“If you can keep being physically active, like walking on a regular basis, all of those positive lifestyle changes are really going to benefit you later down the road, especially your whole family. It doesn't have to be just you.” - Leigh Tracy
On this week’s episode of the Yumlish Podcast, Leigh Tracy defines gestational diabetes and shares steps toward prevention. She also discusses management methods, the frequency of gestational diabetes in the United States, and the effects and impact of this condition on the baby and on the birthing person.
Leigh is a registered dietitian and a certified diabetes care and education specialist who provides nutrition education and diabetes self-management in pregnancy. Currently, she is Coordinator for Diabetes Self-Management in Pregnancy for Sinai Hospital of Baltimore. When she isn’t working, she enjoys spending time with her family and painting.
Shireen: Leigh Tracy is a registered dietician and a certified diabetes care and education specialist, who provides nutrition education and diabetes self-management in pregnancy. When she isn’t working, she enjoys spending time with her family and painting. In this episode, Leigh Tracy shares the signs and symptoms of gestational diabetes and gives us an overview of what a birthing person with gestational diabetes can expect. She explains how culturally competent nutritional therapy can be used to address the signs and symptoms of gestational diabetes and help protect the baby. Tune in to hear more about how you can prevent and manage gestational diabetes using nutritional strategies.
Podcasting from Dallas, Texas I’m Shireen. And this is the Yumlish Podcast. Yumlish is working to empower you to take charge of your health through diet and exercise and reduce the risk of chronic conditions like type 2 diabetes and heart disease. We hope to share a unique perspective and a culturally relevant approach to managing these chronic conditions with you each week. Welcome, Leigh.
Leigh Tracy: Thank you for having me today.
Shireen: Such a pleasure. Um, Leigh, I want to start out by asking you, what drove you to become a dietician and really focus on gestational diabetes?
Leigh Tracy: Yeah. Honestly, when I was very young, my grandma would always talk about the health benefits of food, which really sparked my interest in learning about how food can really help our bodies.
And from then on, I, you know, even through high school, um, I remember talking with my mom about it and just saying how much I love cooking and learning about food and helping people. And she told me about, you know, what a dietician does. And from sophomore year of high school, I knew that’s what I wanted to become.
So I really looked into that whole process, and then now being a dietician for almost seven years and having just different specialties over the years, I’ve really honed in on my love for helping moms, um, manage their blood sugars, uh, especially with the gestational diabetes, because pregnancy in, and of itself is so difficult sometimes.
And then you throw on the gestational diabetes, it can add so much more anxiety and stress. And I really just wanted to help moms learn how to balance their diet and still enjoy, you know, the last few weeks, a couple months of their pregnancy.
Shireen: And so help us understand what is gestational diabetes and how frequently are birthing persons affected by gestational diabetes in the United States?
Leigh Tracy: So gestational diabetes is basically diabetes that occurs during pregnancy when the mom didn’t have diabetes beforehand. And so that can be a real shock for the mom as well. You know, she was doing well, the whole pregnancy, and now she gets this diagnosis that she has this diabetes and it actually, according to the CDC, it’s impacting 2 to 10% of all pregnancies in the United States right now.
Shireen: So what can a birthing person who has gestational diabetes expect to experience through their pregnancy during birth and even after pregnancy?
Leigh Tracy: So when you first get the diagnosis, um, again, it’s always a big shock to the moms. Um, typically the OB will recommend you go see a, you know, a diabetes educator like myself, and also I’m a dietician, so it’s kind of a nice combo.
So you’ll be expected to get that education upfront. You’ll have a few more doctor appointments, different ultrasounds, just to keep a check on the baby, make sure the baby’s growing well. You’ll be checking the blood sugar about four times a day, which can be a lot. Um, we have you check it first thing in the morning, that’s called your fasting blood sugar.
And so you check your blood sugar in the morning before you eat or drink anything. Then we have you check again, one hour from the time you started eating your meals. So I was telling my moms, you know, if you eat breakfast at eight o’clock, I want you to check your, your blood sugar at nine o’clock. And I have them record all their blood sugars, and then I look at all the blood sugars once a week. Every center is going to be a little different, but typically you’re going to be expected to check your blood sugar every day and send in your blood sugars pretty much weekly, just to make sure everything is looking good, because we know it can change week to week.
