Blood sugar control has been an area of interest in healthcare for centuries. Also known as hyperglycemia, high blood sugar over time is associated with several health conditions such as diabetes, cardiovascular disease, nerve damage, kidney impairment, eye injury, and more. With or without diabetes, blood sugar control is essential for health and longevity.
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Pregnancy presents a unique physiological and metabolic circumstance for women and blood sugar control is often altered due to physical and hormonal changes that come along with gestation. Yet, healthy blood sugar levels throughout pregnancy are vital for the optimal health and development of both mom and baby. Keep reading to learn more about changes to glucose metabolism that occur during pregnancy and ways you can naturally manage your blood sugar levels through this distinct time.
Maternal Changes in Glucose Metabolism
Adaptations in glucose metabolism occur during pregnancy to ensure adequate allocation of glucose to the fetus to promote fetal development while maintaining maternal nutrition needs. Natural fluctuations in blood glucose occur during pregnancy for a few reasons.
First, maternal blood glucose is likely to drop early on due to increased maternal blood volume and the increased glucose utilization by the fetus during development.
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Second, peripheral insulin sensitivity is altered throughout pregnancy, increasing early on but markedly decreasing later in pregnancy, reaching its lowest point during the third trimester. The drastic changes in insulin sensitivity during pregnancy are reported to be due to changing levels of placentally derived hormones, such as human placental lactogen, progesterone, cortisol, and prolactin, among others. Additionally, the changes in inflammatory mediators by the placenta and accumulating adipose tissue can also contribute to changes in insulin sensitivity.
Understanding how blood glucose levels are likely to change throughout pregnancy can help women, with or without diabetes, better prepare themselves for a healthy pregnancy.
Gestational diabetes is a type of diabetes that occurs during pregnancy and is thought to be related to hormonal changes that make mom’s body less able to use insulin. According to the American Diabetes Association (ADA), nearly 10% of pregnancies in the U.S. are affected by gestational diabetes yearly.
There are ways to manage gestational diabetes, so that you can have a healthy pregnancy and a healthy baby. However, if left unmanaged, both mom and baby may suffer long-term effects. For baby, high blood glucose levels can increase the risk of miscarriage, preterm birth, breathing problems, low blood sugar at birth, and heavy birth weight, making delivery difficult or even dangerous.
Moreover, high blood sugar throughout pregnancy can increase the likelihood that baby will become overweight and develop type 2 diabetes later in life. For mom, gestational diabetes and high blood sugar throughout pregnancy increase the risk for high blood pressure, preeclampsia, a cesarean section (C-section) delivery, and the development of type 2 diabetes after baby is born.
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Diabetes Going into Pregnancy
Women with diabetes (type 1 or type 2) going into pregnancy should work closely with their health care team to manage blood sugar levels. According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), high blood glucose levels can be harmful to baby during the early stages of pregnancy when the organs begin to form. Therefore, hyperglycemia during early stages of pregnancy can lead to congenital disabilities of the heart, brain, or spine.
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High blood glucose levels can also increase the risk of miscarriage, being stillborn, or premature birth. Furthermore, women going into pregnancy with diabetes may need to alter their standard blood sugar management strategies since hormonal changes during pregnancy can lead to alterations in blood sugar control. If unmanaged, hyperglycemia throughout pregnancy can be harmful for mom as well, worsening long-term diabetes outcomes, such as heart and blood vessel disease, kidney disease, and more.
7 Ways to Manage Your Blood Sugar During Pregnancy
- Understand healthy weight gain during pregnancy. The amount of weight a woman gains during pregnancy can affect both mom and baby’s short- and long-term health outcomes. According to the Centers for Disease Control and Prevention (CDC), gaining less weight than recommended may lead to delivering a baby that is too small, which increases the risk for illness, developmental delays, and difficulty feeding. Moreover, gaining too much weight during pregnancy is associated with delivery complications due to large infant size, increased risk for health complications such as gestational diabetes and preeclampsia, and obesity in baby during childhood. Healthy weight gain differs for everyone and is based on body mass index (BMI) before pregnancy. The CDC offers an easy-to-understand weight gain recommendation guide to support a healthy pregnancy which can be found here.
