As we all know that pregnancy is a time of expectations as well as a time of concerns, worries and anxiety. In this period, there exists a high chance of worsening of the existing health problems and appearance of new ailments. GDM or Gestational Diabetes Mellitus is one such common medical complication associated with pregnancy. The irony is that this condition is simply preventable in most cases. An exclusive care by Ayurveda before conceiving, during pregnancy and after delivery can make a big difference. Ayurveda has specific references on regimens to follow during menstrual period, pregnancy, after delivery and during motherhood. 

To quote: 

"strī hi mūlamapathyānāṃ....strīḥ rakṣati rakṣitaḥ"

'Preserving the health of women preserves the health of the progeny'.

How can Diabetes during Pregnancy be Prevented?

It is possible to lower the risk of developing gestational diabetes through healthy diet and other lifestyle modifications before conception. It is advisable to take the advise of an Ayurveda specialist. The branch of Ayurveda that exclusively deals with gynecology and obstetrics is called Prasūti tantra and Strīroga which is a post graduate course in Ayurveda curriculum. An expert in this field can consult a couple and evaluate them to chart out customized diet and lifestyle regimen much before conception. This will improve the chances for an enjoyable and 'event-free' birthing experience. Controlling mother’s body weight before pregnancy through a variety of exercises and healthy dieting techniques is highly recommended. There are specialized Ayurveda formulations advised for this. 

Screening for diabetes and high-risk cases is a part of antenatal care today. Components of ayurvedic prenatal care includes diet (āhāra), lifestyle (vihāra) and medicines (auṣadha). Month-wise milk decotions and other dietetics are mentioned for antenatal care.  There is a wonderful analogy in Ayurveda regarding pregnancy which goes like this: 

“pūrṇamiva tailapātram-asaṃkṣobhayad-garbhiṇīm-upācarediti”

'A pregnant lady should be handled carefully as (carrying) an oil-pot filled up to its brim.'

People in Kerala are quite acquainted with ayurvedic post-partum care. Emphasis is given to consume post-natal ayurvedic medicines only under medical supervision. Medicines given to those with gestational diabetes, PCOD or such other complications, are different from those given to others. 

Unfortunately, there are plenty of 'grandmothers' and 'midwifes' around, who claim to have performed a lot of deliveries. They might have actually gotten lucky most of the times. But many of them are not professionally trained to identify or manage potential complications. Many a time, such interventions done without an Ayurveda doctor's advice may worsen the existing condition and predisposes to develop type 2 diabetes in the nearby future. 

Most often, diabetes during pregnancy may resolve after delivery. But it may  not for those who were already diabetic. It is not a reason for unwarranted worry, even if a  carrying mother is diagnosed with diabetes. With the right diet and lifestyle plant, coupled with diligent fetal monitoring, a healthy pregnancy, labor and baby can be expected.

Methods to follow to prevent Diabetes during Pregnancy:

1. Healthy diet:  During pregnancy it is common to hear that since there are now two of you, you should be eating for the two. Doing this will result in un-necessary weight gain, which may predisposes to diabetes and other complications. Instead we should focus on the quality of our diet which should be balanced and healthy.

The following are advised by Ayurveda to be included in the diet of a diabetic:

Barley
Green gram
Gooseberry
Jamun
Bamboo rice (mulayari)
Thriphala (A combination of Indian gooseberry, Chebulic myrobalan and Belleric myrobalan)
Corn flour
Bitter green leafy vegetables
Pure honey

• Apart from this, Ayurveda has a special dietetics plan for both husband and wife for getting healthy offspring.
• Eating smaller fractions of meals more frequently helps to keep sugar level stable. Add small portions of snacks in between the major meals.  Never skip any meals, especially breakfast.
• Fruits can also be added to the diet even if diabetic, but don’t take in excess amount. Whole fruits are high in fiber preferred over juices or canned fruits packed in sugar.
• Add raw veggies or salad or steamed vegetables or green leafy vegetables in the diet. Try to eat a variety of vegetables daily as salads, vegetable juices etc.
• Add vegetable soups as a mid-evening snack.
• Take 2 fruits daily (but avoid high sugary fruits).
• Brown rice, whole wheat and oats can be included in the diet. 

Avoid 

• Cutting down sugary foods should be a priority.
• Avoid sodas, cool drinks, alcoholic beverages and sweetened juices which have little nutritional value and are chock-full of sugar. 
• High carbohydrate foods like bread, pizza, and bagels, 
• Avoid fast food, junk foods, fried food, baked goods, such as muffins, donuts or cakes,  processed and packed foods,  desserts, artificial sweeteners. 
• Candy and sweets.
• Very starchy foods, such as white potatoes and white rice. 
• Limit oil intake. (500ml/month).
• Avoid fish that are high in mercury and red meat.
• Refined foods, like white bread, cheese, and butter because of their high glycemic index (GI).

So the motto is ‘Eat smart, today for a healthy baby tomorrow’! 

2. Regular exercise:  It has a variety of physical and mental benefits. However, it is better to refrain from strenuous physical activities as it may cause harm to the baby. Regular exercise helps the body prepare for pregnancy and helps stabilize the sugar levels, blood pressure and metabolic rate. It also helps improve and maintain cardiovascular function. Yoga, meditation, aerobics, walking etc. are excellent options. It is mandatory to ask your doctor before starting any new exercises. Under some circumstances, the doctors do advise complete bed rest. Yoga and aerobics have certain special exercises, which are beneficial for the fetus and the baby. But it must be practiced under the expert supervision of fitness experts. Mother can start walking and other post-partum exercises at the right time after delivery as advised by healthcare professionals. 
3. Try and keep the body weight optimal. Don’t try to lose weight during pregnancy through strict dietary regulations. Even a few kilos can make a difference in the risk level for gestational diabetes. Weight reduction should be done under strict supervision of Ayurveda physician.
4. Other Life style recommendations:

• Sleep and diabetes is often found related. Ensure adequate comfortable night sleep. At the same time, it is better to avoid day sleep unless it is summer season, which is explained as the root cause for many metabolic disorders according to Ayurveda.
• Water intake- Water aids with better management of the blood sugar levels. Reduction of water intake leads to higher concentration of sugar in the blood stream.
• Avoid stress as production of stress hormones drives blood sugar level up. 
• Avoid alcohol and smoking because it may interfere with insulin resistance. 
• It is natural to have a rise of metabolic components that are akin to diabetes in a mother's body- factors like, kapha (the bio-energy of cohesion), medas (body fat), kleda (excessive water).  These are essential to maintain normalcy in the uterus and also for the production of breast milk. Therefore, delivery and breastfeeding results in natural reduction of these factors which can bring down gestational diabetes. 

Another point to keep in mind is that the baby of a mother with diabetes may be overweight and is prone to develop diabetes later on in life. So special care has to be implemented to prevent this. They have to be taught to always eat healthy and be active.

In short, GDM is not a threat. With proper precautions and Ayurveda care, it can be prevented or managed well. Kids are the promises of tomorrow. Let us promise to keep us healthy to keep that promise.