Diet and Health FAQ

Tagged As: south beach diet pregnancy

Question:
I just got the phone call this morning that my 3 hour glucose test came back abnormal and that I have gestational diabetes. I don't have the appt. set up yet w/ the dietician, but am wondering what I need to avoid in the meantime until I get to see them. I've read on various sites general information, but nothing specific (i.e., avoid pasta, avoid sugar, etc.). I know a diet gets structured to your specific needs based on weight, current glucose levels, etc. I just want to be sure I'm staying away from things that won't be good for me. Can anyone share some of their GD tips/nutritional advice? Also, I am almost at the end of 32 weeks. Did the doctors wait too long to start treating this? Have I already done damage to the baby? I know GD gets diagnosed around week 24-28. I did have my initial test 4 weeks ago, but no one ever called me w/ the results and I just figured that no news was good news. It took my doctor asking me at last week's appt what my results were. He had to track them down in the lab which is when he found out my results were abnormal. I am a bit disturbed about the fact that I could've been diagnosed several weeks ago and been on the diet. Do I need to worry that the baby may have suffered damage over the past 4 weeks since I wasn't on a diabetic diet?

Answer:
OK, let me give you some general guidelines from my experience. :) I had borderline sugars with my first pregnancy, culminating in a pretty big baby with neonatal hypoglycemia. My doctor at that time had given me the helpful advice of don't drink juice, which didn't really cover much... THIS time around, I had a problem with very *low* blood sugar in the first trimester, and was put on a diet based on diabetic exchanges. The purpose of this fod plan was to keep my blood glucose steady throughout the day, the same as a diabetic's plan -- and the dietician as much as said that should I develop GD later in the pregnancy, I'd be following essentially the same plan. Funny coincidence, too, I just got my official phone call today that I flunked my one-hour glucose test and need to go in for my three-hour... Anyway, Ericka covered a lot of the nitty-gritty. I'd agree with her that it's very unlikely that the baby has been significantly harmed, in terms of congenital defects, and the biggest tangible risk in gestational diabetes is the chance of having a really big baby and all that may entail. There's a lot of terrific information on the state of the medical literature & etc. here, if you're into that kind of thing: http://www.plus-size-pregnancy.org/gd/gd_index.html And now on to the immediately practical stuff. At 32 weeks, you have a long way to go, and you're entering the phase of pregnancy where the baby is primarily putting on fat anyhow. The theory goes that this is the time to avoid high sugars which will put a little too much weight on the baby. When I was given my diet for evening out blood sugar (and through long discussion with my diabetic mother) these are the general principles I was taught, and from everything I've learned about GD before and since, the same concrete info should help you, too (though of course the advice of your nutritionist and/or doctor supercedes anything I may have to say): * You don't want to be cutting out all of your starches just yet, not without talking to your dietician. If you've ever gone on a low-carb diet, you may already know how crummy that can make you feel. DO stick to whole wheat breads, brown rice instead of white, whole wheat pasta, etc., if you don't already. I find the baked goods labeled low-carb tend to be good about being higher in fiber and lower in added sugars. * You probably DO want to cut out juice, sugared soda, and any sweets you may eat -- candy, doughnuts, cakes, cookies, etc. Don't go looking for low-carb/sugar-free replacements until you get a chance to talk to your nutritionist about it. * You should absolutely have a protein (meat, cheese, nuts, tofu) with every meal and every snack, or failing that, at LEAST a fat, and preferably in an amount that is larger than the amount of starches you're eating until you're testing and know your tolerances. You absolutely do not want to eat a starch without some form of protein or healthy fat offsetting it, so no handfuls of pretzels of popcorn, etc. This is because protein and fats help slow down the uptake of sugar into your bloodstream. * Some people have blood sugar spikes from dairy (mainly in yogurt or milk form) and fruits, so for now, you'll probably want to not have those at the same meal as each other, and again, never without a protein. I can't tell you the weird things this has had me eating. :) * You'll very likely begin self-monitoring your glucose. Finger sticking really, really isn't as bad as you think it will be. It ranges from not feeling anything at all to feeling like you got snapped with a rubber band. Never fear. :) * I found my diet very similar to a South Beach Phase Two diet, and it's worth it to poke around on low-carb recipe sites for meals and recipes. The idea is pretty similar. Or, to go more specific: Breakfast: Eggs are your friend, it might be wise to hard-boil a bunch for quick breakfasts. Breakfast is the most important meal of the day! For real! Omelettes with veggies are great, too, if you have the time. I did OK with a hard-boiled egg and a slice of whole-wheat toast with butter and a smallish bit of sugar-free jam on it with some black tea. YMMV. This is probably NOT the right time to be having cereal or muffins for breakfast. You may also be good with some cottage cheese, a smallish amount of sliced fruit, and a few nuts. Snacks: Try to eat every couple of hours, hence the not-gigantic breakfast :) You will likely be aiming for three snacks a day, midway between breakfast and lunch; and midway between lunch and dinner; and a bedtime snack a few hours after dinner. Good snacks are along the lines of: celery with nut butter on it; string cheese with a small apple; sugar-free yogurt with a couple of tablespoons of sliced almonds mixed in... you get the idea. :) I like to have raw veggies (cucumber, bell pepper, radish) dipped in hummus, but hummus doesn't actually count as a protein for diabetes exchanges, so you might not be allowed over the long-term. Lunch: Try to stick to veggies, around 3 ounces of protein, and no more than two or three servings of carbs (slice of bread, etc.) Not a bad idea to take up having salads with lunch and dinner. For now, stick with simple dressings, if you can -- just a drizzle of olive oil and balsamic vinegar or something like that, the regular stuff can have a lot of sugar in it -- and be sure to have your protein. I personally have a lot of vegan bologna sandwiches these days, because cooking in the middle of the day is a pain in the neck, but the two slices of bread might be too high-carb for you over the long term. Tuna salad is a good choice, too, though of course sparingly; and your basic grilled chicken breasts, turkey burgers, tofu stir-fry, etc., can do the trick. You might not want to chance it for now, but I can get away with having a serving of fruit with lunch and with dinner, provided I'm not skimping on the protein at all. Dinner: As-is with lunch, though my dietician wants me to have closer to 5 ounces of protein. Which, if you're not much of a meat-eater to begin with, is quite an undertaking... Grilling for dinners is a nice choice, if you have the facilities. You might want to keep things simple for a few days, until you have a chance to meet and work up your own plan. Try to avoid the pizzas and French fries of the world for now... I do well with a chili made with kidney beans, diced tomatoes, sauteed onions, ground beef or turkey or frozen shrimp, and a packet of chili seasoning from the grocery. In general, if you eyeball it, just make sure you're eating more protein than you are starch and sugar, along with a decent amount of non-starchy vegetables. That should cover you for now... it's not SO different from the just plain eating healthy except for the part where a bagel with cream cheese is no longer a good choice on its own at any time of day. :) Good luck, and I hope I made things clearer rather than more muddled!