Dietary management of Gestational diabetes

Gestational diabetes mellitus is a form of diabetes or carbohydrate intolerance that occurs during pregnancy, affecting between 5.2-8.8% Australian pregnant women.

An overview of this condition  is outlined in Overview of Gestational diabetes.

What happens when I am diagnosed with Gestational diabetes?

When you are first diagnosed with Gestational diabetes dietary therapy is usually considered to be your first line of treatment in tackling the disease. This means that eating the right diet is essential for optimal outcomes.

Your dietary goals include:

  • Gaining excellent control of your body’s blood glucose levels in accordance with guidelines.
  • Eat a well-balanced diabetic diet with carefully selected carbohydrate foods, that have a low glycaemic index.
  • Weigh yourself regularly and keep a record of it. You must be following the guidelines as discussed in the topic Weight gain.
  • Physical activity for at least 30 minutes every day will help burn off excess calories, control your blood sugar levels and prevent excessive weight gain. Activities safe include brisk walking, swimming and pilates.
  • See a dietician to help you make positive changes with your diet.

Why are carbohydrates so important?

Carbohydrates are an essential part of your diet as they are the key energy source for your body. However these foods must be carefully selected as the type, amount and frequency of carbohydrate consumption has major influence on your blood glucose levels.

Your daily carbohydrate intake should:

  • Make up 35-40% of your total daily calorie intake.
  • Be spread over the day into 3 main meals and 3 small snacks. This will help keep blood sugar levels steady and avoid fluctuations.
  • Main meals should comprise of 2-3 small carbohydrate serves, and snacks 1-2 small serves.
  • Choose low GI and low fat options.

The Glycaemic Index (GI) is a way of ranking foods that contain carbohydrates and how your body and blood sugar levels will respond. The lower the glycaemic index, the smaller the rise in your blood sugar levels resulting in a more sustained release of energy for your body and keeping you fuller for longer.

Gi

Low glycaemic index foods should be the preferred option in your diet. Ways you can achieve this include:

  • Do not overcook carbohydrate foods as this may increase the GI.
  • Avoid sugary soft-drinks that contain large amounts of sugar, and instead opt for freshly squeezed juice or sparkling water instead

gi food substitutions

Why are fats also important in my diet?

Fats affect our body’s ability to digest carbohydrates, as well as can raise the ‘bad cholesterol’ levels. Fats should be limited in your diet, and should include the good quality sources.

Suggestions for keeping fats to a minimum in your diet include:

  • Lower your intake of saturated fat by avoiding untrimmed meats, chops and sausages, butter, and full-fat dairy products.
  • ‘Reduce the spread on bread’ – Use a light margarine on sandwiches instead of butter.
  • Use less fat in cooking using fresh ingredients such as herbs and spices to flavour foods, and use sunflower or canola oil instead that contain the good fats.
  • Choose low-fat dairy products. Look at the label and choose milk, cheese and yoghurt with less than 10% fat content.
  • Trim off any of the animal fat before cooking and choose lean meat varieties.
  • Avoid creamy sauces or dressings. Use instead reduced-fat dressings or no-oil mayonnaise.

In order to assess your diabetic control you will be required to do your own blood sugar monitoring at home. Levels must be taken first thing in the morning for a fasting level, and 2 hours after each main meal for a post-prandial level. National targets specified for Gestational diabetes are a fasting blood sugar level of less than 5.5 and 2 hour post-prandial level of less than 7.0. If your blood glucose levels exceed recommendations on at least 2 occasions within 1-2 week interval then insulin therapy will be necessary.

Your doctor should also refer you to a dietitian who can provide you with an individual eating plan. This will also ensure that you aren’t restricting yourself of too many calories that can cause your body to go into ‘starvation mode’ which has significant health effects, as well as reducing the supply of glucose to the baby which can have detrimental effects on its growth and neurological development. Studies have also shown that women on very strict diets are more likely to be non-compliant with them and have much greater and frequent cravings for sweet foods due to feelings of deprivation.

Having Gestational diabetes does mean changes to your diet. One of the great motivating factors however is that if you follow the guideline and have great glucose levels, insulin therapy and the daily injections it involves can be avoided!

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