Guide to Managing Gestational Diabetes
A Patient's Guide to a Healthy Pregnancy
What is Gestational Diabetes?
Gestational Diabetes (GDM) is a type of diabetes that occurs during pregnancy. After the birth of your baby, you will usually not continue to have diabetes. Having GDM during your pregnancy does put you at increased risk of having diabetes at some time during your life. Because of this, we encourage healthy lifestyle changes to ensure no only a healthy pregnancy, but a healthy lifetime.
GDM is caused due to a failure of your pancreas to appropriately utilize your insulin to remove the glucose in your cells. This is called insulin resistance. When you eat excessive carbohydrates in your diet, you do not have effective insulin to break down all of the glucose-resulting in excess circulating glucose in your bloodstream. This excess glucose is circulated to your baby, and can contribute to excess weight gain for the fetus as well as other potential problems for you and your baby.
Although GDM is a potentially serious condition, you can learn how to control your blood glucose levels and prevent problems for you and your baby. You will learn how to make dietary changes to help your body process carbohydrates and avoid excess circulating glucose. In partnership with your provider, you will monitor your dietary intake, carb intake and amounts, and blood glucose levels. Sometimes changing your diet is not enough to control your blood glucose, and you may be advised to start insulin injections. Your provider will guide you should this occur.
What are Risk Factors for GDM?
*Being overweight
*A family history of Diabetes
*Having a background of African American, Asian, Latino, Native Islander, or Pacific Islander
*Being 25 years of age or older
*History of GDM or a previous baby weighing more than 9 lbs at birth
*You have a history of elevated blood sugars without a diagnosis of Diabetes
How Can GDM Affect My Baby?
Studies have shown that if blood glucose remains too high during pregnancy, babies can grow too large, making vaginal delivery more difficult. In addition, they can experience health problems at birth such as hypoglycemia (low blood glucose), breathing
problems, and jaundice.
How can GDM Affect Me?
GDM can contribute to other pregnancy complications such as preeclampsia and increased risk for cesarean section. You are also at risk of Type II Diabetes later in life, if you do not control your glucose during pregnancy. The good news is that your providers are here to support you with the necessary changes in order to prevent complications for you and your baby!
You may experience fear and guilt when you receive the news that you have GDM. Your providers are here to talk with you and address your fears or questions. Please do not hesitate to ask about any questions or concerns you may have. You will meet with a provider to review dietary changes, blood glucose monitoring, and any additional testing that may be required.
What Changes Will I Need to Make to Control My GDM?
After meeting with your provider to review your treatment plan, you will be provided with glucose monitoring equipment to begin monitoring your blood glucose. You will also review your current diet, and recommended changes will be discussed. You will be asked to keep a log of what you are eating each day, along with the number of carbs in each food item. You will also track your blood sugars for each day. You will be checking a fasting blood sugar upon rising, and a blood sugar one hour after each meal for a total of four (4) times per day. Below are your goals:
Fasting: Less than 95
One hour after meal: Less than 140
Dietary Goals:
You should be eating three healthy meals a day and three healthy snacks per day. Our goal is to keep your total Carbohydrate intake around 200 carbs a day. It is important that you continue to include complex carbs in your diet.
Breakfast should include:
30 grams of carbohydrates
2-4 ounces of protein
Lunch should include:
45 grams of carbohydrates
2-4 ounces of protein
Dinner should include:
45 grams of carbohydrates
2-4 ounces of protein
Three Snacks Per Day should include:
15-30 grams carbohydrates with 1 oz protein
Foods to Avoid:
Simple Carbs: Sugary foods, fast foods, highly processed foods, sodas, sweet tea, fruit juices
High Fat Content: Choose leaner cuts of protein
Foods to Enjoy:
Complex Carbs: Whole grain breads, whole grain rice and pastas, fresh fruits
Protein: Lean Proteins (meats), nuts, low fat cheese and dairy, beans
Vegetables: Green, leafy vegetables, check carb count on sweeter vegs and potatoes
Beverages: Enjoy plenty of fresh water, unsweetened tea, and low fat dairy
Higher Fiber: A goal of 25 grams per day
Food/Blood Sugar Log
Some people find using a small notebook is helpful. Be sure to include how much of the item you are eating such as ounces, and slice, a cup, etc. Note the number of carbs for each item. You will document your blood glucose results according to time of day. Please notify your provider ASAP if your results are significantly higher than goals, or if you have several abnormal results in a day.
Example:
Breakfast: One slice of whole wheat bread (12 grams), two eggs scrambled (1.2 grams), 8 oz non fat Almond Milk (1.5 grams) ½ banana (13 grams), FSBS 1 hour post meal: 120
**Make sure you look at serving size when you are calculating carbs and protein amount.
GDM Management in Review:
Follow the lower carb, high protein, and high fiber diet recommended. *200 carbs/day
Replace sugary drinks with water and lower fat dairy beverages.
Keep a daily log of everything you eat with portion size/amount and number of carbs.
Eat three regular meals per day and three snacks.
Breakfast should be no more than 30 grams of carbs, Lunch and Dinner 45 grams of carbs, and snacks should be between 15-30 grams of carbs.
You will check your blood sugar four times per day:
Fasting, first thing in the morning. The goal is <95
One hour after each meal. The goal is <140
*Please contact your provider should you experience any signs of illness, or if you have more than one abnormal glucose results in a day for further instructions/follow-up.
Bring your log book with you to each visit.