Gestational Diabetes: Understanding It and Managing It Naturally
Gestational diabetes (GD or GDM) can feel overwhelming. Suddenly you are handed new language: glucose curves, carb counting, blood sugar targets, insulin sensitivity. You might also receive fear based warnings about birth outcomes.
Let’s remove the panic and replace it with knowledge.
This guide will help you understand:
What GD actually is
Why it develops (and why it is not your fault)
How it is tested in Canada
What GD means for pregnancy, birth and postpartum
How to manage GD through nutrition and lifestyle
This is informed by research from Evidence Based Birth and the work of Lily Nichols, RDN, author of Real Food for Gestational Diabetes.
What is Gestational Diabetes?
Gestational diabetes is a temporary form of diabetes that develops in pregnancy when the body cannot use insulin effectively. Insulin is the hormone that moves glucose (sugar) from the bloodstream into your cells to be used as energy.
In pregnancy, hormones from the placenta cause insulin resistance.
This is normal. It allows more glucose to stay in the bloodstream so baby has fuel.
Most bodies adapt by producing more insulin.
Some bodies cannot keep up.
Blood sugar rises and GD develops.
You did not cause this.
GD is not caused by eating sugar or being unhealthy.
It is largely influenced by:
Placental hormones
Genetics
Your body’s ability to respond to insulin
According to EBB, up to 18 percent of pregnancies are affected, depending on the population and screening protocol.
Why GD Matters
Unmanaged GD can increase risk of:
Higher birth weight
Shoulder dystocia
Need for induction or cesarean
Newborn low blood sugar after birth
Managed GD drastically reduces these risks.
When blood sugars remain stable:
Babies maintain normal growth
Induction is less likely to be recommended
Birth outcomes are similar to pregnancies without GD
(EBB review, 2018)
How Canada Screens for Gestational Diabetes
Screening happens between 24 and 28 weeks.
Your provider may offer one of two options:
1. The 50 g Glucose Challenge Test
You drink the orange glucose drink
Blood is drawn at 1 hour
No fasting is required
If levels are above a certain threshold, you move on to the diagnostic test.
2. The 75 g Oral Glucose Tolerance Test (OGTT)
You fast overnight
Fasting blood draw
Drink glucose solution
Blood drawn at 1 hour and 2 hours
Some providers offer alternative screening if you cannot tolerate the drink (for example due to nausea), but this varies by province and provider. Most hospitals in Alberta default to the standard testing protocol.
You can always ask:
What is the threshold here?
What are my options if I decline?
What Happens If You Are Diagnosed
You will likely be referred to:
A diabetes educator
A dietitian
Sometimes an endocrinologist
They will give targets for blood sugar monitoring:
Fasting glucose (first thing in the morning)
One or two hours after meals
Natural (Diet and Lifestyle) Management
According to Lily Nichols’ work with thousands of clients, approximately 75 to 90 percent of people with GD can maintain stable blood sugar through nutrition and lifestyle alone.
The goal is to prevent big spikes in blood sugar.
1. Balance your meals
The pattern that helps the most:
Protein + fat + fiber + carbs
Carbs raise blood sugar.
Protein, fat, and fiber slow the rise.
Example pattern:
Eggs + avocado + berries
Greek yogurt + chia + nuts + small fruit
Chicken salad + crackers instead of a sandwich
2. Choose carbs that are slow to absorb
Lily Nichols calls these real food carbohydrates:
Vegetables
Berries
Whole fruit
Legumes
Sweet potato
Whole grains (if tolerated)
Avoid:
Juice
Refined white flour
Soda
Sugary cereals
Not because these foods are “bad,” but because they cause steep glucose spikes.
3. Pair carbs with protein
This is the secret sauce.
If you eat fruit, add nut butter.
If you eat crackers, add cheese.
4. Eat smaller amounts more frequently
Large carb heavy meals cause spikes.
Smaller meals create more stable curves.
5. The 10 minute walk rule
A short walk after eating reduces blood sugar in most people.
This is supported by both Evidence Based Birth and Diabetes Canada guidelines.
6. Don’t fear fat
Healthy fats are essential:
Avocado
Nuts and seeds
Olive oil
Coconut oil
Full fat dairy (if tolerated)
They slow digestion and reduce glucose spikes.
7. Prioritize protein
Aim for 20 to 30 grams of protein per meal.
Protein stabilizes blood sugar and improves insulin sensitivity.
8. Breakfast matters
Morning blood sugar spikes more easily due to hormones.
Start with:
Protein and fat first
Carbs last
Example: eggs + veggies + feta
Not: bagel and juice
Diet Managed vs Medically Managed
If blood sugars remain high despite dietary efforts, your provider may recommend:
Metformin
Insulin
Medication does not mean failure.
It means placenta hormones are strong and your pancreas needs support.
Birth Considerations with GD
Having GD does not automatically mean:
You will be induced
You cannot have a vaginal birth
You must give birth by a certain date
Care providers monitor:
Baby’s growth
Blood sugar stability
Amniotic fluid levels
Many people with GD birth vaginally and on their own timeline, especially when blood sugars are stable.
Postpartum and Long Term Health
GD typically resolves after birth, but it increases future risk of Type 2 diabetes. The risk decreases significantly when:
Blood sugar was diet controlled
You breastfeed
You maintain a whole food based diet postpartum
