Gestational Diabetes: What Is It and How Can Exercise Help?

One of our clients just found out she has gestational diabetes. She’s an avid exerciser, but had terrible morning sickness in her first trimester and lost weight. She gained it back rapidly in her 2nd trimester. She wondered what she could have done differently and how exercise might help her manage her gestational diabetes. We’ve got some answers!

What is Gestational Diabetes?

Gestational diabetes is a type of diabetes that occurs only during pregnancy. The condition develops in some women when their bodies have a difficult time regulating blood sugar levels. Many women are diagnosed with gestational diabetes (high blood sugar levels) between 24 and 28 weeks of pregnancy. According to a 2014 Centers for Disease Control and Prevention study, gestational diabetes affects about 9% of all pregnant women making it one of the most common health problems.

Gestational diabetes can cause high blood sugar levels that are unlikely to cause problems for the mother, but can threaten the health of the baby.

For most women with gestational diabetes, the main worry is that too much glucose will end up in the baby’s blood. When that happens, the baby’s pancreas need to produce more insulin to process the extra glucose. All this excess blood sugar and insulin can cause the baby to put on extra weight, particularly in the upper body. This can lead to macrosomia, a baby with excessive birth weight. A macrosomic baby may be too large to enter the birth canal. Larger babies are at risk for obesity and diabetes later in life.

What puts you at risk for gestational diabetes?

• You were overweight before you got pregnant. Extra weight makes it harder for your body to use insulin.
• You gain weight very quickly during your pregnancy (this can happen after weight loss from morning sickness)
• You have a parent, brother or sister with type 2 diabetes.
• Your blood sugar levels are high, but not high enough for you to be diagnosed with diabetes. This is called prediabetes.
• You had gestational diabetes in a past pregnancy.
• You are over age 25.
• You gave birth to a baby weighing more than 9 pounds.
• You had a baby who was stillborn.
• You’re African-American, American Indian, Hispanic or a Pacific Islander.

When to screen?

Your doctor will evaluate your risk factors for gestational diabetes early in your pregnancy.

If you’re at high risk of gestational diabetes, your doctor may test for diabetes at your first prenatal visit.

If you’re at average risk, you’ll likely have a screening test near the end of your second trimester — between 24 and 28 weeks of pregnancy.

Glucose testing/screening

• Initial glucose test: You’ll be given a sugary drink. One hour later, you’ll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL) is usually considered normal.
• If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. You’ll need an additional glucose test to determine if you have it.
• Follow-up 3 hour glucose test: You’ll fast overnight, then have your blood sugar level measured. Then you’ll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for three hours. If at least two of the blood sugar readings are higher than normal, you’ll be diagnosed with gestational diabetes.

If you’re diagnosed with gestational diabetes

Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections.

How does exercise prevent and control Gestational Diabetes?

For women diagnosed with gestational diabetes diet and exercise are the main course of treatment. Four to five days a week of regular exercise is recommended for the best results in lowering blood sugar.

Exercise helps maintain a normal weight, which is one of the best ways to prevent high blood sugar levels. Exercise also increases the efficiency of the body’s own insulin, helping to keep blood sugar levels in a normal range without injecting insulin. Working out also helps decrease stress, which can raise glucose levels. Finally, participating in a fitness class can improve circulation, which is important for any diabetic.

Studies show women who participate in regular exercise in the first 20 weeks of pregnancy have a reduced risk of developing gestational diabetes. However, when it comes to using exercise to manage blood glucose levels in pregnant women already diagnosed with gestational diabetes, the research is less conclusive. Therefore, it is Oh Baby Fitness’ position that regular exercise participation is important to help prevent gestational diabetes.

Gestational diabetes is usually short-lived. Blood sugar levels typically return to normal soon after delivery. Most women with gestational diabetes do not remain diabetic once the baby is born. Once a woman has had it, however, she is at higher risk for getting it again during a future pregnancy and for becoming diabetic later in life.

In a 2016 meta-analysis published in Diabetologia, researchers found that the risk of developing Type 2 Diabetes after having gestational diabetes is higher if there is a family history of diabetes, with non-white ethnicity, or if a woman is an older age during pregnancy.  The risk of developing Type 2 Diabetes after having gestational diabetes is DOUBLE if the woman has a high BMI.

Women who have gestational diabetes pregnancies MUST tend to their health after baby comes if they want to avoid Type 2 Diabetes in the years following pregnancy.  Reaching or maintaining a healthy body weight and increasing physical activity after pregnancy should be priorities for all women, and even more so for women who have had a gestational diabetes pregnancy.

Tip: Don’t exercise strenuously on the day you take your GD test!

For the gestational diabetes test, you will usually fast on the day of the test, and then are given a very sugary drink. This has a dramatic effect on blood sugar levels, and you’re at a much higher risk of fainting during exercise. If you’re feeling okay you can work out, but you should exercise caution. It can help to eat something (particularly a good protein) between the diabetes test and exercising.

Bottom Line on Gestational Diabetes

Exercise is important for all pregnant women, but especially for those at risk or diagnosed with gestational diabetes, as exercise can help prevent gestational diabetes, and also help manage it after a diagnosis.

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