Ayurveda for Gestational Diabetes provides a holistic approach to maintain health and nutrition during pregnancy.

Ayurvedic guidelines for pregnancy with diabetes focus on practicing a diet and lifestyle that will help you to regulate your blood sugar levels and also lower your risk during the pregnancy.

Now, if you got a diagnosis of diabetes during pregnancy, then your head may already be spinning with multitude of queries. Can you beat gestational diabetes? Is there any risk to the health of your baby?

And what should you eat and do to prevent the health risks of pregnancy diabetes?

So, here it is for you. A holistic outlook on Ayurvedic remedies (herbs to be taken under the guidance of Ayurvedic medical practitioner), best diet and foods and lifestyle tips to lower your blood sugar and deliver a healthy baby.

Before we begin, you should note that the key to gestational diabetes prevention is to act early. So, get the right information about your specific health risks for diabetes in pregnancy.

Also, adopt the right treatment (which could be simple diet and lifestyle changes for some) that suits your specific lifestyle.

In fact, you can avoid complications of diabetes and deliver a healthy baby by timely identifying and managing your health during the full course of pregnancy.

Now, let’s check out what you can do!

What is Gestational Diabetes?

Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance that develops with the onset of or during the pregnancy.

GDM poses health risks to the baby and to the mother. GDM also leads to complications during the pregnancy and at the end of the term.

In the past few years, the incidence of GDM has increased multi-folds, especially for Asian origin women!

Once GDM is diagnosed, one needs to be highly vigilant of their diet and physical activity to manage the blood sugar level within a safe range. GDM may subside or may continue post full term.

Types of Gestational Diabetes

GDM is of two classified into 2 levels based on the required level of intervention for the management of the condition:

• Class A1 – It can be controlled by diet and physical activity
• Class A2 – It needs to be managed by insulin and/or oral medications.

Signs and Symptoms of Gestational Diabetes

There are usually no symptoms of GDM. It is detected by the routine glucose tolerance test as described below. But when your blood sugar levels are out of control, you may experience the following symptoms:

• Excessive hunger
• Extreme tiredness
• Excess thirst
• Frequent Urination
• Water Retention or Edema in lower body
• Episodes of black-out, low blood sugar or hypoglycemia
• Dizziness
• Nervousness

Since these symptoms are very commonly associated even with healthy pregnancy during the last trimesters, it is quite hard to confirm GDM without actual tests.

Frequent Hypoglycemia | Low Blood Sugar Episodes

Poor insulin response and unregulated blood sugar levels during pregnancy with diabetes may also put you at risk of hypoglycemia or low blood sugar level episodes.

If that happens, then you may struggle with frequent hypoglycemia symptoms:

• Hunger;
• Shakiness;
• Drowsiness/ light-headedness;
• Confusion;
• Anxiety;
• Weakness;
• Difficulty speaking;
• Nervousness;
• Nausea,
• Sweating
• Irritability
• Sleeplessness
• Feeling weak/fainted – Blackout or passing out
• Blurred Vision

How to avoid hypoglycemia during Gestational Diabetes?

To avoid low blood sugar levels, you should always keep natural sources of glucose such as healthy snacks and stay hydrated. This is more relevant when you undertake exercise.

Here are few things that you can take:

• Fruits
• Handful of seeds with raisins or dates
• 3-4 glucose tablets (either dissolved in water or taken as such)
• 1/2 a cup of fresh fruit juice
• 1 cup of milk
• A teaspoon of raw honey
• Fresh coconut water
• A glass of lemonade

Development of Gestational Diabetes

Gestational Diabetes usually develops due to preexisting hyperglycemia (high blood sugar levels) and insulin resistance, which gets aggravated during pregnancy.

Here’s what happens!

1. As the pregnancy progresses, the baby needs more and more support in the form of nutrients to develop and grow. To support this process, the placenta secretes multiple hormones such as human placental lactogen, progesterone, prolactin, and cortisol.
2. These hormones can often disturb the function and level of insulin (another hormone by pancreas) in a mother’s body. She may develop temporary high insulin levels and or insulin resistance.
3. As a result of temporary insulin resistance, mother may also develop glucose intolerance and high blood sugar levels. This is termed as gestational diabetes.
4. Now, as the level of placental hormones increases during the last phase of pregnancy, mostly women develop gestational diabetes at that time. Hence, the test for diabetes in pregnancy is done in the 24-28th week in pregnancy.

Who is at Risk of Pregnancy with Diabetes?

Every year, around 2% and 10% of women are diagnosed with gestational diabetes, with 4 million women in India alone. Over the past decades, both the incidence and ratio of pregnancy with diabetes has increased.

