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Dietary Management Of Gestational Diabetes

What is Gestational Diabetes?

Some expecting mothers develop Gestational Diabetes when the body does not produce enough insulin or the insulin does not work properly in order to control the high blood sugar (glucose) levels at the beginning and during pregnancy. Diabetes during pregnancy can be permanent or temporary.

If you suffer from Gestational Diabetes it is very important to ensure that all efforts are made to control your blood sugar levels. The high sugar in your blood may also be taken up by your unborn child (via the placenta), causing your developing child to become too large. A large baby can cause a difficult birth, increase your risk of having a miscarriage and increase the risk of your child developing diseases of the lifestyle later on in his / her life.

Symptoms of High blood sugar (hyperglycaemia) above 10mmol/l include:
Thirst Excessive urinating
Hunger Weight loss
Tiredness Skin infections – itchy skin
Nausea & vomiting Blurred vision
Symptoms of Low blood sugar (hypoglycaemia) 3mmol/l include:
  • Early signs – shakiness, dizziness, irritability, paleness, nausea, sweating,headache and hunger pains.
  • Moderate signs – confusion, slurred speech, anxiety, heart palpitations
  • Severe signs – mood changes, fainting, convulsions and coma
If you suffer from any of these symptoms and feel that your blood sugar levels are too LOW, it is important to:
  • Initially take in some sugar, either 2-4 teaspoons of sugar or 3 glucose sweets(super C’s) or ½ cup fruit juice, coke, sweet tea.
  • Thereafter eat something filling after 10-30 minutes. Examples include brown bread with peanut butter or cheese, or a glass of milk and a banana.
  • General Healthy Dietary Guidelines For Diabetes

    The diet you follow at home has an enormous influence on your blood sugar levels and your baby’s. It is therefore very important to follow a diabetic diet to help control your blood sugar levels.

  • Eat at least 3 small regular meals a day including a variety of food. Meals should be evenly distributed throughout the day and preferably around the same time. If you are on Insulin, it is important to eat the amount of times determined by the Dietician. Never skip a meal.
  • Some Diabetics require snacks between meals
  • Examples of healthy snacks are…

    • Fresh fruit with a slice of bread
    • Brown bread
    • Small tub of low fat yoghurt
    • 3 high fibre biscuits such as Provitas
  • It is important to maintain an ideal body weight depending on the trimester you are in.
    • If you were not overweight before pregnancy a weight gain of 11 – 16kg is required.
    • If you were overweight before pregnancy a weight gain of 7 – 11 kg is the normal.
Restrict the amount of fat in your diet by following a low fat diet.
  • Limit eating fried and fatty foods like take-aways and commercially baked products e.g. pies, pastries and biscuits.
  • Choose low fat/fat free dairy products such as milk, plain yoghurt, maas and cheese
  • Choose lean cuts of meat, cut off or remove excess fat such as the skin on chicken
  • Choose low fat methods of cooking such as grilling, baking, boiling, braaing and steaming rather than frying your food
  • Use a small amount of unsaturated fats such as avocado, canola oil, olive oil, nuts rather than saturated and trans-fatty acids such as sunflower oil, brick margarine, butter, ghee, lard, cream, mayonnaise and processed meats.
    If you use margarine, use a little tub margarine as it is easy to spread thin.
    If you use oil, only use 1 teaspoon per person in your family per meal.
  • Try eating fish 2 – 3 times a week.
  • Avoid foods high in cholesterol e.g. calamari, prawns, meat, caviar, tripe and organ meats.
  • Never use 2 fats at the same time For example if you use a spread containing fat on your bread (peanut butter, cheese spreads, sandwich spreads, cream cheese) do not also use margarine.
  • Avoid sugar and sugar containing foods such as: sweets, chocolates, jam, honey, syrup, marmalade, tinned fruit, cakes, jelly, flavoured milk, chutney, sweet breakfast cereals, ice-cream, fizzy drinks.
    Always check your food labels for other forms of sugar such as: dextrose, maltodextrin, sucrose, cane sugar, beet sugar, and molasses..
  • Sweeteners may be used. However no more that 8 tablets / 4 sachets of sweetener a day. You can substitute 1 teaspoon of sugar for 1 tablet or ½ a sachet.
  • No more than 2- 3 fruits may be eaten a day.
    One portion of fruit which is about the size of a tennis ball should be eaten at one time. Give preference to fresh fruit over fruit juice, canned or dried fruit. Always dilute the juice with water.
  • Eat Fibre rich foods.
    Fibre is the portion of food which slows down your digestion, makes you feel fuller for longer; it helps you control your weight and your blood sugar levels.
    Use whole-wheat/brown or Low GI bread instead of white bread.
    Use high fibre porridge (jungle oats, jungle oat bran) or cereals for breakfast (All Bran, High Fibre, Pronutro).
    Use whole-wheat savoury biscuits (provita, ryvita) instead of plain savoury biscuits (salticrax, snackerbreads).
    Use of Brown Rice instead of white rice and whole-wheat pasta instead of white pasta.
    Include Legumes (beans, peas, lentils), barley and whole-wheat pasta
  • 3 – 4 glasses of Low fat/fat free milk/milk products should be drunk a day to increase milk production. Avoid coffee creamers and full cream products.
  • Exercise regularly throughout your pregnancy (with your Doctor’s permission)
  • Drink water. Ensure your daily water intake is 6 – 8 glasses/day. Tea and juice do not count as water. A Diabetic diet is high in fibre and it is essential to drink sufficient water throughout the day to prevent constipation.
  • Limit your intake of salt and salty foods. Rather cook with spices, herbs, garlic and onions than salt. Limit the amount of salty foods (salted nuts, chips, biscuits, pickles and sauces)

Do not drink alcohol and avoid smoking. These can both increase your blood pressure and increase your chances of having a hypoglycaemic (low blood sugar level) attack.

By Melissa Pyle, BSc. in Dietetics, Registered Dietician (SA)

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