Eating Well With Gestational Diabetes

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Eating Well with Gestational Diabetes 

Guest post by Melissa Gosser, RD

Melissa is a registered dietitian, mommy to two beautiful girls and the woman behind Fit Fab Mommy

eating well with gestational diabetesGestational diabetes is a type of diabetes that women get while pregnant (during gestation).  In simple terms, diabetes occurs when you have high levels of sugar (glucose) in your blood, either because your pancreas doesn’t produce enough insulin or can’t use it properly, therefore sugar remains in your blood stream instead of moving into cells or converting to energy, as it should. While some women are considered higher risk for gestational diabetes, anyone can get it.  Hormonal changes during pregnancy can make a mother insulin resistant, which means your body is not able to make enough insulin or use it efficiently, causing glucose to build up in the blood (also known as hyperglycemia).  While most women with gestational diabetes don’t remain diabetic once the baby is born they are at higher risk of developing it in subsequent pregnancies and becoming diabetic later in life.

Expectant mothers are screened for gestational diabetes around 24-28 weeks (or sooner if you are considered high risk for diabetes) with a glucose-screening test.  This is that sickeningly sweet drink you have to chug down in five minutes (hopefully the morning sickness has subsided by now) that can identify if you have a problem.  If you test positive it doesn’t necessarily mean you have gestational diabetes (it is just a screening test, not a diagnostic test), it means you need to take another test called the glucose tolerance test, which is much longer (3 hours) and will diagnose if you in fact have gestational diabetes.  You are considered high risk for gestational diabetes if you are obese, had gestational diabetes with a previous pregnancy, have sugar in your urine, or have a strong family history of diabetes and will be tested early on.  However, some women don’t have any of these risk factors and still may develop gestational diabetes, this is why it is important that all pregnant women get tested.

If you test positive for gestational diabetes, don’t panic.  Most women with gestational diabetes have perfectly, healthy babies.  However, you must take action immediately to control your gestational diabetes as it can have serious short and long-term effects for both you and your baby.  If uncontrolled, complications for the fetus and baby may include: birth defects (digestive tract, brain and spine abnormalities, heart and connecting blood vessels), stillbirth, macrosomia (a baby that is considerably larger than normal), birth injury (due to large size of baby), hypoglycemia (low blood sugar in the baby upon delivery), or difficulty breathing.   For a mother with uncontrolled gestational diabetes, complications may include: early delivery, preeclampsia (high blood pressure with possible protein in the urine, or liver or kidney abnormalities), C-section, and having a large baby, which can lead to delivery complications.

By following a healthy meal plan, getting regular physical activity and keeping track of blood glucose levels most women with gestational diabetes can control their blood sugar levels.  However, some women may also need insulin to keep blood glucose levels under control. Below are some general guidelines to follow as preventative measures for gestational diabetes.  They are also good guidelines to follow if you do in fact have gestational diabetes, however everyone is different so it is important to meet with a healthcare provider to come up with a plan that is best for you.

Make healthy food choices:

  • Carbohydrates are one of the three main energy sources in food; the other two are protein and fat.
  • Carbs include: Starchy vegetables (corn, peas, potatoes, winter squash, sweet potatoes), sugars, fruits, milk, yogurt, grains (pasta, bread, cereal), sweets (candy, cookies, cakes, ice cream etc.), snacks (popcorn, chips, pretzels, rice cakes, etc.).
  • Don’t skip meals and definitely don’t eliminate carbs all together. Carbs are our bodies’ main source of energy and are important in making our body function properly.
  • Make your carbs count. “Healthy” carbs are carbs that are unrefined, which means they haven’t been processed so they are full of nutrition.  Unrefined carbs contain fiber, which does not raise blood glucose levels because it is not broken down by the body.  So eating an apple or a slice of whole grain bread, while they still contain carbohydrates, are better for you than say refined or processed carbs (such as candy, white breads and pastas) because they contain fiber.  So eat more unrefined carb products (whole grain, fruit) instead of refined or processed carbs.
  • Balance your meals by including a healthy carb (whole grain, fruit), lean protein (lean chicken, fish, meat) and/or healthy fat (olive oil, avocado, almonds, walnuts) in each meal.
  • Eat regularly and space out your carbs evenly throughout the day to help maintain better glucose control. Think 3 meals and 2 snacks spaced out every three to four hours.
  • For breakfast, especially if you are a cereal eater, remember both the cereal and milk count as carbs. You need to add a protein or healthy fat.  Mix and match from the list below.  Pick one carb and one protein:

 

CARBOHYDRATE PROTEIN
Cereal & Milk Eggs (hardboiled or scrambled)
Oatmeal 0% Fat Greek Yogurt
1 slice whole grain toast Almonds & Walnuts
High Protein Waffle Peanut Butter
Fruit Cream Cheese

 

  • For snacks always combine a carb with a protein or healthy fat. Some examples of good snacks include:
    • A piece of fruit (apple, pear, orange) with low-fat string cheese
    • A piece of fruit with nuts (almonds, peanuts, walnuts)
    • A piece of fruit with peanut butter
    • Hummus with raw vegetables (celery, carrots, cucumber)
    • Hummus with whole grain pita
    • Greek yogurt with berries
  • For lunch and dinner, have equal portions carb (grain, bread or starchy vegetable) and protein (meat, chicken, fish) and as many non-starchy vegetables as you want (salad, dark green leafy veggies, etc.)
  • Pay attention to portion size.

Blood Glucose

The American Diabetes Association suggests the following targets for women who develop gestational diabetes during pregnancy.

  • Before a meal (pre-prandial): 95 mg/dl or less
  • 1-hour after a meal (postprandial): 140 mg/dl or less
  • 2-hours after a meal (postprandial): 120 mg/dl or less

For more information on gestational diabetes visit the American Diabetes Association.

 

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