Gestational Diabetes and Good Diet

What is Gestational Diabetes or Pregnancy Diabetes?

A pregnancy condition; gestational diabetes (GDM), also sometimes called Pregnancy Diabetes, occurs when pregnant women who have never been diagnosed with diabetes experience chronic hyperglycaemia. Hyperglycaemia is the technical term for high blood glucose and Chronic means persisting over a period of time. High blood glucose occurs when the body has too little insulin (a hormone used to control blood sugar) or when the body can’t use insulin properly.

Gestational diabetes is diagnosed during pregnancy when your body cannot cope with the extra demand for insulin production resulting in high blood glucose levels. GDM generally happens between the 24th and 32nd week of pregnancy, and mainly goes away after the birth of the baby. However, having GDM in your pregnancy raises your risk of developing type 2 diabetes later in life and may have an impact on your baby’s health. Managing your blood glucose levels will reduce the risk of complications in your pregnancy and in your birth. Around 7-10 % of the pregnancies worldwide are affected by gestational diabetes.

Gestational Diabetes Mellitus (GDM) Causes

When your body can’t create enough insulin while you’re pregnant, you can be diagnosed with gestational diabetes. Insulin- a hormone produced by the pancreas- functions as a key to allow blood sugar to enter your body’s cells for use as fuel. Your body produces more hormones during pregnancy, and combines with other changes like weight gain can lead to GDM.

Moreover, insulin resistance can often be an issue. Insulin resistance is a condition where your body’s cells use insulin less efficiently, and coupled with the fact that in pregnancy the body requires more insulin it can be a very difficult time for your body to try and regulate your blood glucose levels. In late pregnancy, insulin resistance is a common occurrence in pregnant women. Some females already have insulin resistance prior to conception and they require more insulin at the beginning of pregnancy and are more likely to develop gestational diabetes.

Signs of Gestational Diabetes

The signs of gestational diabetes in women are typically nonexistent or can be mistaken for those of normal pregnancy. Most people learn they have GDM when they have a standard examination. Some common gestational diabetes symptoms are;

Glucose Tolerance Test
  • Polydipsia – You have more thirst than normal.
  • Polyphagia – You eat more than normal
  • Polyuria – You urinate more than usual.
  • Tiredness
  • Nausea
  • Blurred vision
  • Frequent bladder infections

Risk Factors of Gestational Diabetes

Some clinical risk factors for gestational diabetes have been documented. Look out for these factors;

  • Body mass index greater than 25 kg/m2 before pregnancy
  • Decreased physical activity
  • Close relative suffering from diabetes
  • Prior history of gestational diabetes
  • Macrosomia in a newborn (weighing more than 9 lb)
  • Metabolic co-morbidities, such hypertension
  • Women over the age of 25
  • Lower levels of HDL (Good Cholesterol)
  • Women suffering from Polycystic Ovarian Syndrome (PCOS)
  • Haemoglobin A1C test- values greater than 5.7%
  • Abnormal fasting blood glucose and oral glucose tolerance test (GTT)

Gestational Diabetes Treatment

Your body’s reaction to a metered dose of sugar is measured by the glucose tolerance test (GTT), often known as the oral glucose tolerance test. At your first antenatal checkup, which usually occurs between weeks 8 and 12 of pregnancy, your doctor will note any risk factors of developing gestational diabetes and recommend the glucose tolerance test.

Your blood glucose levels will determine how you are treated for gestational diabetes. If the condition is not controllable through dietary measures and exercise, you might occasionally need to take an oral drug or an injection of insulin to reduce your blood glucose levels within the normal range.

Treatment for Gestational Diabetes

  • Diet Modifications: Guidelines for Gestational Diabetes diet provided by American Dietary Associations (ADA) suggests that a registered dietitian must provide dietary advice and create a customised plan depending on the patient’s BMI. The three main nutritional concepts; calorie distribution, carbohydrate intake and essential nutrients intake, must all be taken into consideration when making recommendations.
  • Physical Activity: Being physically active can help you control your blood sugar. Maintaining a healthy weight is also beneficial for posture and can help with everyday issues like fatigue and backaches. See your medical professional or exercise specialist to discuss this further.
  • Pharmacological Treatment: It is advised to start pharmacologic treatment if the patient’s glycemic control is insufficient despite their best efforts to adhere to a healthy diet and exercise routine. There are medications that are safe to be used by pregnant women with gestational diabetes.
  • Insulin: When optimal glucose levels cannot be achieved with food and exercise, insulin therapy has been regarded as the gold standard for managing gestational diabetes. Around 10-20 % of women need insulin.

What is the Glycemic Index?