Here are some of the factors that can increase your risk for gestational diabetes:

• Have a family history of diabetes
• You are overweight before your pregnancy
• Have high blood pressure
• Are having multiple babies
• During pregnancy, the weight becomes more than normal
• In the past, suffered from gestational diabetes
• Must have given birth to a baby weighing more than 9 pounds
• Have had a mysterious miscarriage or stillbirth
• Taking glucocorticoids
• Conditions like polycystic ovary syndrome (PCOS)
• Insulin resistance
• Have undergone treatment of infertility
• Suffered from recurrent Urinary Tract Infections (UTI)
• Your age is more than 35 at the time of conception

Health Risks to Mother during Gestational Diabetes

If gestational diabetes is not properly managed, the blood sugar levels will stay high throughout the pregnancy. This can cause many complications and possibly harm both the mother and the baby.

With GDM, a mother has higher chances to face:

1. pregnancy-induced hypertension
2. preeclampsia
3. antepartum hemorrhage
4. preterm labor
5. cesarean delivery

Some of them can be avoided by managing gestational diabetes well.

However, others such as higher susceptibility of the baby and the mother towards Diabetes at a later stage needs to be tightly controlled post delivery.

Health Risks to Baby during Gestational Diabetes

GDM also poses following health risks and complications to the baby:

• high birth weight of the baby and hence higher possibility of cesarean section birth
• post birth unit care requirement
• high-intensity jaundice after delivery
• baby will have much higher chances of developing metabolic disorders, Diabetes, cardiovascular disorders
• congenital malformation
• difficulties during labor
• higher risk of diabetes in future
• a risk to the life of baby and mother such as stillbirth, neonatal deaths, or perinatal mortality

How would GDM affect the Delivery?

As stated earlier, GDM poses multiple health risks to the baby and to the mother.

Should one be diagnosed with GDM, it is necessary to make the required changes to diet and lifestyle and or take medications along with.

While management is necessary, GDM could still affect baby delivery via:

1. Cesarean section delivery

One should be mentally prepared for the requirement of C-section in case of emergency due to sudden changes in blood pressure, blood sugar, heartbeat, or planned due to the size of the baby.

2. Requirement of insulin during delivery

Blood sugar levels must be maintained during labor and delivery as hyperglycemia (high blood sugar) in the mother leads to hypoglycemia (low blood sugar) in the newborn.

When a mother has GDM, she may require insulin support either via a shot or via a plastic tube.

3. Pre-term delivery

This may be required if pre-eclampsia (sudden high blood pressure) develops during the third trimester.

Should this happen, then the only solution to save the life of mother and baby is via early delivery. Apart from this, early delivery may need to be planned for various other reasons including the size of the baby.

The risk to the life of Mother and baby due to the possibility of Still Birth, Perinatal Mortality, or Neonatal Death.

How is GDM diagnosed?

Placental hormones progressively increase Insulin Resistance with pregnancy. It often triggers GDM in the third trimester.

For women with no past history of diabetes or blood sugar at a normal level at the beginning of pregnancy, the gestational diabetes test is done around 24-28 weeks.

For women who are prone to GDM due to past history, high BMI, or existing Diabetics; pre-screening for GDM is done at the first prenatal visit.

Glucose challenge test

GDM is confirmed in 2 ways depending on the national norms and the Doctor. These are called as one-step testing and two-step testing as explained below.

1. One-step test

1. First, you undergo the test of fasting (overnight fasting for at least 8 hours) blood sugar
2. You are given 75 grams (g) of glucose solution to drink.
3. Blood sugar levels are checked repeatedly after one hour and two hours.

GDM is confirmed by the Doctor if your blood sugar level is higher than any of the following values.

Time of Test	The blood Sugar level is higher than or equal to (mg/dL) milligrams per deciliter
Fasting	92
1 Hour	180
2 Hours	153

2. Two-step test

For the two-step test, fasting isn’t required. The patient is provided with a 50g glucose solution to be consumed orally.

After one hour, blood sugar is tested. If the blood sugar level is greater than or equal to 130 mg/dL or 140 mg/dL, a second step test is done for GDM confirmation.

The threshold for the first test is decided by the Doctor according to the patient’s profile and history. The second test is conducted on another visit.

1. In the second test, the fasting blood sugar level is also checked.
2. A 100 g glucose solution is consumed orally after fasting for a minimum of 8 hours.
3. After the consumption of glucose, blood sugar is tested at one, two, and three hours.

GDM confirmation is done if any of the 2 or more values are higher than the stated range. These values are based on Carpenter guidelines.

