Being diagnosed with gestational diabetes mellitus (GDM) can be overwhelming, frustrating and scary. You could be filled with feelings of guilt and anger, to name a few. Having GDM is not your fault — it is caused by pregnancy hormones and is diagnosed in approximately 3 to 8 percent of all pregnant women in the U.S. Lots of confusion can come with this diagnosis and what to eat is probably at the top of the list. The good news is that GDM can be controlled with diet a majority of the time.
To help you do that, we've included a sample menu and several delicious, easy snack recipes courtesy of kids teaching kidssm. Even if you aren't diagnosed with GDM, this healthy eating plan can help you manage your pregnancy weight and give your baby the nutrition it needs to thrive and grow.
Testing for gestational diabetes.
Testing for GDM is referred to as an oral glucose tolerance test (OGTT) and is usually performed at 24 to 28 weeks of pregnancy. This is the time when you become insulin resistant, resulting in a rise in your blood sugar levels. If your body cannot produce enough insulin to keep the blood sugar in a safe range, the result is GDM. The testing procedure involves having your finger stuck for a fasting blood sugar reading. After this, you will drink a sweet, sugary solution and have two more blood samples taken to help determine if your blood sugars are staying within a healthy safe range or rising higher than normal. For women diagnosed with GDM, screening is also recommended between 6 to 12 weeks postpartum to determine if diabetes or prediabetes is present.
Impact of mom's blood sugar on baby.
If you are diagnosed with GDM, there are risks involved for baby and mom, but you can have a healthy pregnancy and you and your baby can go on to live a long and healthy life.
When mom's blood sugar rises too high, the extra sugar crosses the placenta and is fed to the baby. Since baby produces insulin, the extra sugar is stored. If this is done frequently the result is an oversized baby. This is not just a large baby, but instead the result can be shoulder dystocia which means that labor will be difficult for mom and baby because the shoulders cannot pass through the birth canal.
Also, because baby has become used to producing extra insulin to cover the excessive amounts of sugar, insulin production will continue at the time of birth when the food supply is no longer available. This can result in low blood sugar (hypoglycemia) for baby.
Healthy eating to manage gestational diabetes.
Treatment for GDM focuses on keeping your blood glucose levels in the normal range and may include a special diet, exercise, daily blood glucose monitoring and insulin injections. Even if you don't have gestational diabetes, experts recommend adding just 300-400 calories daily to manage pregnancy weight gain. Kelli Culpepper, MD, an OB-GYN at Medical City Dallas who was interviewed by U.S. News and World Report, encourages all of her patients to adopt or continue their healthy eating and exercise habits during pregnancy.
Following a special diet involves eating from all food groups and can be adjusted to meet the special requirements of mom. It is not unusual for pregnant women who have been diagnosed with gestational diabetes to stop eating carbohydrates, but they should definitely be included in the diet, along with protein and fats, to allow intake of all vital nutrients for the development of baby.
In meeting with a registered dietitian nutritionist (RDN), an individualized meal plan is determined for you so that you know:
- What foods to eat
- How much to eat
- When to eat.
You will gain an understanding of how to control your blood glucose that will help you throughout pregnancy for optimal weight and blood sugar management. Monitoring of your blood sugar four times daily is useful in determining how well the blood glucose is being managed.
You and the RDN will monitor your blood sugar and food records so that you have an understanding of how food affects your blood sugar and to discuss if you are satisfied after eating or still hungry, so that adjustments may be made for optimal control.
Below is a sample menu that can help someone with gestational diabetes manage their carbohydrate intake and blood sugar level. You may find that it contains smaller meals and more frequent snacks than you are used to eating. This helps the blood sugar level remain steady. Our bodies can only handle so much food at once, so if we overeat, the blood sugar will rise above normal. Going too long between meals can result in a desire to overeat at the next meal.
Sample healthy menu for pregnant women with or without GDM:
Always check with your doctor or other healthcare professional before beginning any new diet.
Breakfast: 34 grams carbohydrates
One whole wheat mini bagel
2 Tablespoons peanut butter
8 ounces milk (preferably not one of the nut milks, as they do not contain enough protein)
Morning snack: 32 grams carbohydrates
Veggie Roll-Ups (recipe below)
Lunch: 56 grams carbohydrates
One 7-inch whole wheat tortilla
1/2 cup beans
Fresh tomato slices
8 ounces milk
Afternoon snack: 32 grams carbohydrates
Orange Walnut Salad Wrap (recipe below)
Dinner: 60 grams carbohydrates
6 ounces baked salmon
2/3 cup brown rice with green onion
1 cup cooked squash
6 slices fresh tomato
1 cup honeydew melon
1 Tablespoon margarine spread
Bedtime Snack: 34 grams carbohydrates
Blueberry Graham Cracker Cheesecake
The kids teaching kids program is sponsored by Medical City Children's Hospital in partnership with 14 DFW-area school districts, the Texas ProStart National Restaurant Association Educational Foundation and more than a dozen North Texas restaurants. The goal of educating and engaging students in better nutrition is achieved by having registered dietitians work with high school culinary students to create snack recipes that are simple enough for elementary school students to make and are full of healthy, ﬂavorful fruits and vegetables.
Veggie Roll-Ups from Allen High School
- 2 slices whole wheat bread
- 1 tbsp. hummus, original
- 1/4 cup cucumbers, diced
- 1/4 cup red pepper, diced
- 1/4 cup carrot, diced
- Cut crust from bread
- Spread hummus on bread
- Distribute vegetables evenly onto bread
- Roll the slice so the edges meet
- Using butter knife, cut roll into 3 or 4 slices
- Arrange any remaining vegetables on the plate
Orange Walnut Salad Wrap from The Frisco Career and Technical Education Center
- 1 whole wheat tortilla
- 1 1/4 cups spinach, loosely packed
- 1/4 cup orange sections
- 1 teaspoon walnuts, chopped
- 1 Tablespoon raspberry vinaigrette, light
- Peel the oranges and tear into individual pieces
- Toss spinach leaves in vinaigrette
- Fold in oranges and walnuts
- Place the tortilla on a plate, add salad mixture, fold and wrap
Blueberry Graham Cracker Cheesecake from the Frisco Career and Technical Education Center
- 3 Tablespoons Whipped Cream Cheese and Greek Yogurt Spread, plain
- 1/2 cup blueberries, fresh or frozen
- 4 graham cracker squares
- Spread cream cheese/yogurt mixture onto crackers
- Top with blueberries
Grace Rivers is a registered dietitian nutritionist and certified diabetes educator with a practice in Richardson. She has a strong passion for healthy living and loves that she works in the health and nutrition field because she can help others. Follow Grace's blog, eats with Grace, where her mission is to help you incorporate healthy nutrition practices into your everyday life.