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How should I change my diet if I have gestational diabetes?

Melissa Joy Dobbins
Nutrition & Dietetics

If you are diagnosed with gestational diabetes, you should see a registered dietitian to help you create a meal plan tailored to your needs. Ask your doctor for a referral to a dietitian or visit www.eatright.org to find a dietitian in your area. There are some general guidelines that you can follow before seeing a dietitian that can help you get started on better blood glucose control:

1. Eat 3 meals and 3 snacks a day and get at least 175 grams of carbohydrate each day for baby's growth and development.

2. Avoid all concentrated sweets and sugars, including sweet beverages such as juice and regular soda.

3. Be particularly mindful of the amount and type of carbohydrate you eat at breakfast since the hormones during pregnancy tend to make blood glucose levels rise at this time of day. Some people do well by limiting carbohydrates to 15-30 grams at breakfast, and avoiding fruit and cereal with milk at this meal.

4. Also pay special attention to what type of bedtime snack you choose. It is best to get about 30 grams of carbohydrate, plus protein AND fat at this snack, such as 2/3 cup ice cream, whole grain bread with peanut butter, or whole grain crackers with cheese.

5. Individual needs will vary, and your dietitian can help determine the best calorie and carbohydrate levels for you based on your weight and what trimester you are in. However, many people can benefit from aiming for about 20-30 grams of carbohydrate at snacks, about 45 grams of carbohdrate at lunch and about 45-60 grams of carbohdrate at dinner. Some people need to get a little less or a little more, so it's important to determine what works best for your individual needs.

Overall, most people can still eat the foods they enjoy just by watching the portion sizes. Choosing nutrient-rich foods at meals and snacks can help you get the most nutrients without extra "empty" calories that can lead to excess weight gain and raise your blood glucose levels.

People with gestational diabetes should eat well balanced meals and avoid foods with a lot of sugar such as sweets, soda, juice, candy and desserts. Foods that are healthy for people with gestational diabetes include vegetables, fruits, fish, lean meats, and whole grain breads, pastas, and rice. It is okay to eat snacks as long as the snacks are healthy foods. Many people with gestational diabetes may need to eat less than they are used to, depending on their weight and activity levels. Patients with gestational diabetes should strongly consider a visit with a registered dietician to help them plan their diet and understand more about how foods affect people with gestational diabetes.
Charla Simon
OBGYN (Obstetrics & Gynecology)

If you are diagnosed with gestational diabetes the first therapy recommended is dietary modification.  Approximately 1/2 of patients are able to control blood sugars with these modicifactions and do not need to go on to insulin or oral hypoglycemic therapy.

All women diagnosed with gestational diabetes should meet with a dietician to review dietary recommendations, exercise and weight gain goals, and develop meal plans.  The specific recommendations may depend on the results of your intial blood sugar monitoring (fasting and 2 hour post-meal results). 

The dietician will design a plan recommending a specific amount of carbohydrate per day and per meal.  In general, pregnant women are most prone to hyperglycemia in the morning and limiting carbohydrates including juice and fruit in the morning  is a first step.  It is usually recommended to keep carbohydrates to 30g or less in the morning (but again specific recommendations can vary from patient to patient).

All diabetic women are encouraged to restrict or eliminate refined sugar from the diet (including sweets and breads and pasta products not containing whole-grains). 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.