Please note that in sharing my experiences, I’m not advocating that anyone do things differently than prescribed by their doctor, and I’m no medical professional–I’m simply trying to encourage others going through this same thing. I know that the first time I was diagnosed, way back with my first pregnancy, I felt lost and scared, and like I had done something wrong. A little encouragement can go a long way!
I’ve had gestational diabetes diagnosed in four of my pregnancies. To be honest, I think I probably had it in the other one, too, it just wasn’t caught. Different place, different doctor, blah, blah, blah. So I’ve become very experienced at handling it, and learning what works and what doesn’t.
First, let’s talk carbs. Based on the diet I was given by the nutritionist that works with the maternal-fetal specialists that handle diabetic patients, I’m allowed about 11-12 “servings” of carbs a day. What constitutes a serving? 15 grams of carbs equals one carb serving, at least in my diet. The general breakdown of these servings is 1-2 at breakfast, 1 for a morning snack, 3-4 at lunch, 1 for an afternoon snack, 3-4 at dinner, and 1 again for an evening snack. So, in general, definitely not more than 13 servings, and usually closer to 11 for the whole day.
Here’s what I’ve learned about that. I need to stay really close to the low end of the carb range at breakfast. I think part of it is my personal metabolism, but I think this tends to ring true for gestational diabetics in general–you need to ease into the day, carb-wise. And for me, the carbs can’t come from cereal. The nutritionist that I first saw referred to cereal as “partially digested food,” which is gross, but true, when you stop to think about it. Even the high-fiber cereals, when hit with milk, start to break down, so there’s just not much work for your body to do in the digestion process. Thus, higher sugars. Protein is important at breakfast, to balance out the carbs. So, a piece of whole grain, low carb bread, with some peanut butter or an egg on top is an excellent choice. This is my most redundant meal…I don’t tend to stray from eating the same thing day in and day out, which, let’s face it, can be boring. But when you’re trying as hard as possible to stay right around 15 grams of carbs at one meal, you have to deal with not having a lot of options.
Lunch provides a little more flexibility than breakfast. I usually stay around three carb servings at this meal, but I also don’t feel bad if I approach four. And 45-60 grams of carbs does leave you with a lot of options. A sandwich, (again on whole grain bread) is one option, as is a salad and some yogurt, or a bowl of soup, and, depending on the carb levels of the soup, a piece of bread on the side. Even a small serving of pasta is doable. Again, it’s important to remember to balance the carbs out with fiber and protein.
Dinner is the meal at which I’m most likely to eat my full allotment of carbs, mostly because I just really like dinner, and want to enjoy it! You have to be careful, though, of meals with side dishes. A sloppy joe or hamburger is usually OK by itself, (unless the bun is huge!), but when you start adding chips or fries on the side, it can add up really quickly. I speak from experience, because I’ve made the mistake of not really paying attention to the total of the parts of a meal like that, and my blood sugar reflected it. But, in general, you can eat most of the things you normally would, as long as you pay close attention to portion size, and again, balancing the carbs in the meal with protein and fiber.
Snacks can be interesting. It’s actually nice to have an excuse to snack, especially if you’re hungry all the time. And the regularly scheduled snacks are important. It can be a challenge, though, because sometimes you just don’t feel like eating, and yet you know you need to, to make sure you don’t start having unexpected dips and spikes in your sugar levels throughout the day. And then there’s the issue of finding a snack that fits into that one carb serving limit. My favorite snack is a high fiber granola bar. While the carbs look high on the surface, there are some adjustments that can be made in regards to net carbs, because of the high level of fiber. So, the bar has 24 grams of carbs, but also has nine grams of fiber, which can be subtracted from the carb total, leaving you with 15 net carbs. Right where you want to be!
Other good snacks can be a few crackers with some cheese, some cottage cheese, or some yogurt, (depending on the sugar content). Fresh vegetables make a good snack, (although not so much carrots or other starchy vegetables), but you have to be careful with fresh fruit. Bananas are a gestational diabetics mortal enemy, despite their high nutritional content! But, as with meals, you basically want to balance your allotment of carbs with something that either has fiber or protein or both. Just because you can have 15 grams of carbs doesn’t mean you want to waste them all on a sugary treat. It may be satisfying in the short-term, but it won’t stick with you, leaving you feeling sluggish and hungry, and can leave your blood sugars out of whack later.
Of course, there are times when every pregnant woman wants to splurge on a treat. And it can be done, very occasionally, if you’re willing to make up for it. Exercise is great at lowering blood sugar. So, if you know you’re going to be enjoying a (small) piece of birthday cake, plan on taking a walk afterward. You’ll feel better for it, and it will help regulate your blood sugar, keeping it within a more acceptable range. Exercise is also beneficial if you know you have a meal that your body doesn’t process as well, like my issues with breakfast. This doesn’t mean overindulging in the meal, but if you go for a walk after, it may help prevent your numbers from getting too high.
Of course, everybody is different. With all of my pregnancies, I’ve been fortunate enough to be able to control my gestational diabetes through diet, (and exercise), alone, so all of my advice comes from the perspective of never having needed medication. Some women do need medication, and of course that’s OK. You do whatever you have to do to keep yourself and your baby healthy. You don’t have total control over how your body reacts to this kind of situation, and no matter how hard you work at controlling your diet, you may need extra help. What’s important is following your doctor’s recommendations, and being honest with him or her about your numbers, how you’re feeling, and any problems you may run into. If they know you’re struggling with a particular aspect of managing your diabetes, they’ll be better able to figure out how to help you, and keep you and your baby healthy!