November was World Diabetes Awareness Month, and this year, gestational diabetes is being highlighted.
Defined as either diabetes that is first diagnosed during pregnancy (meaning you had it before getting pregnant, but were undiagnosed) or diabetes that develops during pregnancy, gestational diabetes often slips under the radar, but it affects up to 18% of all pregnancies.
In either case, your blood sugar rises because pregnancy hormones affect your body’s insulin actions. This actually happens in all pregnancies, but gestational diabetes is only diagnosed when blood sugar is unable to stay within a safe range.
This is especially important for Black women to be aware of since we are at a higher risk for developing a form of diabetes due to diet and lifestyle. Developing diabetes during pregnancy also puts you at higher risk for developing Type 2 diabetes.
What Are The Effects Of Gestational Diabetes?
- High blood sugar can lead to you developing Type 2 diabetes, a condition where your body doesn’t use its insulin properly. In fact, a review of past studies found that women with gestational diabetes were more likely to develop Type 2 diabetes in the five years after pregnancy.
Black women are the third largest group of Americans with some form of diabetes.
- Your baby can be large at birth, a condition called macrosomia, where the baby is 8lbs 13oz or more.
- Being large puts the baby at greater risk for a birth injury called shoulder dystocia, where their shoulders become stuck during vaginal delivery. This is a risky situation and could turn into an emergency for both mom and baby, and may cause neurological brain damage to the baby.
- The baby’s blood sugar may be too low after birth. This can cause permanent changes to his or her metabolism, predisposing them to developing diabetes, heart disease, and obesity in their lifetime.
- It puts you at higher risk for a C-section and preeclampsia—a condition that causes high blood pressure and damage to your organs.
- Your baby may get jaundice, a condition that causes yellowing of the baby’s skin and eyes due to unfiltered pigment in their red blood cells.
How Do I Get Tested For Gestational Diabetes?
A gestational diabetes test requires drinking a glucose drink, and then testing your blood one hour later to see how your body reacts. If your blood sugar is too high, you’re diagnosed with gestational diabetes. When blood sugar is moderately high, the doctor will have you undergo a three-hour test in which you will have to consume the glucose drink and have your blood drawn every hour.
(Quick side bar: There is controversy surrounding this standard testing method of the glucose drink, and there are other options if you don’t want to drink it. You can listen to author Lily Nichols talk about them in this podcast.)
Most doctors wait until the 24-28 week mark to test because it’s around that time that your insulin resistance builds; however, some doctors choose to screen earlier.
Early screening—that is, screening done as early as the first month of pregnancy—is a great option for a few reasons. First and foremost, an early diagnosis allows you to get control of it now as opposed to later, reducing the risk and harm to your baby.
Secondly, it’s more accurate. The screening is done during your initial bloodwork and it’s 98% accurate in predicting a gestational diabetes diagnosis later in pregnancy. In fact, since it is tested so early, it is an indicator of having prediabetes before pregnancy.
And thirdly, it prevents you from having to drink that glucose drink, which has a less accurate diagnoses rate.
At your first prenatal appointment, you can ask your doctor to perform an early screening. The doctor doesn’t require anything extra of you—they just have to check a box when they submit your blood work.
Gestational Diabetes Risk Factors
It’s especially smart to screen early for gestational diabetes if you meet any one of the following risk criteria:
- You have a family history of gestational diabetes, prediabetes, or Type 2 diabetes.
- You’re overweight when you get pregnant.
- You’re 25 years old or older.
- You’re not white.
- You’ve previously given birth to a baby who weighed at least 8lbs 13oz.
You should know that more than 40% of women with gestational diabetes have no risk factors at all. That testifies to the fact that while you don’t have control over your hormones, you are able to influence other factors.
As a Black woman, you already meet just one of the criteria, and that puts you at a higher risk for developing gestational diabetes. It’s necessary to note that many Black people do have a family history of diabetes, and statistically, Black women are the third largest group of Americans with some form of diabetes.
What You Can Do Right Now
The history of diabetes among Black people isn’t because of genes, as global statistics prove; rather, it’s a matter of limited access to quality food.
Since the beginning of the United States, we have been disproportionately underserved in diet—from the scraps given to slaves, to the processed foods flooding the grocery store, to health food stores not existing in predominantly Black communities. Inaccessibility has played a leading role in Black American health.
You can ask your doctor to perform an early screening. The doctor doesn’t require anything extra of you.
But even with limited access, there are choices you can make to lower the chance of diabetes.
A real food diet is so important to your health and how your body handles pregnancy, as well as the baby’s development and health through their life AND your grandchildren’s. Yes—what you eat now affects your grandchild’s health, because high blood sugar can cause a permanent metabolic change.
This doesn’t mean you have to give up fried chicken or macaroni and cheese, but you should be mindful of what you eat and what it does to your body.
Fruits, vegetables, seafood, and meat are loaded with nutrients that your body NEEDS. It’s always best to get nutrients from these foods rather than from a vitamin or supplement.
Don’t get me wrong—vitamins are good because they help us get the nutrients we commonly lack due to a poor diet. But sometimes vitamins can be ineffective because our bodies don’t always absorb them as they’re intended. So eating real food—not processed or sugar loaded—is the best way to give your body what it needs to perform its absolute best.
Foods that you should eat less of or avoid completely:
- Foods with added sugar, like cereal, granola, and snack cakes. It’s better to make these yourself with the base ingredients so that you can choose the type and amount of sweetener, or purchase a healthier version online or at a health food store.
- Foods made with white flour, such as tortillas, pasta, bread, and doughnuts. Whole-wheat alternatives are a better choice, but whole wheat must be the first ingredient listed on the package.
- Instant products, like rice, oatmeal, and ramen. Brown rice and steel-cut oats are better choices.
- Starchy vegetables (e.g. potatoes, winter squash, peas, and corn). Sweet potatoes and zucchini are good options.
- Trans fat (e.g. Crisco, margarine, and solidified peanut butter). Instead, use butter, coconut or olive oil, and natural peanut butter.
These types of foods will skyrocket your blood sugar. (And trans fat paralyzes the effectiveness of your insulin.) Again, you don’t have to remove these from your diet altogether, but try to eat less or smaller portions than you do now.
For a more in-depth dive into diet, you can read Lily Nichols’ books Real Food for Pregnancy and Real Food for Gestational Diabetes. And talk to you doctor at your next appointment about any issues this article raises for you.
Gestational diabetes may sound scary, but practicing healthy habits now lowers your risk of diagnosis. A diagnosis doesn’t mean you can’t enjoy your pregnancy, and it doesn’t make anything about you or your baby permanent. Treat it as information that empowers you to make better choices to insure your and your baby’s health.