- Eat to live. Healthy eating is a cornerstone of healthy living with or without diabetes. Yet, for those with trouble controlling blood sugar, it’s essential to understand that food can play a direct role. Some dietary strategies to help balance blood sugar include (1) choosing fiber-rich carbohydrates, (2) making every meal balanced (3) avoiding sugar-sweetened beverages. Fiber is a nondigestible carbohydrate found naturally in plant foods such as fruits, starchy vegetables, beans and legumes, oats, and other whole grains. Fiber moderates how quickly you digest and absorb the carbohydrates you eat, which helps control the release and rise of blood sugar levels. Furthermore, the ADA offers a simple method of meal planning to ensure meal balance. First, fill ½ your plate with non-starchy vegetables. Then fill ¼ of your plate with lean protein and the other ¼ with a high fiber carbohydrate. Lastly, include a small serving of unsaturated fat. Finally, limit or avoid sugar-sweetened beverages. Research has found that consuming beverages such as soda, sweet teas, juices, and other sugar-sweetened beverages is associated with increased blood sugar and risk of developing diabetes.
- Get moving with regular exercise. Exercise can lower blood sugar levels for up to 24 hours after your workout by increasing sugar uptake into your cells. Pregnant or not, it is wise to start a new exercise plan by speaking with your health care provider to ensure safe execution. After receiving the guidance most suited for your individual needs, create a plan that makes sense for you. Exercise is helpful anytime and anywhere. You can exercise for 30 min to 1 hour at a time or break up your exercise into 10 min bouts (aka “exercise snacks”) throughout your day. Exercise can be anything, squats in your office, a walk around the block, dancing with friends, weightlifting, or group classes. Choose what brings you joy, add it to your calendar, and give it the respect it deserves.
- Manage your stress. Stress can affect blood sugar levels through the action of glucocorticoid hormones. Higher secretion of glucocorticoids, such as cortisol, influence glucose metabolism by promoting (1) gluconeogenesis in the liver, (2) suppressing glucose uptake by other cells, (3) promoting lipolysis in adipocytes, (4) suppressing insulin secretion, and (5) inflicting insulin resistance and inflammation. Studies show that blood sugar control during stress can be improved through stress-reducing techniques such as exercise, relaxation, and mindfulness-based practices like Find a method that works best for you and keep those stress levels in check.
- Get your sleep. Poor sleep can affect blood sugar levels and insulin sensitivity through its reciprocal relationship with stress. It turns out that when sleep homeostasis is out of whack, it affects circulating stress hormones, such as cortisol, which leads to the same blood sugar control issues discussed in #4. While there are many tips for improving sleep quality, such as creating a bedtime routine and cutting screen time before bed, a bigger issue is often overlooked—boundary setting. Many people have so much on their plates that taking on a sleep schedule is unrealistic and often leads to a feeling of failure or being overwhelmed. The best, and sometimes hardest, place to start is by looking at your day, your commitments, and your taskers and identifying what you can get rid of, delegate, or move around to make more space for you and your health needs.
- Stay hydrated. Drinking water and staying hydrated may help lower blood sugar levels and reduce diabetes risk. Some evidence suggests water has this effect simply by increasing blood volume, lowering sugar concentration, and helping you feel full, so you eat less food. However, newer evidence suggests water may offer more to blood sugar control than that. Although not confirmed yet, some researchers theorize that the hormone arginine vasopressin (AVP) may play a role. According to a 2020 paper published in the Annals of Nutrition and Metabolism, high AVP is associated with metabolic disease and increased risk of developing type 2 diabetes. Furthermore, the researchers identified that individuals who drink less water tend to have higher levels of circulating AVP, which may be lowered by increasing water intake. A large, randomized trial is ongoing to determine if water can meaningfully reduce fasting glucose, risk of new-onset diabetes, and other cardiometabolic risk factors.
- Know your A1C. Your A1C (aka hemoglobin A1C or HbA1c) is a simple blood test that measures your average blood sugar levels over the past three months. This test is one of the best tools available to help you and your health care team understand and manage your risk for high blood sugar and diabetes. Some early signs or symptoms of high blood sugar include frequent urination, increased thirst, blurred vision, fatigue, and headache. However, according to the Mayo Clinic, hyperglycemia doesn’t cause symptoms until blood glucose levels are significantly elevated. Don’t wait until signs or symptoms show up. Regular testing can help ensure you stay on track. HbA1c tests can now be done from the comfort of your home so you can measure, modify, and monitor as needed.