Nutrition Basics For Women with Gestational Diabetes

This guide provides basic information to help you start lowering your blood glucose until your appointment with a registered dietitian, the nutrition expert. These are general guidelines which may be tailored to meet your needs. Food is an important tool that you can use to control your blood sugar during pregnancy. Eating healthfully often means making changes in your current eating habits. A registered dietitian can provide in-depth personalized nutrition education to help you develop a personal action plan.

Diabetes and the foods you eat
When you eat or drink, much of your food is broken down into a simple sugar called glucose. Glucose (sugar) provides the energy your body needs for daily activities. Insulin is a hormone that helps your body use glucose for energy. Without enough insulin, sugar cannot get into the body's cells for use as energy. This causes blood glucose to rise. Too much sugar in the blood is called "high blood glucose" or diabetes.

Gestational diabetes
Gestational diabetes is a condition characterized by high blood glucose levels discovered during pregnancy. Gestational diabetes is the result of hormonal changes that occur in all women during pregnancy. Increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus and transfers nutrients from the mother to the baby) interfere with the ability of insulin to manage glucose. This condition is called "insulin resistance." As the placenta grows larger during pregnancy, it produces more hormones and increases this insulin resistance. Usually the mother's pancreas is able to produce more insulin (about three times the normal amount) to overcome the insulin resistance. If the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, glucose levels will rise, resulting in gestational diabetes.

High blood glucose levels that are not treated during pregnancy can cause problems for you and your baby. Gestational diabetes does not cause your baby to have diabetes. However, if left untreated, gestational diabetes can cause your baby to produce too much insulin and gain too much weight, increasing the risk of premature delivery.

Usually, blood glucose levels return to normal after childbirth. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Diabetes and carbohydrates
Carbohydrates (foods high in starch and sugar) have the greatest impact on blood glucose levels, since they are broken down into glucose during digestion. It is important to control the amount of carbohydrate by eating the same amount of carbohydrate along with some protein and fat at each meal.

Goals for healthy eating

• Eat three small meals and two or three snacks at regular times every day. Do not skip meals or snacks.
• Eat less carbohydrate at breakfast than at other meals because this is when insulin resistance is the greatest.
• Try to eat a consistent amount of carbohydrate during each meal and snack.
• If you have morning sickness, eat 1-2 servings of crackers, cereal or pretzels before getting out of bed; eat small, frequent meals throughout the day and avoid fatty, fried and greasy foods. If you take insulin and have morning sickness, make sure you know how to treat low blood glucose.

• Choose foods high in fiber such as whole-grain breads, cereals, pasta, rice, fruits and vegetables.

• Eat foods with less sugar and fat.

• Drink at least 8 cups (or 64 ounces) of liquids per day.

• Make sure you are getting enough vitamins and minerals in your daily diet. Ask your health care provider about taking a prenatal vitamin and mineral supplement to meet the nutritional needs of your pregnancy.

Here are some other guidelines:

Eat and drink at least 4 servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1200 mg. of calcium in your daily diet. Sources of calcium include dairy products, some nuts, green vegetables and foods and beverages fortified with calcium, such as calcium-fortified, unsweetened ready-to-eat cereals.

Eat at least three servings of iron-rich foods per day to ensure you are getting 30 mg. of iron in your daily diet. Sources of iron include enriched grain products (rice); lean meat, poultry and fish; eggs and leafy green vegetables.

Choose at least one source of Vitamin C every day. Sources of Vitamin C include oranges, grapefruits, strawberries, honeydew, broccoli, cauliflower, brussel sprouts, green peppers, tomatoes and mustard greens.

Choose at least one source of folic acid every day. Sources include dark green leafy vegetables, veal, fortified grain products, legumes (lima beans, black beans, black-eyed peas and chickpeas) and fruits.

Choose at least one source of Vitamin A every other day. Sources rich in Vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots and cantaloupe.

• Avoid alcoholic beverages during pregnancy. Alcohol has been linked to premature delivery and low birth weight babies. If you think you may have a problem with alcohol use, please talk to your health care provider so he or she can help protect you and your baby.
• Limit caffeine to no more than 300 mg. per day (two 8-ounce cups of coffee, three 8-ounce cups of tea or three 12-ounce glasses of caffeinated soda). Remember, chocolate contains caffeine -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
• DO NOT DIET or try to lose weight during pregnancy -- both you and your baby need the proper nutrients in order to be healthy. Ask your health care provider how much weight you should gain during pregnancy. A woman of average weight before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your health care provider recommends.
• Eat a variety of foods to get all the nutrients you need. The Food Guide Pyramid on the next page provides an example of the number of servings you should eat from each food group every day.
• The use of non-nutritive or artificial sweeteners approved by the Food and Drug Administration is acceptable during pregnancy. These FDA-approved sweeteners include aspartame and acesulfame-K. The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and may remain in fetal tissues. Talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.

This handout provides general guidelines for lowering your blood sugar. The next step is to make an appointment with a registered dietitian, the nutrition expert. A registered dietitian will evaluate different health factors to determine your individual nutritional status; review your diet history targeting carbohydrate (glucose) sources; explain product selection, label reading, cooking methods, menu planning and dining out; and develop an individualized treatment
that will meet your needs.

Key: - Fat (naturally occurring and added) - Sugars (added) These symbols show that fat and added sugars come mostly from fats, oils and sweets, but can be part of or added to foods from other food groups as well. Source: U.S. Department of Agriculture, U.S. Department of Health and Human Services

Property of:
The Cleveland Clinic
Cleveland, OH
www.clevelandclinic.org

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/.

This document was last reviewed on: 11/1/2001

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This is not a health care site. The editor is not a health care professional, is not qualified, and does not give medical or mental health advice.

Please consult with qualified professionals in order to find the right regimen and treatment for you. Do not make changes without consulting your health care team. .

Because this site is for all diabetics at all stages of life, some information may not be appropriate for you - remember information may be different for type 1, type 2, type 1.5, and gestational diabetics.

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