Seed to Feed Me: GESTATIONAL DIABETES

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Gestational Diabetes is the name given to diabetes which can occur during pregnancy. It occurs when the level of glucose in the blood becomes too high. During pregnancy extra hormones can increase the demand for insulin, the hormone that controls the glucose levels in the blood. Sometimes there is not enough insulin to control the blood glucose level and this can lead to gestational diabetes.

Regular monitoring by your midwife at your antenatal appointments should mean that regular blood samples are taken, which are screened for glucose. If these come back high you will be asked to take a glucose load test. In this test you will have to fast overnight and drink a glucose solution in the morning prior to another blood test being taken exactly 2 hours after drinking it. A diagnosis is made when the blood glucose level is 7.8 mmol/l or above two hours after the test.

You are more at risk from suffering from gestational diabetes if you:

Have a family history of type 2 diabetes
Had an unexplained still birth or neonatal death in previous pregnancy.
Have a BMI (body mass index) above 30kg/m2
Had a very large infant (9lb or more) in a previous pregnancy
Are South Asian, Black Caribbean and middle Eastern

However one in five pregnant women will be diagnosed with gestational diabetes, especially in the last trimester of their pregnancy. But you can control your glucose levels and manage your diabetes by following an eating plan.

Diet

It is important to follow a balanced diet when you are pregnant to ensure you and your baby get all the nutrients you require. You do not need to eat for two as you do not require much more food than you would normally require (approx 200 extra calories a day). However, you should not aim to lose weight during your pregnancy either. It is important to keep your weight stable and to eat the right kinds of food.

Food that cause your blood glucose levels to rise are carbohydrates as these are broken down into sugar in the body (glucose). You need a regular supply of carbohydrate to fuel your body and insulin that you produce helps you to use this glucose for energy. The amount of glucose produced depends on the amount of carbohydrate eaten. It is therefore important to spread carbohydrate foods evenly over the day and avoid large portions.

Foods containing carbohydrates include:

All types of bread and bread products
Fruit and fruit juices
Snacks like biscuits, cakes, crisps, cereals
Pies and pasties
Sugar (glucose, fructose)
Confectionery
Potatoes
Milk, yogurt and ice cream
Pulses (peas, beans and lentils)
Grains (pasta, rice, couscous)
Cereal based products

You should try to avoid too much weight gain and avoid large portions of carbohydrates. Eat regular meals. Try to distribute your carbohydrate intake evenly at each meal.

Blood glucose monitoring

Blood glucose monitoring will help you to understand how different carbohydrate foods and portions affect your blood glucose levels. You may be issued a blood glucose monitoring system to take your own measurements. A simple finger prick blood sample is taken and measured prior to meals and one hour after eating.

A diary can be keep of the measured glucose levels to help build up a picture of which foods are more likely to cause spikes in your glucose levels. You are aiming for a measurement of less than 7.8 mmol/l. It can be difficult to keep below this figure, especially breakfast, and you will need to modify your eating habits. You may find it beneficial to have two smaller portions spaced over several hours rather than one portion.

Glycaemia index

Starchy foods with a low Glycaemia index (GI) release glucose very slowly into the blood, helping you to control your blood glucose level. Avoid foods with a high glycaemia index.

Low GI foods:

Wholegrain or mixed grain breads (granary, rye, linseed)
Pasta, buckwheat and bulgar wheat
Most vegetables
Low fat milk, diet yogurt
Apples, apricots, citrus, cherries, grapes, mangos, pear, plums, prunes, kiwi, strawberries
Sweet potato
Porridge
Oatmeal biscuits
Dark chocolate, peanuts, cashew nuts

Medium GI foods:

Pitta, muffins, crumpets
Basmati rice, couscous, quinola
Beans and pulses; ice cream, low fat custard
Apricot, banana, pineapple, fruit juice, mixed dried fruit, dried figs, sultana and raisins
New potatoes, boiled potatoes
Shredded wheat
Rich tea, digestives, shortbread
Honey, reduced sugar jams

High GI foods:

White breads, wholemeal bread, baguettes, bagels; brown rice, white rice, rice cakes, crackers
Beetroot and broad beans
Soya milk, rice milk
Dried dates, melon, jam and marmalade
Chips, instant potato, roast potato, mashed potato
Rice krispies, cornflakes, sugary cereals, sultana bran
Crackers, custard creams, bourbon biscuits
Sugar, glucose tablets, soft drinks, sweets.