Everything You Need To Know About Gestational Diabetes | My Baba

Gestational diabetes is something that affects woman during pregnancy. Diabetes is a condition where there is too much glucose (sugar) in the blood. Gestational diabetes is a common condition, and up to 18 in every 100 women giving birth in England and Wales may be affected, so it’s a topic to be aware of. We asked Diabetes Specialist Dietician Sophie Cairns to tell us everything we need to know. 

What is gestational diabetes?

Gestational diabetes is diabetes diagnosed during pregnancy. It occurs most often in the last 2-3 months of pregnancy because the body cannot meet the additional needs for insulin at this stage in pregnancy. In most cases, gestational diabetes goes when the baby is born.

How is gestational diabetes treated?

Treatment for gestational diabetes aims to keep blood glucose at healthy levels (<7.8 mmol/l). You will be taught blood glucose testing to monitor your blood glucose levels first thing in the morning and then after main meals. The treatment always includes an eating plan and physical activity. It may also be necessary to include anti-diabetic pills or insulin injections.

How does food affect my blood glucose?

Carbohydrate is an important source of energy, vitamins, minerals and fibre and is also the main nutrient that affects blood glucose values. When you eat carbohydrates it’s digested into glucose which the blood picks up from the small bowel. The impact on your blood glucose is affected by the total amount and type of carbohydrate food. Protein and fat does not directly impact your blood glucose.

Carbohydrates are found in oats, cereals, rice, pasta, potato, bread, cakes and biscuits, fruit and berries, milk and yoghurt and sugary foods like soft drinks and sweets.

Do I have to cut out carbohydrates completely?

Your eating plan may contain fewer carbohydrates than you normally eat. However you still need it for energy and nutrients. It’s best to choose from slow releasing carbohydrates and spread out your intake over the whole day. If you follow the eat well plate with maximum a third of your portion from carbohydrates balanced with lean protein and vegetables you’ll feel fuller for longer and get better blood glucose control.

What is Glycaemic index (GI)?

Glycaemic index is a ranking of food containing carbohydrates based on how they affect our blood glucose. All food is given a number between 0-100, the higher the number, the higher blood glucose they give us after eating. If you chose slow-releasing carbohydrates with a low or medium GI they will reduce the peak of your blood glucose after meals.

Low GI (<55): Porridge oats, betavivo, oatbran, basmati rice, pasta, noodles, sweet potato, granary or rye bread, pulses, beans, lentils, vegetables, nuts, fruit

Medium GI (55-70): Shredded wheat, instant porridge, shreddies, muesli bars, new potatoes, cous cous, biscuits, oatcakes

High GI (>70): Cornflakes, cocopops, rice crispies, white/wholemeal bread, rice cakes, mashed potato

All sugary foods like sweets, soft drinks, cakes are high in quick sugar and are best to be avoided during gestational diabetes.

What is the best breakfast?

Your blood sugar is more likely to be higher after breakfast than any other meal so a good breakfast is really important. Oats are naturally high in the fibre betaglucans which can lower the blood glucose peak after the meal compared to a high GI breakfast. Choosing an oatbran, like betavivo, or porridge with fresh berries and milk/yoghurt is a very nutritious option. If you prefer toast then choose a seeded granary type for the lowest GI.

I feel hungry, what can I eat without raising my blood glucose?

A snack containing a small amount of carbohydrates will give you energy and help with a balanced blood sugar control throughout the day. We advise you to eat 2-3 portions of fruit every day, but only one portion at a time. Other snacks you can eat are natural yoghurt, rye/sourdough crisp bread with avocado/cream cheese/spread, handful of nuts and seeds, cottage cheese, vegetable sticks and dip etc

Does it matter when I do exercise?

Physical activity is an important part of the treatment of gestational diabetes. In pregnancy we can recommend walking, antenatal yoga or swimming. If you can, schedule 30 minutes of gentle exercise every day. If you exercise in the hour after your meal, it will give you extra help to prevent a peak in your blood glucose.

What can I eat during labour?

We aim to keep your blood glucose within healthy levels during labour. Drink water or bring sugar free drinks to quench your thirst. If you are passing meal times but you don’t want to eat you may want to sip on some fruit juice to replace the energy. If you sip on a glass over an hour your blood glucose shouldn’t rise much.

If you feel like eating you can snack on slow-releasing carbohydrates like a cereal bar, oatbran and yoghurt, fruit, 2-4 crackers or a slice of toast.

How can I avoid type 2 Diabetes later in life?

If you carry excess weight on your body your risk of developing type 2 diabetes later in life is increased. Just by losing 5% of your weight and keeping active you’ll almost half that risk.

  • Making healthy food choices! Continue with low GI foods as they will keep you fuller for longer and eat a variety of fresh vegetables and fruit every day. The most important thing though is to limit your portion size! A good tip is to buy smaller plates!
  • Regular exercise helps reduce insulin resistance and maintain a healthy weight. To get additional health benefits such as weight loss from physical activity after pregnancy, the World Health Organization recommends 300 minutes at moderate-intensity level per week, or engaging in 150 minutes of vigorous-intensity physical activity per week.

Note: Everyone who gets gestational diabetes should be referred to a dietician for individual advice and an eating plan.

By Sophie Cairns, Diabetes Specialist Dietician for Betavivo.

References:
The World Health Organization, Global Strategy on Diet, Physical Activity and Health 2011
International table of glycemic index and glycemic load values: 2002, Am J Clin Nutr 2002;76:5-56
National Institute for health and care excellence (NICE). Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period Guideline 2015
Different types of dietary advice for women with gestational diabetes mellitus, The Cochrane Library, Issue 3 2013

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