What is Gestational Diabetes (GDM)

It is a form of diabetes that occurs during pregnancy. It is also an early warning sign of the likelihood of developing type 2 diabetes later on in life. [1] For most women, GDM settles after the birth of the baby. GDM can increase the risk of high blood glucose levels in your new born, having a baby that is large for gestational age (macrosomia), preeclampsia or even needing a caesarian section. Therefore, it is vital to manage GDM adequately and support a safe pregnancy and birth. GDM is usually diagnosed from 24-28 weeks with an oral glucose tolerance test but may even occur earlier in your pregnancy. [1]

GDM can occur in some women due to the changes in hormones, insulin resistance, preexisting conditions like PCOS, family medical history of diabetes or even from certain ethnic backgrounds. [2] Nevertheless, GDM can be managed through diet, lifestyle and medical interventions to support a safe pregnancy.

Healthy eating with GDM [3]

  • Aim to eat 3 moderate sized meals and 2-3 snacks. Spread out over the day. Large amounts of carbohydrate foods at any one meal or snack can cause blood glucose levels to rise too high.
  • Choose the right type and amount of carbohydrate foods at each meal and snack.
  • Choose foods that are low in saturated fat.
  • Make high fibre food choices.
  • Eat a variety of foods that provide the nutrients you need during pregnancy.  
  • Nutrients for pregnancy; Iron (found in red meat, chicken, fish, legumes), Folate (found in dark green leafy vegetables) and Iodine (found in fish, bread, dairy foods).

Carbohydrates

  • Carbohydrates are found in a variety of food and drinks and provides the body with energy.
  • Carbohydrates break down into glucose during digestion and can increase blood glucose levels.
  • Many foods containing carbohydrates also provide dietary fibre, vitamins and minerals.
  • The amount and type of carbohydrates you eat will affect your blood glucose levels.
  • Not eating enough carbohydrates can affect your baby’s brain and nerve development. Do not avoid carbohydrates, try to include some carbohydrate at most meals and snacks each day.

Type of Carbohydrates

Carbohydrates break down into glucose at different rates. The glycemic index (GI) tells us how slowly or quickly carbohydrate foods affect blood glucose levels.

High-GI : Carbohydrate foods that break down into glucose quickly, which means a higher and faster rise in blood glucose levels after eating.

Low GI : carbohydrate foods break down into glucose slowly. They result in a smaller and slower rise in blood glucose levels after eating.

Choose foods with a lower GI as they are a better choice to manage blood glucose levels. These foods are high in fiber and have a lower GI.

  • Rice: Red rice, basmati rice (white/red), low GI rice white/red  (CIC)
  • Bread: wholegrain/whole meal/multi-seed bread, whole meal wraps, chapati, atta flour roti
  • Cereals: Rolled oats
  • Pasta: whole meal pasta, buckwheat pasta
  • Noodles: red rice noodles, kurakkan noodles (any brown or red noodles)
  • Dairy: milk, yoghurt (unflavored)
  • Vegetables and legumes: lentils, chickpeas, kidney beans, other red/orange and green leafy vegetables.
  • Fruit: fresh fruit

Sugars

  • Sugars such as white, raw, brown sugar, honey, maple syrup, glucose syrups are also carbohydrates, but they provide no nutritional benefit and can cause your blood glucose levels to rise too high.
  • Limit added sugars and avoid foods and drinks high in sugar such as soft drinks, cordials, fruit juices, cakes, desserts, biscuits, chocolates, lollies.

Fats

  • Use small amounts of healthy fats such as olive oil, canola oils, margarine, unsalted nuts and seeds, avocado.
  • Limit the saturated fat such as fried food, butter, ghee, cream, sour cream and coconut milk/cream and choose lean meats such as skinless chicken, low fat dairy food.
  • Aim to avoid takeaway and processed foods high in saturated fats such as pastries, packaged biscuits, savoury snacks, chips, chocolates and processed meats such as sausages, ham etc.
  • If these fats are eaten in large quantities it can result in extra weight gain, which can further increase insulin resistance.

Putting together a balanced meal

  • Fill half of your plate with salad (home-made) or mixed vegetables (not including potato, corn, sweet potato, taro, cassava)
  • Choose a lower GI carbohydrate food such as red rice, low GI rice, buck wheat pasta, multi-seed brown bread etc. or chickpeas, kidney beans etc.
  • Add a moderate serve of lean protein food, such as chicken, fish, beef, eggs etc.

References

  1. American Diabetes Association, 2019. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes care42(Supplement 1), pp.S13-S28.
  • Buchanan, T.A., Xiang, A.H. and Page, K.A., 2012. Gestational diabetes mellitus: risks and management during and after pregnancy. Nature Reviews Endocrinology8(11), pp.639-649.
Leave a reply