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1Dec/092

Sample Diet for Gestational Diabetes

What is it? Gestational (jes-ta-shun-ull) diabetes is when your blood sugar (glucose) is too high while you are pregnant. Gestational diabetes often goes away after the baby is born. But, you may get diabetes later if you have diabetes during pregnancy.

  • In diabetes, your body does not make enough insulin or the insulin it makes does not work right. This causes your blood sugar levels to be too high. This can be harmful to you and your unborn child. Controlling your blood sugar is important for the health of your unborn baby.

  • The carbohydrates (kar-bo-hi-drates) in your food become glucose in your body. Glucose is a major energy source for your body. Carbohydrates come from starchy foods such as breads, pasta, potatoes, rice, and other grains. Carbohydrates are also found in fruits, dairy foods, vegetables, sugar, and sweets.

  • You need to eat the right amount of carbohydrates, protein, and fat while you are pregnant. This requires more planning if you are taking insulin to control your blood sugar while you are pregnant.

What is carbohydrate counting? Carbohydrate counting means keeping track of the amount of carbohydrates you eat every day. You should eat the same amount of carbohydrates at the same times each day. This will help keep your blood sugar within the normal range.

  • One serving of a carbohydrate food contains 12 to 15 grams of carbohydrate. A serving is equal to one of the portions listed below. You can exchange or trade one carbohydrate food for another from the same food group. For example, you can choose 1 slice of bread instead of 1/2 cup cooked cereal.

  • Vegetables contain only 5 grams of carbohydrate per serving. Do not count vegetables as carbohydrates unless you eat more than 2 servings per meal. Meat, meat substitutes, and fats are not counted as carbohydrates.

Care:

Calorie Intake:

  • Most pregnant women need about 300 extra calories per day in the second and third trimesters to gain enough weight. This equals about 16 to 17 calories per pound of ideal body weight.

  • An extra 10 to 12 grams of protein per day is also needed to help your baby grow normally. It is also helpful to get 45 to 60% of your calories from carbohydrates, 15 to 25% from protein, and 20 to 30% from fat.

Eating Plans:

  • Your dietitian (di-uh-tih-shun) will show you how to meet the guidelines above. You may use the sample menu below or the Diabetes Meal Planning Guide to do this. Ask for the CareNotes?handout about the diabetic exchange diet to find the serving sizes of foods not on the lists below.

  • Some people with gestational diabetes can control their blood sugar with diet alone. They do this by eating 3 meals and 1 to 3 snacks each day.

  • You will need a snack at bedtime to prevent your blood sugar levels from being too low overnight. Your dietitian will tell you if you need snacks in the morning or afternoon.

  • Eat at the same times each day, whenever possible, and never skip meals or snacks. Spread your food out evenly over the day so that you eat about every 2 to 3 hours. Eat only the amount that is on the food list. Or the amount your dietitian tells you to eat for each type of carbohydrate food.

  • Avoid foods and beverages with added sugar, corn syrup, honey, molasses, or maple syrup, or jams and jellies.

  • Read the labels of packaged foods to find the grams of carbohydrate a serving has in it.

Other Factors:

  • Choosing high fiber foods will help control your blood sugar and have regular bowel movements. High fiber foods are fresh fruits and vegetables, whole grain breads, cooked dried beans, and bran cereals.

  • Check with your doctor before exercising during pregnancy. Tell your dietitian about your exercise plan so your diet can be changed if needed. You may need extra carbohydrates before exercise to keep your blood sugar from dropping too low.

  • Talk with your caregiver if your blood sugar levels are too low or too high. Make sure your cholesterol and other blood lipids (fats) are checked at least once a year. You may need to follow a lowfat diet if they are too high.

Serving Sizes: Use the list below to measure foods and serving sizes. A serving size means the size of food after it is cooked or prepared.

  • 1 pint or 2 cups (16 fluid ounces) of liquid is the size of 1-1/3 soda-pop cans.

  • 1-1/2 cup (12 fluid ounces) of liquid is the size of a soda-pop can.

  • 1 cup of food is the size of a large handful, or 8 fluid ounces of liquid.

  • ?cup of food is about half of a large handful, or 4 fluid ounces of liquid.

  • 2 tablespoons (Tbsp) is about the size of a large walnut.

  • 1 tablespoon (Tbsp) is about the size of the tip of your thumb (from the last crease).

  • 1 teaspoon (tsp) is about the size of the tip of your little finger (from the last crease).

