’s list of resources:
http://www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/pregcon.pdf

Although more research is needed, it is possible that better control of blood glucose levels during pregnancy can improve the baby’s lifelong health. Some studies suggest that being exposed to too much glucose in the womb may increase the baby’s risk of obesity, diabetes and cardiovascular disease later in life.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel.
International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy. Diabetes Care. 2010, 33(3): 676-682.

Cundy T. Proposed new diagnostic criteria for gestational diabetes – a pause for thought? Diabet Med. 2011, Aug 9. (Epub ahead of print].

Odent, M. Gestational diabetes and health promotion. The Lancet. 2009, 374(9691): 684.