Gestational Diabetes – 3 Common Diet Mistakes


Today’s guest post “Gestational Diabetes – 3 Common Diet Mistakes” is written by registered dietitian and gestational diabetes expert Lily Nichols

gestational diabetesWhen the doctor said “You have gestational diabetes,” you practically broke down. You thought it couldn’t happen to you and now you’re completely overwhelmed trying to figure out how to manage it. Maybe you were given a glucose meter to check your blood sugar and you’re afraid of poking your finger. Maybe you were told your baby will come out big if you don’t change your diet. Most of all, you’re terrified that you might need insulin.

For some women, changing their diet and exercise is all that’s needed to lower blood sugar. Actually, diet and exercise are the primary treatments for gestational diabetes. That means there is a chance you won’t need medicine or insulin. Only your medical provider can make that call.

As a perinatal dietitian and diabetes educator for women with gestational diabetes, I’ve heard all of these concerns and more. The women in our OB/GYN office are lucky, because they get a full hour-long class with me to learn the ins and outs of eating to manage gestational diabetes. Plus, I continue to see them throughout their pregnancy, because what worked at 24 weeks might not work at week 36.

Those first few days (or weeks) after diagnosis and before they see me are rough. Most ladies end up starving themselves in an attempt to control their blood sugar because they don’t know any other way.

Luckily, there’s another way. Here are the 3 most common diet mistakes women make before they come to my gestational diabetes class:

Mistake #1 – Eating Low Fat

We’ve been told for so long that “fat will make us fat” or “low fat diets are healthy,” so it seems like reducing fat intake would be a good thing. The problem is, when you take the fat out of food, it tastes like cardboard, so food companies usually add other ingredients to the products to make them more palatable. Often, this means adding more sugar. And what does sugar do? It raises your blood sugar. So if you’re eating low-fat cookies thinking it will help your blood sugar, it might be doing the opposite.

Fat keeps you full for a long time and does not raise the blood sugar, meaning you don’t get hungry as often. If you’re struggling to wait the 1 to 2 hours after a meal to check your blood sugar, what you’re eating is not keeping you full for long enough. If you give in and eat more food during those 1 to 2 hours, your glucose readings will be inaccurate. And if you try to fill up on more carbohydrates (such as cereal, bread, pasta, potatoes, fruit or milk), your blood sugar will go up too much and you’ll get hungry quickly. On the other hand, if you eat slightly less carbohydrates and combine it with some fat (think bread + peanut butter, crackers + cheese or corn chips + guacamole), you’ll stay full longer and your blood sugar will likely come out at a normal level. Give it a try.

Mistake #2 – Starving Yourself

It would seem that not eating would help prevent blood sugar from going up, and that’s true. But, it could leave you with low blood sugar and may deprive the baby of necessary nutrients. Plus, women who ignore their hunger cues are more likely to ignore their fullness cues. In other words, you’ll binge later if you starve yourself now. Instead of going without, plan small snacks into your day. Small amounts of food will only raise the blood sugar a small amount, enough to give you and the baby energy, but not too much to make your doctor worried. If you skip snacks, you’ll eat a lot at your next meal and big meals often mean high blood sugar. Think of feeding yourself just like you would feed a baby – small amounts spread throughout the day.

If your snacks or meals are not keeping you full for long, you might not be getting enough protein. A piece of fruit by itself won’t keep you full for long, and neither will a small handful of crackers. Just like fat, protein keeps you full for much longer than carbohydrates and doesn’t make your blood sugar go up. Aim for 7-15 grams of protein at each snack. Consider trying greek yogurt, which has double or triple the protein of regular yogurt and less carbohydrates. Other options would be: hard boiled egg, string cheese, cottage cheese, nuts (any kind), peanut butter, beef jerky, and cooked chicken or meat.

Also, non-starchy vegetables (anything other than potatoes, sweet potatoes, corn, peas and winter squash) can help fill you up without spiking your blood sugar and will give additional beneficial nutrients to the baby, like folate and vitamin C. We all know we need to eat more vegetables.

Mistake #3  – Not Checking Your Blood Sugar

Maybe you’re afraid of poking yourself, you think it will hurt, or you’re nervous about seeing a high number. These are all normal concerns that should be shared with your healthcare team. If you ignore or “conveniently forget” to check your blood sugar too often, your doctor will have no way of knowing how you are doing. It’s especially important to check your first morning blood sugar, also called your fasting blood sugar. This is an indication of your baseline blood sugar without food in your body and helps give insight into what your blood sugar levels are like overnight, which when you think about it, is almost half of the hours in a day.

If your fasting blood sugar is high (typically anything above 90 or 95 mg/dl), that means baby may have been exposed to high blood sugar all night long, which can make the baby grow too big or lead to other complications at birth and beyond. Babies of moms who have poorly controlled diabetes during pregnancy are more likely to become overweight, obese or diabetic in their lifetime. That is not fate or destiny. It is within your control to give your child the healthiest start in life and it begins with monitoring your blood sugar now. Numbers are not good or bad and they say nothing about you or your self-worth. Blood sugar readings are simply information that your doctor uses to make decisions about how to best care for you and your baby. Think of it like the speedometer on your car or the thermostat in your house. I suggest keeping your meter at your bedside next to your alarm, so you see it right when you wake up as a reminder.

For many women, having gestational diabetes is an incredibly positive experience. It’s a chance to focus on making good food choices to grow a healthy baby. If you want to learn more about managing gestational diabetes through diet, feel free to contact me. I work one-on-one with a limited number of highly motivated expecting moms via phone or Skype.

Contact Fit for Expecting to get started with an exercise program to help manage your gestational diabetes.

About the author: Lily Nichols – RD, CLT is a registered dietitian, nutrition consultant, and certified pilates instructor. A foodie at heart, she teaches her clients how to reconnect with food, so healthy eating becomes mindful and satisfying, not forced. Her private practice, Nichols Nutrition , focuses on integrative whole-food nutrition, food sensitivities, and prenatal nutrition. An expert in gestational diabetes, Lily has consulted for the California Diabetes and Pregnancy Program: Sweet Success, helping to revise their Guidelines for Care. She is a frequent speaker at professional conferences on prenatal nutrition.  For free tips on healthy eating, be sure to sign up for her weekly email updates.

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