What is Gestational Diabetes
Gestational diabetes (GDM) is a state of high blood glucose that usually develops during the second and third trimester of pregnancy and is resolved after giving birth.   It affects about 7-10% of pregnancies globally and 1 in 5 pregnant women in Singapore.   Risk factors for GDM include being overweight, a history of GDM in a previous pregnancy, history of diabetes especially among immediate family members, and previously having a baby heavier than 4kg at birth.   
GDM often presents without symptoms and is usually detected during routine testing of the oral glucose tolerance of pregnant women (at 24-28 weeks in Singapore). Uncontrolled or poorly-managed GDM can lead to complications including an excessively large baby (leading to difficult labour), premature birth, higher risk of pre-eclampsia, and higher risk developing type 2 diabetes mellitus (T2DM) in the future (for both baby and mother).     
Fortunately, many cases of GDM can be managed through control of blood sugar levels by eating well and keeping to an active lifestyle. Controlling blood sugar levels through diet involves eating balanced meals that do not cause large spikes to the blood sugar levels (lower glycaemic index (GI) food). High quality carbohydrates such as wholegrain pasta, brown rice and bread are lower in GI and higher in fibre than their refined counterparts. Studies have shown that eating such high quality carbohydrates help to manage blood sugar levels in GDM.    Importantly, pregnant women with GDM should not avoid eating carbohydrates altogether. Pregnant women are advised to consume quality carbohydrates (i.e., not sugar) consistently and regularly.  This is because carbohydrates are vital at every stage of life. They’re the body’s primary source of energy and the brain’s preferred energy source. Carbs are broken down by the body into glucose – a type of sugar. Glucose is used as fuel by your body’s cells, tissues, and organs.
What to eat if you have gestational diabetes?
- Plenty of whole fruits and vegetables.
- Moderate amounts of lean proteins and healthy fats.
- Moderate amounts of whole grains, such as bread, cereal, pasta, and rice, plus starchy vegetables, such as corn and peas.
- Fewer foods that have a lot of sugar, such as soft drinks, fruit juices, and pastries.
Not everyone is a fan of wholegrains due to the gritty texture and nutty taste. If you are pregnant and is not a fan of brown rice, here is a great option. Adding Alchemy Fibre™️ For Rice to white rice while cooking gives you a lower GI rice (same range as brown rice) and also provides 10x fibre of regular white rice. Best of all, white rice retains its soft, fluffy texture that many rice lovers enjoy.
A final note on managing Gestational Diabetes
Women with gestational diabetes should also keep active with low impact activities such as walking and swimming. Regular exercise has been shown to be effective at keeping insulin and blood glucose levels in check.   However, if GDM cannot be controlled with changes in diet and lifestyle, medication such as insulin will be prescribed.   It is important to work closely with a healthcare professional to manage GDM so that both mother and baby can be healthy.
National University Hospital, “Gestational Diabetes (GDM),” NUH, Aug 2017. [Online]. Available: https://www.nuh.com.sg/our-services/Specialties/Obstetrics-Gynaecology/Documents/Gestational%20Diabetes%20%28GDM%29.pdf. [Accessed 20 Oct 2021].
National Health Service (UK), “Gestational Diabetes (Overview),” NHS, 06 Aug 2019. [Online]. Available: https://www.nhs.uk/conditions/gestational-diabetes/. [Accessed 20 Oct 2021].
S. Behboudi-Gandevani, M. Amiri, R. Bidhendi Yarandi and F. Ramezani Tehrani, ” The impact of diagnostic criteria for gestational diabetes on its prevalence: a systematic review and meta-analysis.,” Diabetol Metab Syndr., vol. 11, p. 11, 2019.
HealthHub, “Guide 3: Keeping Gestational Diabetes in Check,” Ministry of Health, [Online]. Available: https://www.healthhub.sg/live-healthy/1700/guide-3-keeping-gestational-diabetes-in-check. [Accessed 20 Oct 2021].
W. Lim, “Gestational Diabetes Mellitus: What Is It and How Does It Affect You and Your Baby?,” SingHealth, [Online]. Available: https://www.healthxchange.sg/diabetes/essential-guide-diabetes/gestational-diabetes-mellitus-what-how-affect-you-baby. [Accessed 20 Oct 2021].
P. V. Popova, E. A. Pustozerov, A. S. Tkachuk and E. N. Grineva, ” Improving nutrition for the prevention of gestational diabetes: Current status and perspectives.,” World J Diabetes., vol. 12, no. 9, pp. 1494-1506, 2021.
HAPO Study Cooperative Research Group, “Hyperglycemia and adverse pregnancy outcomes.,” N Engl J Med., vol. 358, no. 19, pp. 1991-2002, 2008.
A. Ben-Haroush, Y. Yogev and M. Hod, “Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes.,” Diabet Med., vol. 21, no. 2, pp. 103-113, 2004.
L. Rasmussen, C. W. Poulsen, U. Kampmann, S. B. Smedegaard, P. G. Ovesen and J. Fuglsang, “Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus.,” Nutrients, vol. 12, no. 10, p. 3050, 2020.
C. S. Wan, A. Nankervis, H. Teede and R. Aroni, “Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: A systematic review and meta-analysis.,” Nutr Diet., vol. 76, no. 2, pp. 211-232, 2019.
V. A. Mustad, D. T. T. Huynh, J. M. López-Pedrosa, C. Campoy and R. Rueda, “The Role of Dietary Carbohydrates in Gestational Diabetes.,” Nutrients, vol. 12, no. 2, p. 385, 2020.
T. C. Thiam, K. T. Tan and C. S. J. Tee, “Nutrition During Pregnancy—Eating Right for Two,” HealthHub, 2008. [Online]. Available: https://www.healthhub.sg/live-healthy/928/pregnancy-nutrition-during-pregnancy-eating-right-for-two. [Accessed 21 Oct 2021].
B. H. C. Chua and J. E. Chan, “Exercise During Your Pregnancy,” HealthHub, 22 Jun 2021. [Online]. Available: https://www.healthhub.sg/live-healthy/1416/move-in-your-time. [Accessed 20 Oct 2021].