PCOS and Pregnancy: Preventing Gestational Diabetes

Pregnancy is an exciting time, especially because so many women with PCOS have been trying to conceive for years. Having PCOS and being pregnant, however, poses additional risks for women with the syndrome, especially for developing gestational diabetes mellitus (GDM), a condition of high glucose levels during pregnancy. Women with PCOS have an increased risk of developing GDM, regardless if they are overweight or not. Insulin levels significantly increase in the second and third trimesters of pregnancy as a normal part of pregnancy; the majority of women with PCOS already have high insulin levels.

You are at high risk for gestational diabetes if you:

  • Have PCOS
  • Are obese
  • Have previously given birth to a large baby (nine pounds or greater)
  • Have had gestational diabetes with a past pregnancy
  • Have glycosuria (sugar in your urine) before or during pregnancy
  • Have a strong family history of diabetes
  • Are of older maternal age
  • Experience excessive weight gain during pregnancy

If not well managed, GDM can cause significant problems during pregnancy and labor for mom and baby. The good news is that diet and exercise modifications can help to prevent GDM. Here are some of the most effective ways to reduce your chances of developing GDM during your pregnancy.

Screen Early in Pregnancy

After you find out you’re pregnant, glucose testing should be done as soon as possible to screen for GDM. If the results are normal, testing should be repeated by the standard screening time for all pregnant women, between 24 and 28 weeks gestation. While early testing won’t prevent GDM, interventions to maintain proper blood glucose levels that are started early on, will help to optimize pregnancy outcomes.

Limit Sweets and Refined Carbs

Since high sugar and refined carbs dramatically increase glucose and insulin levels, they are best to be limited during pregnancy. This includes juice, regular soda, white bread, sugary cereals, pastries and baked goods.

Increase Fiber

Be sure to include fiber in your meals. This can be from fruits, vegetables, beans, lentils, and whole-grains. One large study looked at the diets of women before they got pregnant. Every 10 gram daily increase in fiber reduced their risk of GDM by 26%.

Seek Nutrition Counseling

All women with GDM should receive nutritional counseling from a registered dietitian nutritionist (RDN) such at the ones at the PCOS Nutrition Center. An RDN can tell you which foods to eat and which to avoid and can tell you about ideal portions and meal timing to optimize glucose levels and to support a healthy pregnancy. Dieting is never recommended during pregnancy.

Exercise Regularly

Engaging in consistent, moderate-intensity physical activity may improve insulin resistance by lowering blood sugar levels, and aid in weight management in pregnancy. In one study, researchers found that women who were physically active before and during their pregnancy reduced their risk of GDM by about 70% or even more. The women got about 4 hours a week of physical activity. Walking and swimming are great, low impact exercises to do during pregnancy.

Take Myo Inositol

It has been shown that myo-inositol (MYO) can reduce the risk of GDM in pregnancy in women with PCOS. One study showed the prevalence of GDM in the MYO group was 17.4% compared with 54% in the control group. More studies are needed to show the benefits and risks of taking MYO in pregnancy. MYO could cause low blood sugar and should only be used in pregnancy under the care of a physician.

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  • Sarah

    April 19, 2014 at 3:13 pm

    What a great site, and a good article. These are all excellent tips but I would strongly encourage women with PCOS to ALSO discuss the risks and benefits of using Metformin while TTC and during pregnancy with their doctor. Some women cannot excercise during pregnancy due to activity restrictions to prevent preterm labor. Many women are not comfortable taking supplements which have not been thoroughly studied in pregnancy. Metformin on the other hand has been studied in pregnancy with some greatly improved outcomes for women with PCOS. Women with PCOS are highly susceptible to miscarriage and Metformin can help them carry a pregnancy to term AND avoid gestational diabetes. I had 11 miscarriages before I tried metformin. The first fertility treatment cycle on it (after many ending in loss) I conceived my daughter and carried her to full term (one other difference- I also took HGH injections prescribed by my physician for about a week prior to and during ovulation to improve egg quality and reduce miscarriage rate). My daughter was born full term (I was on modified bed rest due to previous 2T losses) at a healthy weight and I did not get GD, despite many risk factors of PCOS, age, obesity.

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