Healthy Eating

for

Gestational
Diabetes

This booklet gives basic information only.

For personal advice, see your Dietitian

Reviewed by Nutrition Department 2018

Dietitian: Nikki Levitas, 9382 6544
 What is Gestational Diabetes

Gestational Diabetes is a type of diabetes that occurs during pregnancy. It happens because
the body is not making enough insulin or insulin cannot work effectively. This occurs due to
changing hormone levels. Insulin is a hormone that helps move glucose (sugar) from the blood
into our cells where it is needed. Glucose is needed in our bodies as it is used by the muscles
and brain for energy. It is also important for the growth and development of your baby. When
carbohydrate food is eaten, it breaks down into glucose in our bloodstream. If insulin is not
working properly then glucose may not move from our blood into our cells and can cause a rise
in our blood glucose levels. This may impact on the health of you and your baby.

Following a healthy eating plan will assist in: -

- Managing your blood glucose levels within the target range
- Providing adequate nutrition for you and your growing baby
- Achieving appropriate weight gain during your pregnancy

What foods should I eat?

Carbohydrates:
The goal of healthy eating in Gestational diabetes is to help keep your blood glucose levels
stable. This can be achieved by including foods that contain carbohydrates regularly throughout
the day. This ensures a slow and steady supply of glucose into your blood which helps manage
mother and baby’s glucose levels.

Carbohydrate Foods

Breads, pastas, noodles, foods made with flour

Rice, grains, breakfast cereals Potato, corn, sweet potato, yams, tapioca, taro,
baked beans, cooked dried beans, lentils

Fruits

Milk, yoghurt, custard, ice-cream

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 Fruit
Breads
1 medium apple, orange, pear or peach
1 slice of bread (grain, wholemeal, fruit ) 1 small banana or ½ large
½ medium bread roll 2 or 3 small plums, kiwifruit, mandarins,
1 small Indian roti nectarines or apricots
1 cup cherries
Starchy Vegetables & Main Meal options 1 cup grapes
⅓ cup of cooked pasta or rice or quinoa 1 cup fruit salad or pears canned in juice
⅓ cup cous-cous cooked (1 ½ Tbs dry) ½ cup mango or pineapple canned in juice
¼ cup Polenta, Semolina, boiled 1 ½ tablespoons of sultanas
1 small (egg size) potato or ½ large potato 5 prunes, 4 dried dates, 2 dried figs, 8 dried
apricot halves
½ cup of sweet potato or taro
½ cup of sweet corn or ½ medium corn on the cob
½ cup of baked beans, kidney beans, borlotti beans, Milk Products
cannelini beans or chickpeas 1 cup of milk or soy milk (skim, light or full cream)
¾ cup of lentils (red, green, brown) boiled ½ cup (100mls) flavoured yoghurt
2 large carrots 1 cup (200mls) diet or natural yoghurt
¾ cup parsnip or pumpkin (baked) 2 scoops of low fat ice-cream

Cereals Biscuits & Crackers

⅓ cup of raw rolled oats (or ½ cup of cooked porridge with 2 Ryvita® crackers
milk) 2 Salada or Premium biscuits
¼ cup of muesli 2 thick or 4 thin Rice cakes
1½ wheat biscuits (eg: Wheat Bix® or Vita Brits®) 4 Vita-weat® crackers (regular size)
½ cup of Guardian®, All-Bran® (original), Special K® 10 Rice crackers
⅓ cup Sultana Bran®, Just Right® 4 Arnotts™ Cruskits
2 Arnotts™ Snack Right Fruit slice
Sugars and Treats 6 Jatz biscuits
4 small squares plain chocolate (25g) 3 Sao biscuits
2 Tbs Milo or Ovaltine

Carbohydrate Portions
Each item below is ONE carbohydrate portion (about 15g of carbohydrate)
In your first week, aim for: (maximum 10-12 serves/day)
Breakfas Snack 1 Lunch Snack 2 Dinner Snack
t 3
2-3 1-2 2-3 1-2 2-3 1
portions portion portion portion portion portion
s s s s
You may be able to eat less than this. Check with your Diabetes Educator, Dietitian or Doctor.

 It is important to:-
- eat carbohydrate foods at each meal and snack
- spread carbohydrates over the day
- eat similar amounts of carbohydrates from day to day
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  Carbohydrate foods that contain little nutritional value include sugar (sucrose), soft
drinks, cordials, fruit juices, lollies, cakes and biscuits. Try avoiding these foods where
possible.

