Nutrition Basics For Women with Gestational Diabetes
This guide provides basic information to help you start lowering
your blood glucose until your appointment with a registered dietitian,
the nutrition expert. These are general guidelines which may be
tailored to meet your needs. Food is an important tool that you
can use to control your blood sugar during pregnancy. Eating healthfully
often means making changes in your current eating habits. A registered
dietitian can provide in-depth personalized nutrition education
to help you develop a personal action plan.
Diabetes and the foods you eat
When you eat or drink, much of your food is broken down into a simple
sugar called glucose. Glucose (sugar) provides the energy your body
needs for daily activities. Insulin is a hormone that helps your
body use glucose for energy. Without enough insulin, sugar cannot
get into the body's cells for use as energy. This causes blood glucose
to rise. Too much sugar in the blood is called "high blood
glucose" or diabetes.
Gestational diabetes is a condition characterized by high blood
glucose levels discovered during pregnancy. Gestational diabetes
is the result of hormonal changes that occur in all women during
pregnancy. Increased levels of certain hormones made in the placenta
(the organ that connects the baby by the umbilical cord to the uterus
and transfers nutrients from the mother to the baby) interfere with
the ability of insulin to manage glucose. This condition is called
"insulin resistance." As the placenta grows larger during
pregnancy, it produces more hormones and increases this insulin
resistance. Usually the mother's pancreas is able to produce more
insulin (about three times the normal amount) to overcome the insulin
resistance. If the pancreas cannot produce enough insulin to overcome
the effect of the increased hormones during pregnancy, glucose levels
will rise, resulting in gestational diabetes.
High blood glucose levels that are not treated during pregnancy
can cause problems for you and your baby. Gestational diabetes does
not cause your baby to have diabetes. However, if left untreated,
gestational diabetes can cause your baby to produce too much insulin
and gain too much weight, increasing the risk of premature delivery.
Usually, blood glucose levels return to normal after childbirth.
However, women who have had gestational diabetes have an increased
risk of developing type 2 diabetes later in life.
Diabetes and carbohydrates
Carbohydrates (foods high in starch and sugar) have the greatest
impact on blood glucose levels, since they are broken down into
glucose during digestion. It is important to control the amount
of carbohydrate by eating the same amount of carbohydrate along
with some protein and fat at each meal.
Goals for healthy eating
- Eat three small meals and two or three snacks at regular
times every day. Do not skip meals or snacks.
- Eat less carbohydrate at breakfast than at other meals because
this is when insulin resistance is the greatest.
- Try to eat a consistent amount of carbohydrate during
each meal and snack.
- If you have morning sickness, eat 1-2 servings of crackers,
cereal or pretzels before getting out of bed; eat small, frequent
meals throughout the day and avoid fatty, fried and greasy foods.
If you take insulin and have morning sickness, make sure you know
how to treat low blood glucose.
Choose foods high in fiber such as whole-grain breads,
cereals, pasta, rice, fruits and vegetables.
Eat foods with less sugar and fat.
Drink at least 8 cups (or 64 ounces) of liquids per day.
Make sure you are getting enough vitamins and minerals
in your daily diet. Ask your health care provider about
taking a prenatal vitamin and mineral supplement to meet the
nutritional needs of your pregnancy.
Here are some other guidelines:
Eat and drink at least 4 servings of dairy products and calcium-rich
foods a day to help ensure that you are getting 1200 mg. of
calcium in your daily diet. Sources of calcium include dairy products,
some nuts, green vegetables and foods and beverages fortified with
calcium, such as calcium-fortified, unsweetened ready-to-eat cereals.
Eat at least three servings of iron-rich foods per day
to ensure you are getting 30 mg. of iron in your daily diet. Sources
of iron include enriched grain products (rice); lean meat, poultry
and fish; eggs and leafy green vegetables.
Choose at least one source of Vitamin C every day. Sources
of Vitamin C include oranges, grapefruits, strawberries, honeydew,
broccoli, cauliflower, brussel sprouts, green peppers, tomatoes
and mustard greens.