  • 3 ounces of cooked meat, fish, or poultry is about the size of a deck of cards.

  • 1 ounce of cooked meat, fish, or poultry is about ?cup.

  • One ounce of hard cheese is about a 1 inch cube.

  • A serving of vegetables is ?cup (1/2 handful) cooked, or 1 cup (1 handful) raw.

Goals for Blood Glucose Control

During pregnancy, it is critical to maintain healthy blood sugar levels throughout the day and evening. Screening for gestational diabetes is typically conducted between the 24th and 28th week of pregnancy. A fasting glucose needs to be less than 95 milligrams/deciliter, and a two-hour postprandial (after meal) reading needs to be less than 120 milligrams/deciliter. Healthy eating habits and smart food choices are essential to meeting these goals.

Basics of Sample Diet for Gestational Diabetes

The goal is to provide the pregnant woman with adequate energy, commonly known as calories, to ensure nutritional adequacy and appropriate weight gain to support the mother’s body and the needs of the growing baby while also maintaining blood glucose levels. While calorie needs are highly individualized, the average women with an appropriate weight prior to conception needs an additional 300 calories during the second and third trimester. As with any pregnancy, these additional calories need to contain quality nutrition loaded with essential vitamins and minerals to support a healthy pregnancy and outcome. Also, protein requirements are increased by an extra 10 grams per day above the Recommended Dietary Allowance (RDA) of 0.8 grams per kilogram of body weight.

Meal planning should center on eating several small meals throughout the day. Small, frequent meals support the stabilization of healthy blood sugars much better than one or two large meals. The sample diet for gestational diabetes offered here follows this guideline. Food combining to ensure that carbohydrates are not ingested alone is also important.

Sample Diet 1

Breakfast

  • 2 slices whole grain toast
  • 2 tablespoons of peanut butter
  • ½ cup of 100% juice

Mid-morning Snack

  • 1 apple
  • 1 cup cottage cheese

Lunch

  • 1 cup of lentil soup (or other bean soup)
  • 1 serving of whole grain crackers
  • 2 ounces of low fat cheese
  • 1 cup baby carrots

Mid-afternoon Snack

  • 20 raw almonds
  • 1 cup grapes

Dinner

  • 6 ounces of fish of choice
  • 1 cup steamed broccoli
  • 1 cup brown rice
  • 1 cup reduced-fat milk

Evening Snack

  • 5 cups air-popped popcorn (plain)

Sample Diet 2

Breakfast

  • 2 egg whites, scrambled
  • 1 whole egg, scrambled
  • 1 whole wheat English muffin
  • 1 teaspoon butter or margarine
  • 1 slice of melon

Mid-morning

  • 6 ounces yogurt
  • 1/4 cup of low fat granola

Lunch

  • 2 slices whole grain bread
  • 2 ounces sliced turkey or chicken (low-sodium)
  • 1 slice of cheese
  • lettuce leaves
  • tomato slices
  • 1 tablespoon of mustard or mayonnaise
  • 1 apple
  • 1 cup reduced fat milk

Mid-afternoon Snack

  • ¼ cup hummus
  • 1 cup of raw vegetables of choice

Dinner

  • 5 ounces grilled chicken breast
  • 1 cup steamed carrots (or vegetable of choice)
  • 1 small baked sweet potato
  • 2 tablespoons of sour cream

Evening Snack

  • Small smoothie made with:
  • 1 cup reduced-fat milk
  • ½ cup strawberries
  • crushed ice

Additional Recommendations

A suitable sample diet for gestational diabetes also includes plenty of fluid intake throughout the day. While fruit and vegetable juice is acceptable, it is best not to drink these alone, but rather enjoy small amounts at a time with meals and snacks. Water is the best option as it contains no sugar to counteract the goals for keeping glucose amounts intact. A snack before bed is suggested as a way to decrease the chances of an overnight hypoglycemic episode. For those women that wake up with high blood glucose readings, it may be mandatory to reduce the amount of carbohydrate eaten at the breakfast meal.

For those women who require insulin to treat their gestational diabetes, the quantity and frequency of carbohydrate needs to be matched to the insulin requirements accordingly. In all cases, simple sugars such as white table sugar, honey, jams, maple syrup, candy, non-diet soft drinks, and the like should be omitted entirely from the diet.

Exercise is a key component to assisting insulin function. Be sure to discuss this option, and diet regimes, with your obstetrician before beginning any specific plan.

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