Glycemic index (GI) is used to calculate how much a particular food will raise blood sugar levels. The GI of a food determines how much of an impact it may have on your blood sugar levels. Foods are graded from 0 to 100 and are categorised as low, medium, or high glycemic foods. When compared to diets high in protein, fat, or fiber, foods high in refined carbohydrates frequently have a high GI. Meat, fish, poultry, nuts, seeds, herbs, spices, and oils are examples of foods that have a low GI since they don’t contain any carbohydrates.

What Foods To Avoid in GDM

gestational diabetes

Pregnancy is indeed a crucial time, and with the raging cravings, the condition of Pregnancy diabetes can be problematic. Nevertheless, there are many delicious substitutes for some of your favourite dishes. Avoid items that have been heavily processed, such as white bread, and anything that contains a lot of sugar in general and look for Low GI foods. Avoid these foods:

  • Meals that are particularly large serves of starchy, such white pasta and rice etc.
  • Sugary granola bars, sweetened oatmeal, and sweetened cereals
  • Fast food and fried foods
  • Sweetened beverages, including soda, juice, and other sugary liquids
  • Alcoholic drinks
  • Cakes, muffins, and other baked foods

Pregnancy Diabetes Diet Plan

Generalised Meal Plan for GDM – Please seek your Registered Dietitian for a personalized Meal Plan.

Breakfast 

  • ½ cup of low GI cereal (Porridge, Oats etc.) with 1 cup milk (normal/reduced fat or skim), Soy milk OR Low GIYoghurt
  • 1 egg boiled 

Morning Snack: 

  • 2 Fresh fruits (Apple, pear, peach, apricot, papaya etc.) 

Lunch

  • 1 sandwich or bread roll (multigrain) – filled with egg/chicken/fish.
  • 1 bowl of salad (Freshly prepared lettuce, tomato, cucumber, low fat cheese, onion etc)

Snack: 

  • 1cup Greek yogurt topped with figs and nuts (Almonds/cashew nuts etc.) 

Dinner: 

  • 1/2 -1 cup brown rice
  • 1 cup of Steamed vegetables (non-starchy vegetables)
  • 1 piece chicken cutlet/chicken piece/fish filet

*Before sleeping: 1 cup of milk (normal/reduced fat or skim) with 1 teaspoon of chia seeds.

Snacks for Gestational Diabetes

signs of gestational diabetes

Snacks are an excellent way to satisfy an evening snack attack and you can still maintain stable blood sugar levels. If you have gestational diabetes, these healthier options for meals and snacks are shown below.

  • Vegetables (Fresh or frozen) can be eaten grilled, cooked, or raw. Pair raw vegetables with a protein source, such as hummus or cheese, for a filling snack. 
  • While egg whites largely contain protein, whole eggs are a great source of several nutrients.
  • Fresh fruits are a great source of natural sugars that are not at all harmful for the patient with Gestational Diabetes, but you do need to be careful of the portion size. Fruit combined with some nuts or nut butter is a great combination to snack on.
  • Greek yogurt without added sugar garnished with diced apple, cinnamon, and sunflower seeds.
  • Nuts and seeds are a great source of healthy fats.
  • Baked Chicken or Fish. 

Top Tips for Healthy Eating with Gestational Diabetes

  • Consume a balanced, low-sugar gestational diabetes diet. To be sure you’re getting the nourishment you need, consult your dietitian.
  • Swap out ice cream, cookies, and other sugary treats with foods that naturally contain sugar, such as fruits, carrots, and raisins.
  • Watch your portion amounts and include vegetables and healthful grains.
  • Eat three small meals and 2-3 snacks throughout the day at around the same times.
  • Get 40% of your daily calories from carbs and 20% from protein. Most of the carbs should be complex, high-fiber carbs, with fat being between 25% and 40% (healthy fats)
  • Have a small serves of carbohydrate in each meal
  • Consume low GI foods
  • Consume 20-35 grams of fiber a day. Foods like whole-grain breads, cereals, and pasta; brown or wild rice; oatmeal; and vegetables and fruits will help achieve the target.
  • Avoid skipping meals. Aim to have a nutritious snack or meal approximately every three hours to control your blood sugar levels. Regularly consuming nutrient-dense foods will help you stay satisfied and maintain stable blood sugar levels.
  • If your doctor advises taking probiotics along with your prenatal vitamins, do so.
  • To stay hydrated, keep a water bottle with you and sip from it frequently throughout the day.

Sources:

https://www.cdc.gov/diabetes/basics/gestational.html#:~:text=What%20Causes%20Gestational%20Diabetes%3F,body%20for%20use%20as%20energy.

https://www.healthline.com/health/pregnancy/gestational-diabetes-food-list#Food-Fix:-What-to-Eat-When-Pregnant

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515446/

https://emedicine.medscape.com/article/127547-overview

https://journals.lww.com/jaapa/fulltext/2019/09000/managing_gestational_diabetes.4.aspx

https://www.webmd.com/diabetes/gestational-diabetes