Dietary advice and blood glucose control
You were diagnosed having gestational diabetes due to an abnormal oral glucose tolerance test (OGTT). Management of gestational diabetes starts with a diet. This brochure gives you information about nutrition during pregnancy. There are also some general nutritional advices, though specified for pregnancy.
All carbohydrates are turned into glucose by our body. Glucose is fuel for our cells. Insulin makes sure that glucose can enter cells. When you consume too many carbohydrates at once, the body suddenly needs more insulin to let all the glucose pass the cell membranes. This is not a problem but with a disturbed glucose metabolism, it is. The glucose will then stay in your bloodstream, which will lead to a high(er) blood glucose. Because glucose passes the placenta, the unborn baby will receive extra sugar. Due to an increased availability of glucose in the maternal bloodstream, children tend to grow faster than is desirable.
Make sure you have a regular intake consisting of 3 main courses and 3 to 4 snacks. This way the intake of carbohydrates is divided throughout the day. “Carbohydrates” is a collective term for:
- Starch: bread, porridge, cereals, potatoes, pasta, rice and vegetables
- Milk sugar: milk products such as buttermilk, yogurt, cottage cheese and custard
- Fruit sugar: fruit and fruit juices
- Sugar: granulated sugar, biscuits, sweets, chocolate, pastry
Limit the use of sugar and sugar rich products
- It is advisable not so add sugar to coffee and tea and stay off soda, lemonades and sweetened milk drinks.
- Choose, preferably, unsweetened milk-drinks, water and light soda (to a limited extent).
- Fruit-juices such as apple- and orange juice contain a lot of natural fruit sugar. If you have the habit of drinking fruit juices try to drink 1 glass of unsweetened fruit juice instead of eating 1 piece of fruit.
- In a healthy diet you can eat two pieces of fruit; spread throughout the day.
- Be scarce with sugar, this means that you should also eat less products that contain a lot of sugar such as biscuits, sweets, pastry etcetera.
- Choose a snack, for example one portion of fruit, one slice of gingerbread, nutrition biscuits such as one Liga/Sultana/Evergreen, knäckebröd, a little bowl of yoghurt etcetera.
- Preferably use savory sandwich toppings as sandwich spreads such as cheese and cold cuts.
Eat enough dietary fibers
Dietary fibers play an important role in our diet. Fibers are indigestible parts of vegetable foods. They are needed for an optimal functioning of the gut. Fibers from fruit, vegetables and legumes have a favorable effect on glucose and cholesterol-levels in your blood.
Nutrition during pregnancy
A healthy diet during pregnancy is important. The baby is depending on the nutrition you take, though more than usual in not needed. During pregnancy you need more energy, but you also are less active which means you use less energy. When you eat the amounts mentioned below, you will receive enough nutrients for you and your child.
Required amounts a day
During the pregnancy you have to be carefull with the following foods and preferably avoid them:
- Do not eat liver or eat more than one slice of bread per day with toppings that are made of liver (such as liverwurst and pâté).
- Do not eat raw meat such as filet americain, tartar, roast beef etc.
- Cold cuts such as raw ham, smoked meat, bacon and sausage meats are processed and therefore can be eaten.
- Wash all vegetables well
- Do not eat cheese made from raw milk and do not drink raw milk either.
- Do not eat prepackaged smoked fish.
- Do not eat more than 2 portions of fatty/oily fish per week
- Limit the intake of caffeine containing drinks to 4 per day (coffee/coke)
Do not use alcohol.
There are also some recommendations that are specific for pregnant women. The use of folic acid and vitamin D are advisable. Folic acid (400 μg daily) is needed from at least four weeks before the fertilization up to, and including the first eight weeks of the pregnancy. Extra vitamin D is needed during the entire pregnancy. Do not use a combined vitamin A-D preparation. This is to prevent an overdose of vitamin A. You can also choose to take multi-vitamin specific for pregnant women, such as Gravitamon/Davitamon mamma. This contains the extra recommended folic acid and vitamin D and all other micro-nutrients you need in your pregnancy.
Before the first glucose measurements you will have to follow a diet. Measurements are taken for four times a day (fasting and 1 hour after each meal, i.e. breakfast, lunch, supper) as explained by the nurse. After the first week of dieting you will measure your glucose levels and inform the Transmuraal Vrouwen Dagcentrum of the results. The nurse will (after possible conference with the doctor) advise on further policy. Thereafter you will measure once a week. The glucose values need to be maintained within normal range as to be able to condition treating gestational diabetes with only a diet. For normal ranges see the patient information on glucose measurements. If values are not normal you need to contact the Transmuraal Vrouwen Dagcentrum and once a month to communicate your blood glucose values.
Example of a healthy diet
When you have questions regarding this brochure you can contact:
Transmuraal Vrouwen Dagcentrum
043-387 41 45
Dieticians or specialized nurse of the “brugpoli” of the hospital
043-387 56 69