Choose at least one source of folic acid every day. Sources
include dark green leafy vegetables, veal, fortified grain products,
legumes (lima beans, black beans, black-eyed peas and chickpeas)
Choose at least one source of Vitamin A every other day.
Sources rich in Vitamin A include carrots, pumpkins, sweet potatoes,
spinach, water squash, turnip greens, beet greens, apricots and
- Avoid alcoholic beverages during pregnancy. Alcohol
has been linked to premature delivery and low birth weight babies.
If you think you may have a problem with alcohol use, please talk
to your health care provider so he or she can help protect you
and your baby.
- Limit caffeine to no more than 300 mg. per day (two
8-ounce cups of coffee, three 8-ounce cups of tea or three 12-ounce
glasses of caffeinated soda). Remember, chocolate contains caffeine
-- the amount of caffeine in a chocolate bar is equal to 1/4 cup
- DO NOT DIET or try to lose weight during pregnancy --
both you and your baby need the proper nutrients in order to be
healthy. Ask your health care provider how much weight you should
gain during pregnancy. A woman of average weight before pregnancy
can expect to gain 25 to 35 pounds during pregnancy. You may need
to gain more or less weight, depending on what your health care
- Eat a variety of foods to get all the nutrients you
need. The Food Guide Pyramid on the next page provides an example
of the number of servings you should eat from each food group
- The use of non-nutritive or artificial sweeteners approved
by the Food and Drug Administration is acceptable during pregnancy.
These FDA-approved sweeteners include aspartame and acesulfame-K.
The use of saccharin is strongly discouraged during pregnancy
because it can cross the placenta and may remain in fetal tissues.
Talk with your health care provider about how much non-nutritive
sweetener is acceptable during pregnancy.
Foods to Choose to Lower
Breads and Grains
Fruits and Vegetables
|1 slice of bread
1/2 bagel or English muffin
1 plain rice cake
6 crackers (such as matzo, bread sticks, rye crisps, saltines)
3 graham crackers
3/4 cup ready-to-eat cereal
1/2 cup pasta or rice
1/2 cup corn
Small plain baked potato
1 small pancake
1 6-inch tortilla
1 piece of fresh fruit
1 melon wedge
1/2 cup chopped, cooked, frozen or unsweetened canned fruits
3-5 or more vegetable servings/day
1/2 cup cooked or canned vegetables
1 cup chopped, uncooked or frozen vegetables
|1 cup low-fat milk
1 cup soy milk
1 cup low-fat unsweetened yogurt
1 1/2 ounces of cheese
1/2 cup low-fat cottage cheese
Meat, Fish, Poultry
Fats and Oils
In limited amounts
(approximately 5-8 tsp/day)
Sweets and Snacks
In limited amounts
|2 ounces cooked lean meat, fish or
2 ounces of cheese
2 eggs or the equivalent in egg substitutes
1 cup cooked dried beans or peas
2 tbsp peanut butter
1/4 cup tofu (bean curd)
|Vegetable oil (olive, canola or peanut
Fat-free or low-fat salad dressing
Peanut butter and crackers
Cheese and crackers
Plain popcorn, pretzels
Sugar-free candy and gum
This handout provides general
guidelines for lowering your blood sugar. The next step is to make
an appointment with a registered dietitian, the nutrition expert.
A registered dietitian will evaluate different health factors to
determine your individual nutritional status; review your diet history
targeting carbohydrate (glucose) sources; explain product selection,
label reading, cooking methods, menu planning and dining out; and
develop an individualized treatment
that will meet your needs.
- Fat (naturally occurring and added)
These symbols show that fat and added sugars come mostly
from fats, oils and sweets, but can be part of or added to
foods from other food groups as well.
Source: U.S. Department of Agriculture,
U.S. Department of Health and Human Services
The Cleveland Clinic
This information is provided by the Cleveland Clinic and is not
intended to replace the medical advice of your doctor or health
care provider. Please consult your health care provider for advice
about a specific medical condition. For additional written health
information, please contact the Health Information Center at the
Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273
extension 43771 or visit www.clevelandclinic.org/health/.
This document was last reviewed on: 11/1/2001