Time of Test	The blood Sugar level is higher than or equal to (mg/dL) milligrams per deciliter
Fasting	95
1 Hour	180
2 Hours	155
3 Hours	140

After the birth of the baby!

Women with GDM have a 40% higher chance of developing Diabetes later in life. Studies indicate that there is a 60% chance of developing type 2 diabetes within 4 years.

That’s why you should manage your blood sugar levels with appropriate changes in diet and lifestyle not just during pregnancy but much after as well.

Here’s how the usual check-up process and possibility of Diabetes after delivery.

After delivery, your doctor will recommend you to monitor your blood sugar levels on a regular basis.

After 6 weeks of delivery, the blood test is conducted to check whether the glucose level has turned to normal!

Based on this, one would fall into 3 possible categories:

• Normal: Blood glucose level has returned to normal after all the hormonal changes have balanced out.
• Impaired Glucose/Insulin Tolerance: This would require tight monitoring of blood glucose and also permanent changes to diet and lifestyle.
• Diabetic: May or may not require medication. Dietary and lifestyle changes are mandatory.

Treatment and Management of Gestational Diabetes

The treatment of gestational diabetes depends on the blood sugar levels of the whole day. Most of the time, doctors advise you to test your blood sugar before and after meals and to manage your blood sugar with diet and exercise.

It has been observed that non-invasive and natural techniques such as Yoga, Diet Management and Exercise have a positive effect on the overall well being of mother and baby.

On the other hand, some women may require oral medications or insulin support when lifestyle changes are not enough.

This is assessed after regular monitoring and observing elevated blood glucose levels even after 2 weeks of changes in diet. Oral medications and insulin usually come along with possible side effects.

Insulin Support to manage GDM

As per Mayo Clinic, about 10 to 20 percent of women with gestational diabetes require insulin to reduce the blood cholesterol level.

These women may need insulin till their delivery. Always ask your doctor about the timing of taking insulin to avoid lower blood sugar level as it may cause harm both for you and your baby.

He may advise you about how to handle the condition when your blood sugar level falls too much.

Natural Treatment | Ayurveda for Gestational Diabetes

Ayurveda for gestational diabetes management involves intervention with Aahara (diet), Vihaara (lifestyle) and Ayurvedic herbs.

A mother’s body undergoes various hormonal and physical changes that affect the mental state and put additional stress on the functions and organs.

Maternal stress can affect the development of the baby through transfer of stress hormones via placenta.

That’s why it is important to manage stress levels and help the expectant mother to relax and rejuvenate.

1. Pranayama (Breathing Exercises) for Pregnancy with Diabetes

Breathing, relaxation, and meditation have proven to be highly effective to reduce the complications that arise with diabetes and with hypertension during pregnancy.

Pranayama positively affects the brain by increasing the capability of our neural networks to reorganize and regenerate. This directly affects your memory, cognition and response to stressful situations.

Thus, regular practice of pranayama helps to significantly reduces stress.

• Breathing exercises such Pranayama involve controlled deep breathing to stretch the lung tissues and vagal nerve. 
• Pranayama increase the flow of oxygen to the body’s tissues.
• It also helps to reduce blood pressure, heart rate, metabolic rate, and hence the requirement of oxygen.

Women with gestational diabetes should practice these 2 pranayama on regular basis:

• Anulom-Vilom Pranayama
• Bhramari Pranayama

2. Ayurvedic Herbs for Gestational Diabetes

All the herbs and formulations that have been shared in this post are for information purpose only. All of these are potent Ayurvedic medicines that should be taken under the supervision of a qualified Ayurvedic doctor only. Do not indiscriminately use Ayurvedic herbs as it may cause more harm than benefit.

1. Gurmaar (Gymnema Sylvestre)

“The Sugar Killer”. It contains the gymnemic acid molecules which are anti-diabetic in nature. These prevent the glucose molecules from entering the bloodstream.

2. Karela

Karela (Bitter gourd) is also anti-diabetic. The micronutrients present in it reduces the complications arise due to gestational diabetes.

3. Tulsi

Tulsi is one of the holy plants in Hindu mythology which has excellent medicinal properties. It is really beneficial to boost immunity, to treat cough, cold and sore throat.

Tulsi is also helpful to manage blood glucose levels during pregnancy.

4. Turmeric powder

Take turmeric with aloe vera juice to control the initial stage of gestational diabetes.

5. Curry leaves

It is quite common in Indian kitchens. You can take 5-7 leaves regularly in empty stomach. It works well in reducing blood glucose levels.

6. Aloe Vera

Aloe can help manage your glucose levels normally. The gel from this plant controls glucose in the circulatory system. This helps to curb the food cravings and those of sugar in Diabetes mellitus.