Um, those blood sugars and, you know, there’s going to be some diet changes sometimes for moms, depending on what their current diet was. Um, sometimes if a mom was drinking, lots of, you know, sugary beverages beforehand, we’ll recommend to really cut that out right now and focus on drinking water. You know, if they weren’t exercising and again, it doesn’t have to be exercise.
It just any physical activity, you know, light walking can be really good. Um, so we might ask you to just start doing that. As throughout the pregnancy, again, they’re always checking on the baby, checking the growth of the baby because sometimes a C-section is needed depending on the size of the baby or any other complications going on.
Once you deliver your baby, the gestational diabetes should go away. And that’s always a relief to the moms to know that there is an end point for this whole thing. And so after you deliver, you will have to come back and get another test done to make sure that the diabetes has in fact gone way. And that’s usually around six to 12 weeks postpartum.
Shireen: Help us understand the science of it. So what is it about the pregnancy that is causing gestational diabetes?
Leigh Tracy: Great question. So let me tell you first about what happens normally in our body without any type of diabetes. So normally when we eat foods that contain carbohydrates, so that includes grains, fruit, starchy vegetables, dairy, sweets obviously. Whenever we eat those types of foods, our body is breaking that down into sugar, or it’s also called glucose, and we use that sugar as energy in our body.
And what specifically happens is our organ, called the pancreas, actually secretes a hormone called insulin. And I like to think of insulin like a key. So you take your insulin key and it unlocks ourselves to let that sugar go into the cells and give us energy. Now, during pregnancy, in general, the placenta, which is so vital for the pregnancy, it’s creating all these nutrients and secreting all these hormones to help maintain the pregnancy.
And that’s great, but there gets to a point in the pregnancy where the hormones from the placenta caused something called insulin resistance. And again, that insulin is like a key to get that sugar into ourselves. So insulin resistance means it’s not able to work as properly, like it used to, so the key isn’t working. It’s kind of jammed.
Um, and so the sugar is not able to get into the cells and give us energy as much as it used to. Now, normally during pregnancy, the body will compensate. And produce more insulin to overcome that issue. But if not, if the body can’t produce enough insulin to overcome that resistance part, gestational diabetes will occur.
So basically your body’s just having a little trouble compensating for those extra hormones causing this insulin resistance and your body just can’t get that sugar into itself properly. And so you have all this extra sugar floating around, which we don’t want. So that’s how I tell my moms. I’m like, it’s not you, it’s your placenta because I get so many moms coming to me and they’re just like, what could I have done? It’s my fault. And it can cause a lot of guilt that’s so not needed, because it’s honestly just something that happens physically. And, you know, you could be in the best health and it can still happen sometimes. I’ve seen that before.
Shireen: Um, you spoke a little bit ago that ideally the gestational diabetes should be done, and you shouldn’t have to worry about diabetes. Um, post-birth now there are instances of where gestational diabetes puts you at risk for type 2. Can you tell us a little bit more about that correlation there and what can one do?
Leigh Tracy: Yeah. So it does put you at risk, you know, about five, 10 years later forgetting the actual type 2 diabetes, because of the whole, um, insulin resistance part of the body and your body had trouble, you know, overcoming that.
Um, and depending to, you know, just how much extra weight gain you’ve had during pregnancy, I think, and I don’t want women to stress about all the weight gain. Cause you know, during pregnancy you have all different cravings and stuff. but I just say, do what you can. Um, if you have a family history of diabetes already and you have gestational diabetes, it does increase it even more so. So those are some other like genetics that you just can’t fix. Um, so if you, if you do have gestational diabetes afterwards. Once it goes away, I do recommend you follow up with your primary care doctor to get different lab works done yearly, such as the A1C. And that basically is a lab test that checks your average blood sugar over two-to-three-month period of time.
So they can really track to see how are your blood sugars doing? Are you starting to go up a little too high? You know, can we make any lifestyle changes right now to help prevent any onset of that diabetes from actually happening? And so what I really stress after the pregnancy, after the delivery is, Hey, if you’ve made some great lifestyle changes, you know, you started drinking more water, you and your family started eating more of those non-starchy vegetables, like leafy greens, zucchini, tomato, carrots.
If you start making such changes like that and you enjoy it, you know, keep it up. That’s really going to help prevent, you know, the, that diabetes from coming on later because you’re filling your body with such good nutrients and, you know, the more added sugars, you know, uh, usually beginning you might not be as active right after birth.
