Gestational Diabetes - what to eat?

[whoami24601]

I was diagnosed with GD at 28 weeks, after a routine blood test. I was given a blood sugar monitor and things started well - my sugars seemed fairly stable so I allowed myself the odd treat (the dietitian said that was fine). On one or two occasions my sugars were very slightly raised, but in general my readings were within range (quite often at the lower end!). Went to see the consultant last week, and without any discussion he just looked at my numbers and decided they were too high. He prescribed me Metformin to take twice a day.

Since then I've made a real effort to keep my sugars stable (smaller portions, fewer snacks, healthier meals etc) and it seems to be working.

HOWEVER

Yesterday I saw the midwife, and she said I have ketones in my urine which means I'm not eating enough! I've also lost a few kgs since my last weigh in! So now I don't know what to do for the best!

Can anyone help? I thought I was doing all the right things, but now I just feel shit and like I'm getting everything wrong!

I thought you were supposed to try and limit all carbs? So it’s not about eating less, but cutting carbs from your diet for the remainder of your pregnancy?

Did the dietician discuss he foods you could/couldn’t eat?

What’s happening is your body is unable to make enough insulin for you and the baby. So eating a ‘healthy meal’ that has carbs in will send your blood sugar high, as your body is unable to produce enough insulin to deal with it properly. The extra sugar in your blood causes all sorts of problems for you and your baby.

A friend just had a baby at 38 weeks for GD. Despite having steroids before a section, the baby ended up on NICU for a few days with respiratory distress, as the extra sugar stops the lungs developing properly. It’s fine now, but just goes to show the impact GD can have on a baby.

I’d take the metformin, and really work hard to cut out all carbs from your diet. It’s not forever, only a few weeks to go. And think of the chocolate/champagne celebration post birth!

I have gestational diabetes and I have found the gestational diabetes UK mum's on Facebook so so helpful to figure out what to eat and get support. They also have a website gestationaldiabetes.co.uk.

It explains about what you can and cannot eat and gives loads of advice. The advice is so much better than I got from the diabetes nurses who basically told me to keep eating cereal and bread - I can't tolerate either!

Because of the advice on the site I have managed to stay diet controlled throughout.

Limit carbs but do eat them. if you're eating crisps, eat a bag from a multipack as they're smaller. No more than 15 grapes in one sitting. If you're eating fruit or a cake, have it straight after your lunch/dinner.

No fruit juice. Only sugar free drinks.

Watch your milk intake. It doesn't matter if it's blue, green or red, the sugar content is the same.

I also second the website above and specifically the Facebook page. It's about managing the right type and amount of carbs not cutting them out completely! The information and support on there is great. I ended up on metformin and insulin as it can't always be diet controlled but at the end of the day you are doing what is best for you both!

I had GD and one think to keep in mind is that it does tend to get worse as you go along. I was literally on the borderline when diagnosed so was diet restricted, but then later prescribed metformin, then the dose was doubled and little one was induced early (which failed so in the end CS)

Don’t restrict your eating whatever you do, you and your baby need the calories! Your body is working hard after all 😊

Instead change what you eat-

Stay clear of potato’s, they cause massive spikes! Instead have small portions of pasta or whole grains. Avoid refined carbs like white bread as they will give you a bigger spike.

Eats lots of protein - meat, fish, eggs and cheese is your biggest friend! And when your not having so many carbs to fill you up they help you feel full.

Eat lots of veggies to fill your plate, you both need the nutrients. You need fruit too, but be sparing. Try and have a couple of portions of fruit a day but as a snack and not too close to any of your meals. They are healthy but still cause a spike. Whatever you do don’t drink fruit juice though!

Use trial and error to help see you through. I was working when pregnant and didn’t have time to make cooked breakfasts in the morning so I tested different cereals- some places recommend shredded wheat as it’s just whole grains but for some reason it made me spike (even though whole grain bread didn’t!) in the end I found a protein granola in aldi which if measured carefully did the job and was fine.

Also be conscious that different times of day effect your sugars. Often you will be higher first thing in the morning so be particularly cautious then

Ooh also almonds are your best friend 😊

And don’t feel bad, it’s bloody heard to begin with!

And because you’re diet will be changing so drastically you may well lose weight, I lost a lot but it was all just stored up fat and baby was getting everything he needed! He’s now a beautiful 12 month old!

I have type 1 diabetes.

Low carb/carb free snack suggestions.. Cold meats, smoked fish, meet and fish in general, nuts, salads, cheese, cherry tomatoes, crudités (though I could never get excited about a raw carrot). Cheese is better than milk as the carbs are less easily absorbed.

*meat obviously

Yes to everything Biscuit said. And that website can be useful. Not good to cut out carbs completely. Keep them in small portions and mostly complex/ wholegrain. Grapes are actually high in sugar - berries much better. I used to have strawberries, cream and grated 70% chocolate on top as occasional treat.

NB be nice to yourself! This is tough and can be v stressful. Treat yourself to occasional prenatal massage if you can. GD can really fluctuate - that's what I found particularly difficult.

I had ketones occasionally and everything was fine but consultant said it's best to avoid ketones happening too much during pregnancy.

Sounds like you're doing a great job keeping on top of things. They really seem to be on the ball with GD these days so try not to worry.

Forgot to say - I found walking great. Exercise improves your insulin sensitivity

Thanks all! So I’m trying to up my protein (eating eggs a lot as they’re cheap and easy!) and cut down on carbs. I even managed a chippy tea (stuck to fish with just a few chips). That seems to be working so far. The dietitian never mentioned limiting carbs, just sticking to whole grain versions (which I was doing, but then was eating as much as I always have!) I’ve also been researching low carb snacks so I can add in calories hopefully without too many sugar spikes. Today’s snack - apple and peanut butter I’m actually looking forward to it!

What about fats though? There seems to be conflicting advice about whether they’re good or bad...

Ketones can be produced from eating less carbs and your body entering a state of ketosis. Health professionals always panic with ketones in urine because it could indicate preeclampsia, however in your case as it's come about after you've changed your diet I wouldn't worry