I’m writing this before the sun rises on my daughter’s fifth birthday. Next to my screen is a video monitor where I can watch my 4-month-old son sleep. These healthy, sleeping children are the outcome of two pregnancies during which I managed a diagnosis of gestational diabetes mellitus (GDM).
As I learned through personal experience, a pregnant woman’s blood sugar response during pregnancy has very little to do with her lifestyle choices, and everything to do with pregnancy hormones and genetic predispositions.
When it came time to test my glucose tolerance during my first pregnancy, my response to the one-hour test was the highest my OB had ever seen. It technically qualified as a diagnosis of GDM without doing the official three-hour diagnostic test, which we did anyway to confirm. As a fitness professional, I eat a very healthy, whole food diet and my doctors, who had referred patients to me for years, were shocked. They knew how active I was and how careful I was about what I ate, and I didn’t have any of the lifestyle risk factors associated with the diagnosis. Although discovering I had gestational diabetes was somewhat of a surprise to me, it resonated as true, because several family members on both sides of my family have diabetes. Due to the genetic hand I’ve been dealt, my body struggles to metabolize sugar.
A lot of fear, mystery and stigma surround gestational diabetes. Since being diagnosed myself a little over five years ago, I’ve met countless women who have revealed to me that they are also managing this diagnosis—often quietly, without telling anyone beyond their closest friends. Whether overt or subtle, the women I know tend to accept personal blame and feel guilt for this diagnosis, as if it’s their fault for eating that donut or not prioritizing exercise. Take a deep breath, and let it go.
Lifestyle choices are not responsible for causing gestational diabetes. But lifestyle choices do hold the power to help you manage the diagnosis healthfully, to keep you and your baby safe during pregnancy and pave the way for a strong labor and postnatal recovery.
How do I counsel friends and clients who tell me they’ve “failed” (even that is such a loaded, blame-laden word) their glucose test? The good news is two-fold:
1.) If you do have GDM, it’s not your fault;
2.) You can likely control your blood sugar during the rest of your pregnancy through diet—the most powerful driver—and exercise.
You will know you’re controlling it with four pricks a day, and it’s very empowering and not a big deal after you get used to it. You’ll have the confidence of keeping your baby safe and healthy, and extra motivation to focus on the most nourishing, nutrient-dense foods. You will have the data at your fingertips (literally). If brown rice spikes your blood sugar (and it will), then don’t eat it. Pivot as you go, listening to your body and watching your numbers. In some ways, I think a diagnosis of GDM is a gift. It prompts the healthiest choices during pregnancy and sets you on a path to avoid the chronic disease pattern that is likely part of your (and my) genetic inheritance.
Leah Keller is a certified personal trainer and the founder of Every Mother (formerly the Dia Method), a prenatal and postnatal fitness system endorsed by medical and birth professionals worldwide. Keller has more than two decades of fitness experience. She coaches women of all ages through evidence-based exercises to improve core strength, function, and total body fitness. Her method, Every Mother, is featured in the forthcoming book The New Rules of Pregnancy. Keller currently lives in San Francisco with her husband, daughter, and baby boy.
Photographed by Allison Busch