And, and if you’re breastfeeding, that’s also a great way to help reduce your risk of developing diabetes later in life. And if not, it’s still okay. Um, I say, you know, if you can keep being physically active, like walking on a regular basis, all of those positive lifestyle changes are really going to benefit you, um, later down the road, especially your whole family. It doesn’t have to be just you.
Shireen: What culturally competent nutritional therapy can be used to help manage gestational diabetes?
Leigh Tracy: So there’s different things. So I work with a lot of different moms that have different, um, you know, ethnic, um, ethnicities. And so, you know, specifically I work with a lot of, um, Hispanic population.
And so you have a lot of the rice and beans, um, the plantains, and it can be really hard. Um, You know, I don’t want to make them change everything about their diet because we can still make it work. Um, and so, you know, I let them know, Hey, if you’re going to have rice and beans, definitely load up a little bit more on the beans versus the rice, because that’s really going to help slow down how quickly your body is breaking down that food, both the beans and the rice into sugar in your body.
Um, again, I’ll stress the importance of adding different non-starchy vegetables. So if your diet really is high in, um, You know, like eggplant, uh, you know, even the, like I said, the leafy greens, all that, it’s going to be a really good addition. Um, sometimes you do have to cut back a little bit on the rice portion, depending on what you’re used to.
Um, a lot of times they do run into more rice and beans and less of the non-starchy vegetables. So, you know, if they did have gestational diabetes, I still recommend, you know, adding those great non-starchy vegetables into their diet. And just being open and honest with your dietician or diabetes educator about what you really want to still control, because a lot of this can be hard for moms because it feels like they don’t have control. You know, food is one of those things we can control. And when you’re told, Hey, we need to adjust some things you’re eating, that can be really hard to deal with.
Shireen: What affects might gestational diabetes have on the baby either before, during and after birth?
Leigh Tracy: So, you know, I do, I never want to scare the moms, but I say it is a real serious diagnosis, you know, it’s something not to be taken lightly. And, you know, so you kind of get that spectrum of, um, okay. My baby could become extra-large. And so some moms are like, okay, you know, big babies is great, but I’m like, well, you know, if your, if your baby does grow a little too quickly, because the baby is getting all this extra sugar from your food, because you know, the baby is getting all this nutrients from you.
And there are high blood sugars circulating in the body. That’s going to the baby and the baby will actually adjust, um, his or her own, uh, mechanisms of absorbing that sugar. And so again, that can increase the baby’s, the growth. And so we are checking how big the baby’s getting, and if the baby is getting very large, you may need to get a C-section or if you do still do have a vaginal birth, you could actually have, um, some complications with the shoulder, just OSHA.
And that can cause a lot of issues for the baby afterwards. One other risk is if the baby is used to having higher blood sugar circulating after birth, the baby can actually have hypoglycemia, which is low blood sugar. And if that’s not managed properly, immediately after birth, that can actually have some brain injury complications.
So we want to make sure that throughout the pregnancy, the blood sugars are managed well to help avoid that low blood sugar, um, impact of the child. And then the baby, um, can actually be at risk now for developing type 2 diabetes, as well as having some cardiovascular issues later in life, and some of that insulin resistance.
Um, and it honestly, in worst cases, the baby, the baby could end up, um, being still born. So that is something we really want to avoid. That’s why, again, we have all these different testing and checking the baby usually, um, very often to make sure the baby’s doing well throughout the remainder of the pregnancy.
Shireen: Alright, Leigh, so myth or a fact, how does gestational diabetes impact breastfeeds?
Leigh Tracy: Right. So good news is, um, that’s a myth. It does not impact the breast milk at all. So you don’t have to worry about it changing the composition of your breast milk or your ability to breastfeed your child. So, you know, that is something that you can still do afterwards.
And again, that’s still going to be great for you and the child, especially to help you reduce your risk of developing type 2 diabetes later on.
Shireen: Um, for the listeners out there, who are listening to us, and they’re a little bit scared by what you mentioned on gestational diabetes. What steps can they really take to prevent gestational diabetes? I know you talked about the risk of it and some of it is out of, you know, out of control, but, um, are there things that folks can do to prevent it?