Regular consumption of aloe can enhance your kidney and colon well being, two of the most affected organs by diabetes.

7. Methi | Fenugreek

Fenugreek is another Ayurvedic herb with multiple functionalities.

One of the most important of those is that it helps in managing blood sugar levels. The fiber present in methi forms a thick-gel layer in the intestine, thus preventing the absorption of sugar.

8. Giloy | Guduchi

It is a hypoglycemic agent.

• It helps burn off excess glucose and helps to decrease high blood sugar levels.
• Enhances insulin sensitivity

3. Your Diet | What should you eat if you have GDM?

Dietary intervention is absolutely essential to managing the blood sugar levels with or without additional treatment. One should be watchful of the quantity and quality of foods consumed to avoid large fluctuation in glucose levels in the blood.

Here you can find 7 Days of Gestational Diabetes Diet Plan, Best Foods and guidelines to manage your blood sugar with diet.

In a majority of the cases, complications of GDM can be avoided and GDM managed well by switching one’s diet. Here are some of the points to consider:

• Stop the consumption of simple carbohydrates such as processed and packaged foods, white carbohydrates such as white flour, white sugar, and white rice.
• Consume foods rich in complex carbohydrates such as brown, red, or black rice, millets, whole wheat flour, and tubers.
• Reduce the number of carbohydrates and replace them with proteins and healthy fats.
• Go for plant-based proteins such as peas, lentils, and beans whenever possible. Proteins will keep you full for long, hence help avoid low blood sugar episodes.
• Include probiotic foods such as fermented foods in your diet. This supports gut flora and helps to mitigate the effect of placental hormones in the body.
• Avoid big meals that are far apart. Instead, consume multiple small to moderate sized meals with healthy snacks such as sprouts, salads, nuts, and fruits in between.

4. Yoga for Gestational Diabetes

Yoga improves deeper awareness levels in the yogis. Thus, it helps the pregnant women with diabetes to accurately monitor her energy level, blood sugar level and appetite.

Benefits of Yoga for Pregnancy with Diabetes

These are essential components of yogic asanas, which help to support both body and mind.

• Mind and body practices help to relieve the physiological and mental stress that a mother undergoes during pregnancy.
• Additionally, yoga increases blood and hence oxygen circulation through the uterus, placenta, and through to the baby.
• Regular practice of yoga for women with gestational diabetes will help to regulate the blood sugar levels through a balancing effect on insulin.
• Some yoga asana can help to stimulate the pancreas and the liver, hence supporting insulin sensitivity in the pregnant women.
• Also, yoga helps to regulate the stress hormones, cortisol and adrenaline. Thus, it improves the emotional well being of the mother and stimulates relaxation response in the body.

How to Begin Yoga for Gestational Diabetes?

If you are new to yoga and struggled with conception or have had history of miscarriage in the past, then you should wait till the 2nd trimester to begin yoga.

However, if you have practiced yoga before or you have a risk free and symptom free (nausea and hypoglycemia) pregnancy, then you can begin. However, you should still consult your doctor before you start new practice or make any changes to your yoga routine.

Always follow the rhythms and needs of your body. And that’s the first step of developing self awareness that yoga practice teaches us to do.

Yoga Asana for Gestational Diabetes

Here are some yoga asana that are helpful for women with gestational diabetes:

• Child’s Pose
• Cow Pose
• Mountain Pose
• Standing Forward Bend
• Triangle Pose
• Extended Side Angle
• Warrior Pose 2
• Bharadvaja Twist
• Tree Pose
• Standing Twist

Before you Go!

Pregnancy with gestational diabetes is surely more complex. But you can definitely make it easier for yourself by making suitable changes in your diet and lifestyle. And as always, the key is to start early.

If you know that you are prone to gestational diabetes, then you should take care of your health before conceiving and carry on after delivery.

This way you can avoid the health risks in pregnancy and spend quality years with your child going forward.

So, start today! And do share with us in comments on how this post has helped you. Or if you would like more information. We will get back the soonest.

References

1. GESTATIONAL DIABETES MELLITUS; MANAGEMENT THROUGH AYURVEDA
2. Ayurvedic Management of Gestational Diabetes Mellitus – A Case Study
3. The effects of mindfulness eating and yoga exercise on blood sugar levels of pregnant women with gestational diabetes mellitus
4. GARBHINI MADHUMEHA AND ITS MANAGEMENT W.R.T GDM – A CONCEPTUAL STUDY, Dr. Manisha Gupta, Dr. Suman Kumari, Dr. Ramesh M,ISSN 2455-3301
5. Exercise guidelines for gestational diabetes mellitus
6. Systematic Review of Yoga for Pregnant Women: Current Status and Future Directions