Gestational Diabetes (GDM)

What is GDM?
GDM is a carbohydrate intolerance that can vary in severity and is generally usually diagnosed during the 24th to 28th week of pregnancy.  It is recommended that all pregnant women be screened for gestational diabetes during the 24th and 28th weeks of their pregnancy with an oral glucose tolerance test.  Risk factors for GDM include being older when pregnant, being of African or Hispanic ancestry, obesity, GDM in a previous pregnancy, and having a previous baby weighing over 9 pounds.  The condition may present with symptoms including increased thirst, increased urination, weight loss dispite adequate intake, fatigue, etc.  Symptoms are usually mild and not life-threatening to the pregnant woman, some women are even symptom free, and in many cases the blood glucose level returns to normal after delivery.

Treatment of GDM
Maintaining control of blood sugar levels significantly reduces the risk to the baby.  The goals of treatment are to maintain blood glucose levels within normal limits during the duration of the pregnancy, and ensure the well-being of the fetus.

Nutritional management includes providing adequate calories and nutrients required for pregnancy, as well as proper control of blood glucose levels.

Meal Planning for Diabetes in Pregnancy

Sample Menus for Diabetes in Pregnancy

 

 

 

 

 

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 Tips for Meal Planning
To control your blood sugar, you need to watch what, how much, and when you eat.  It is important to consume balanced meals and snacks, paying special attention to amounts and types of carbohydrates.  Here are some general guidelines.

Eat consistently during the day, distributing your carbohydrate choices evenly.  The best way is to eat 3 meals a day.

  • Try not to go longer than 4 hours without eating during the day
  • Healthy snacks are ok if you become hungry
  • Include some protein and healthy fat

Eat breakfast soon after waking:

  • Have no more than 2 carbohydrate servings
  • It is best to avoid fruit, fruit juice, and cold cereal with milk

Include a good source of protein at every meal and snack.  High protein foods are:

  • Low-fat meats
  • Chicken
  • Fish
  • Low fat cheese
  • Nuts
  • Natural peanut butter
  • Low fat cottage cheese
  • Eggs

Choose high fiber foods, such as:

  • 100% whole wheat bread or "White Wheat"
  • Fresh and frozen vegetables
  • Beans and legumes
  • Fresh fruit

Substitute healthy alternative for white-colored foods may cause your blood sugar to rise significantly. 

"White" food:

Try this:

White rice

Brown rice

White bread

Whole wheat bread

Regular pasta

Wheat pasta

Potatoes

Sweet potato

Include small amounts of healthy fats, such as:

  • Olive and canola oil (rather than vegetable oil)
  • Nuts, peanuts, almonds, and walnuts
  • Avocados

Lower your saturated fat intake with lean sources of protein:

  • Chicken
  • Roast beef
  • Turkey
  • Ham
  • Fish
  • 2% or low-fat cheese

Look for leaner cuts of red meat, such as round and loin:

  • Look for less marbling
  • Remove all visible fat and skin from meats
  • Bake, broil, steam, boil, or grill foods (rather than frying)
  • Use skim or 1% low fat milk and dairy products

Watch sodium intake

  • Limit lunch meat, bacon, sausage, and hot dogs
  • Rinse canned beans and vegetables
  • Resist the urge to use the salt shaker
  • Limit frozen and pre-prepared meals/snacks and canned soups
  • Guidelines: <400 mg for snacks and side dishes and <800 mg for meals

AVOID SUGAR AND CONCENTRATED SWEETS.  These include:

  • Table sugar
  • Honey
  • Molasses
  • Candy
  • Jams and jellies
  • Cookies
  • Cakes
  • Regular soda
  • Chocolate
  • Ice cream
  • Fruit canned in heavy or lite syrup
  • Sugar-sweetened drinks (like Kool-Aid, Hi-C, and sweet tea)

Artificial sweeteners may be used to sweeten foods and drinks

  • Studies have shown that moderate amounts are safe for you and your baby

Food safety is important

  • Avoid undercooked meat
  • Avoid shark, swordfish, king mackerel, and tilefish
  • Limit all other fish to 12 oz. or less per week
  • Eat no more than 6 oz. (1 can) of light tuna per week (avoid albacore)
  • Cook eggs until done
  • Only consume pasteurized milk and dairy products
  • Avoid soft or vein cheeses
  • Watch out for cross-contamination (i.e. handling raw meat and eggs)

Regular exercise can help control blood sugar levels.  Try these things:

  • Walking
  • Swimming
  • Housework
  • Playing with kids

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Sample Menus for Diabetes in Pregnancy:

Breakfast

Breakfast Sandwich                                                              Oatmeal

1 poached or scrambled egg                                       1 cup cooked oatmeal (2)

1 whole grain English muffin (2)                                           1 tsp Splenda

1 slice cheese                                                                  1 tsp cinnamon

1 slice Canadian bacon                                                      ¼ cup of walnuts

  Lunch

Ham Sandwich and Yogurt                                        Soup and ½ Sandwich

2/3cup light yogurt (6 oz container) (1)          1 cup low sodium vegetable soup (1)

2 slices low sodium ham                                     1 slice whole wheat bread (1)

2 slices whole wheat bread (2)                       1 slice reduced-fat American cheese

Lettuce and tomato                                                   2 oz. deli turkey

Mustard and/or mayonnaise                                         1 slice tomato

½ banana (1)                                                           1 small apple (1)

Dinner

Chicken Fajitas                                                         Healthier Hamburger

3 oz chicken breast                                                   3 oz. hamburger patty

2 6-inch flour tortillas (2)                                           1 hamburger bun (2)

2/3 cup rice (2)                                          Green salad with non-starchy veggies

1 oz. 2% shredded cheese                                        1 corn on the cob (1)

Shredded lettuce and tomato                                      1 cup skim milk (1)

Reduced-fat sour cream and salsa

Snacks

3 cups air-popped popcorn (1)

2/3 cup (6 oz.) light yogurt with 2 Tbsp nuts (1)

6 crackers with 2 oz. tuna (1)

3 graham crackers with natural peanut butter (1)

½ banana and 1 Tbsp of natural peanut butter (1)

½ cup peaches with ½ cup non-fat cottage cheese (1)

1 small apple (1) and 1 oz. of low-fat cheese

1 cup carrot sticks with 2 tbsp low-fat ranch dressing

½ medium baked potato with ¼ cup shredded 2% cheese (1)

(x) = # of carbohydrate choices