Leigh Tracy: So again, there’s things you can do to help reduce your risk of getting it. Um, there’s certain things you can’t change, such as ethnicity, family history, you know, those things, um, your age, when you are, you know, trying to have a baby or are pregnant, um, those things you obviously can’t change.
So things you can really help right now, um, whether you. Thinking about getting pregnant or currently pregnant, really work on eating a balanced diet. And what I mean by that, lots of vegetables and, you know, the non-starchy vegetables, especially like, like I said, I can’t stress enough about those, like the leafy greens, the tomatoes, having, as I say, half a plate of vegetables at almost, not all meals, at least lunch and dinner, I know sometimes veggies in the morning can be a little tough.
Um, if you’re not sure huge fan of that, but having a high intake of those dietary fiber foods is really good to help keep you full, manage your weight, um, and physical activity. You know, if you’re able to just start walking, you don’t need a gym membership, you don’t need to exercise an hour every day.
You know, I say start with just 10 minutes a day, if you can, you know, there’s different apps out there right now, depending where you are in the country. if it’s too hot outside, can you do something inside, and just to get your body in that groove already is great. Physical activity that actually does help to lower your blood sugar naturally, that I see as a natural medicine.
So whether you have gestational diabetes or not, it’s a great way, cause you can think of your muscles as soaking up that sugar because it needs it for energy. So, that can be super helpful. Try not to, um, you know, consume too much of those sugary beverages, you know, like sodas, even juice. I say, you know, even if it’s an all-natural juice, it’s still going to have the natural sugar from the fruit.
So it’s not that you can’t ever have it. It’s not that they’re horrible. It’s just saying, no once in a while. Have one of those beverages. It’s okay, but try to make the water, your primary source of fluid. That’s really going to help with your body. Now, if you have any other health conditions going on, let’s say you have prediabetes. You’re, you’re kind of in that limbo of, you’re not diabetic. You don’t have diabetes right now, but you’re, you’re getting kind of close. That’s something to really talk with your doctor about before even getting pregnant. Cause you want to make sure you can manage that before even get pregnant, if you can, because we really want to make sure that the pregnancy doesn’t tip you over into the full-blown diabetes itself.
Um, and then also there are some women with PCOS, and that’s polycystic ovarian syndrome. There’s different forms of that, but one of the main things with PCOS is it can – you already have an issue typically with insulin resistance. And so there’s some things you have to do medication wise to take, to help lower and manage that insulin resistance.
Um, so having that us does increase your risk. So I say really speaking with your GYN or your OB about ways to really help manage that. And typically it’s going to be, um, with medication, um, to help, you know, with that already.
Shireen: So with that, Leigh, we’re toward the end of the episode, at this point, can you tell our listeners how they can connect with you and even learn more about your work?
Leigh Tracy: Sure. So, you know, if you have any questions, um, I always say first go to your, if you’re pregnant with gestational diabetes, go right to your center. Um, you should hopefully have a dietician there or a certified diabetes educator to help you throughout this process, but still, I would love to help you out. If you have any questions, you can find me on LinkedIn, under Leigh Tracy, and, you know, be happy to help you navigate some of this craziness during pregnancy, ‘cause I know it’s definitely a lot.
Shireen: Absolutely. And we will link your LinkedIn in our show notes. So folks can click on it and get right to, uh, connecting with you.
Leigh Tracy: Wonderful.
Shireen: So to our listeners out there, what additional questions do you have about gestational diabetes? Head over to our Facebook, head over to our Instagram and throw in your questions. Let us know what additional questions you have about gestational diabetes. With that, Leigh, I want to thank you so much for your time. It was an absolute pleasure having you on here with us today.
Leigh Tracy: Thank you so much for having me. I really enjoyed today.
Shireen: Thank you for listening to the Yumlish Podcast. Make sure to follow us on social media @Yumlish_ on Instagram and Twitter and @Yumlish on Facebook and LinkedIn for tips about managing your diabetes or other chronic conditions. You can also visit our website Yumlish.Com for even more information, and to get involved with all of the exciting opportunities Yumlish has to offer all of the links are in the show notes below. So please don’t hesitate to check us out. If you like this week’s show, make sure to subscribe to the Yumlish podcast. Give us a like, comment, or a five-star review, and share us with a friend. This is Shireen signing off. Thank you again, and we’ll see you next time.
Remember your health always comes first. Stay well!