The most important part of managing gestational diabetes is your diet, therefore, it is essential to discuss this with a dietitian or health professional.

A healthy eating plan will help to manage your blood glucose levels and meet the nutritional needs for you and your baby. It will also assist in achieving suitable weight changes. In all pregnancies, calcium, protein, iron,and folate are all important nutrients. In pregnancies affected by gestational diabetes, carbohydrates play a very important role.

Carbohydrates

Carbohydrates are nutrients that come from certain foods. They are broken down into glucose in the body. This glucose is then used as the body's main source of energy.

Foods containing carbohydrates include:

• Pasta, rice, noodles
• Breads and breakfast cereals, crisp breads
• Potato, sweet potato, corn
• Legumes, for example baked beans, red kidney beans, lentils
• Fruits
• Milk, yoghurt, custard

These foods are a good source of energy, vitamins, minerals and fibre. They need to be included in a healthy eating plan.

Carbohydrates are also found in regular soft drinks, cordials, fruit juices, and lollies. These foods are high in carbohydrate and provide little other nutrients. They should be restricted, as they will raise blood glucose levels very high and very quickly. Carbohydrates are also found in biscuits, cakes and processed foods such as chips, pizza and burgers. These foods are high in fat and should be limited.

It is important to spread carbohydrate foods over 3 small meals and 2 – 3 snacks per day.

Types of Carbohydrates

Different types of carbohydrates will increase blood glucose levels at different rates.

The Glycaemic Index (GI) is a measure of how quickly and how high blood glucose levels rise after eating a particular food i.e.

• Foods that have a high GI produce a fast, high rise in blood glucose levels
• Foods that have a low GI produce a slower, lower rise in blood glucose levels

Low GI foods:

• make you feel fuller for longer
• prevent large fluctuations in blood glucose levels
• may help in weight management.

Aim to at least include 1 low GI food at each meal.

Amounts of carbohydrates

The amount of carbohydrate you eat is very important. This is where a dietitian or health professional can provide some guidance.

Basically aim for 2-3 serves of carbohydrate at each meal
And, 1-2 serves of carbohydrate at each snack.
1 serve is approximately equal to 15 grams of carbohydrate.

A list of foods that all contain 1 serve of carbohydrate can be found at the link at the end of this section.

Try to include a variety of carbohydrate serves in your diet to achieve optimal nutrition.

Read the label!

A useful way to work out the carbohydrate serves of foods is to read the 'Nutrition Information' label on the packaging of foods.

1. Look at the Total Carbohydrate in the per serve column (this includes any sugars in the food)
2. Think about how much of that serving size you will eat to determine how much carbohydrate is in your serve.

Free Foods

'Free' foods are nutritious foods that will not cause excess weight gain and will not affect blood glucose levels. These free foods include;

All vegetables ( except potato, sweet potato, corn, legumes, taro)
Some fruits – lemon, lime, passionfruit, small serves of berries, and rhubarb
Drinks – water, soda water, plain mineral water.

Fat

Fat does not directly affect blood glucose levels. However, if eaten in large amounts it can cause extra weight gain. This can further increase insulin resistance.

Eat small amounts of healthier fats such as canola, olive, sunflower, rice bran oils; polyunsaturated margarines, avocados and unsalted nuts.
Limit saturated fats (choose lean meats; remove skin from chicken, choose low fat dairy foods).
Limit take away and processed foods e.g. pizza

Protein

Protein is essential for the growth of your baby.

Include 2 serves of meat or meat alternatives in your diet each day.

Legumes will be needed to be counted in your carbohydrate serves as they will affect blood glucose levels

Calcium

Calcium requirements increase in pregnancy. Aim to include 3 - 4 serves low fat calcium rich foods each day. Good sources include milk, yoghurt, and custard. These foods need to be counted in your carbohydrate serves.

Points to remember

Artificial Sweeteners

Small amounts of sweeteners are not known to be harmful, but should be avoided as much as possible. Aspatame (Nutrasweet, Equal) (951), Sucralose (Splenda)(955), Acesulphame Potassium (950) can be used.

There is no known safe level of alcohol consumption in pregnancy.

Avoid large amounts of caffeine. No more than 2 cups of coffee or 2 caffeine containing drinks or 4 cups of tea is advisable.

Eat Regularly

Skipping meals or restricting carbohydrate foods is not the answer to high blood glucose levels. It is not healthy for you and can be harmful to your developing baby.

In summary

Choose a variety of foods that are

• enjoyable to eat
• a good source of carbohydrate
• low in fat
• provide the nutrients required in pregnancy (iron, calcium, folic acid, protein)

Eat regular meals, eat small amounts often, include some carbohydrate in every meal and snack. Eat to satisfy your hunger and maintain a healthy weight.

For further information, please refer to the resource: 'Healthy Eating for Gestational Diabetes'
This is a publication by SA Health and the Women's and Children's Hospital. It is a comprehensive and easy to read guide. It contains a sample meal plan, and a list of carbohydrate foods that are equal to one serve.