If you have type 1 or type 2 diabetes and become pregnant, or are diagnosed with diabetes during your pregnancy, it is imperative that you control your blood glucose levels to help to ensure a healthy pregnancy. Physical activity and following a diabetic meal plan have been shown to help with blood glucose control. All forms of diabetes during pregnancy can benefit from following a consistent carbohydrate diet. Women with type 1 or type 2 diabetes who become pregnant can follow the same meal plan as women who are diagnosed with gestational diabetes.
Significance
According to the National Diabetes Clearinghouse, 3 percent to 8 percent of pregnant women have diabetes. Elevated blood glucose levels during pregnancy can increase the risk of birth defects and neural tube defects, which are birth defects that specifically affect the brain and spinal cord. Sugar from the mother's blood passes through the placenta into the growing baby's blood; therefore, if your blood glucose levels are high, your baby's will be as well. Uncontrolled blood sugars increase the risk of miscarriage and stillbirth. Women with elevated blood sugars are also more likely to give birth to a baby greater than 10 lbs., which is considered to be a large birth weight baby.
Blood Glucose Goals
If you have diabetes during your pregnancy, you will be asked to test your blood glucose level daily, possibly several times each day. Your goal for fasting state, which is typically taken in the morning before you eat breakfast, is 90mg/dL or lower. Fasting state means you have not had anything to eat or drink for at least eight hours. One hour after eating, your blood sugar should be less than 120mg/dL.
Carbohydrates
Carbohydrates are what make your blood glucose levels increase. They serve as an important energy source for you and your growing baby. It is not recommended to follow a low-carbohydrate diet during pregnancy to control blood sugars. Instead, it is important that you not consume too many carbohydrates at one time. Doing so may cause your blood glucose levels to increase above target range. It is recommended that you use carbohydrate counting to track the number of grams of carbohydrate you consume each time you eat. Sources of carbohydrates include cereals, pasta, rice, legumes, milk, yogurt, fruit, fruit juice, potatoes, peas, corn and sweets. Please note that sugar-free items often contain carbohydrates, and therefore will increase your blood sugar.
Meal Plan
Aim for three regular meals each day, with snacks in between as needed. Read nutrition fact labels on foods for "total carbohydrate" content of the food. You need not pay attention to grams of sugar in foods because it is already accounted for in the total carbohydrate. Also, pay close attention to portion sizes. If you consume twice the portion size listed on the label, you also need to double the grams of carbohydrate. Breakfast should be limited to 15 g to 20 g of carbohydrate, whereas lunch and dinner can contain up to 60 g of carbohydrate each. Snacks during the day should be no more than 20 g of carbohydrate.
Weight Gain
If you have trouble gaining weight while following this meal plan, you may add calories from foods that will not make your blood glucose increase. Proteins and fats do not increase blood glucose levels. Proteins include meat, chicken, fish, eggs, cheese, cottage cheese and natural peanut butter. Fats include butter, margarine, mayonnaise and most salad dressings. Therefore, you can increase your intake of these foods to help to achieve your weight gain goals without increasing blood glucose levels. Some women do require the use of insulin to keep their blood glucose levels under control.
References
- National Diabetes Information Clearinghouse
- March of Dimes: Pregnancy complications
- "Up to Date"; Treatment and Course of Diabetes Mellitus; Jovanovic, Lois; 2005
- ADA Nutrition care manual: Gestational Diabetes Nutrition Therapy