 In some cases, women may be eating the right amount and types of carbohydrate foods
but still have high blood glucose levels. If this happens, it is important not to cut back on
carbohydrates. These women may need insulin.
 Meals that are too large or too small can cause problems.

Large meals can cause:

 high blood glucose
 excess weight gain

Meals that are too small or skipping meals can cause:

 hunger and overeating later in the day
 poor nutrition for you and your baby
 hypoglycaemia (blood glucose less than 3.5) in people on insulin

Early meals are often best!
Late meals can lead to high glucose. If possible, have breakfast before 9.30 am, and your
evening meal before 7.30 pm.

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 Have a healthy snack, every 2-3 hours between meals and before bed.

1. Healthy snacks reduce hunger and over-eating later in the day.

2. Healthy snacks reduce hunger at your meals, so you can eat less and get lower
glucose readings.

3. Healthy snacks help you to eat enough nutrients for you and your baby.

4. Healthy snacks can prevent hypoglycaemia (glucose less than 3.5) if you are on
insulin.

Snacking Do’s Snacking Don’ts

 Plan regular times for snacks.  Don’t eat lots of snacks in front of
the TV.
 Reduce food at your main
meals if you were not having  Limit or avoid snacks that are
snacks before. For example, high in fat or sugar, such as fried
instead of having a sandwich foods, chips, biscuits, cheeses,
plus fruit for lunch, you could chocolates and cakes
have the sandwich at lunch,
then the fruit as a snack in 2-3
hours.

 Choose healthy snacks such

as fresh fruit, yoghurt, milk or But its too much food!
wholegrain bread. If you are not used to eating this often,
at first it will feel strange. If you are also
eating more fruit, vegetables and fibre,
then it can feel like a lot of food. For a
time, you may have to ‘force’ yourself.
But there are many benefits! After a
while, your body will adapt and want to
eat this way.

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What about the Glycaemic index (GI)?
The GI of a food is a measure of how quickly the carbohydrate in the food is broken down into glucose
and released into the blood. The GI refers only to foods that contain carbohydrates. The GI is
measured on a scale of 1-100. Foods with a value of 55 or less are said to be low GI.
A low GI diet:
- Leads to smaller rises in blood glucose levels resulting in better control of diabetes
- Helps you to feel fuller for longer. This can prevent overeating
- Helps to manage body weight

Low GI High GI

Burgen bread (Soy-Linseed, Rye, Pumpkin seed), White bread, Melba Toast, Bagel, Lebanese bread
Pumpernickel, Tip Top 9 grain and Spicy fruit loaf, (white), Wholemeal bread, Turkish bread, Gluten
Authentic sourdough (rye and wheat), Corn Tortilla free bread, French Baguette

Rolled Oats, All Bran original, Guardian, Coco Pops, Corn flakes, Rice Krispies, Rice
Untoasted muesli, Oat bran, Special K (original, bubbles, Instant oats, Crunchy nut cornflakes, Mini
fruit and nut medley), Sustain, Semolina cooked Wheats

Ryvita (Pumpkin seeds, sunflower seeds and oats Corn Thins, Rice cakes/crackers, Pretzels, Sao,
crispbread), Rich tea biscuits water crackers, Cruskits

SunRice Clever Rice (Doongara), SunRice Rice (Instant, Jasmine, Brown, Calrose, Arborio),
naturally low GI (Brown and White) Wheat Pasta, Sushi Rice, Millet, Tapioca, Gnocchi, Udon
Basmati Long grain rice, Israeli cous cous, Mung noodles, Instant noodles, Cous cous
bean noodles, Rice noodles, Quinoa

Corn, Yam, Soya beans, Legumes, Carisma Potatoes (new, Sebago, Desiree, Pontiac). Sweet
potatoes (Coles), Sweet potato (orange fleshed) potato (white fleshed)

Milk (cows, soya and almond), Yoghurt, Fruche, Rice milk, Oat milk
Low fat ice cream

Most Fruit Watermelon, Lychees

For a more detailed list you can contact your dietitian.

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 Eat lots of vegetables each day

Vegetables are vital for good health! Try to have at

least 2-3 cups of vegetables each day. When
eating a cooked meal, have at least half of your
meal as vegetables.

Most vegetables will not affect your blood glucose and may be eaten freely – fresh, frozen,
canned, raw and cooked.

Semi starchy vegetables such as Carrots, Pumpkin, Peas and Beetroot seldom cause a rise in
your blood glucose levels unless eaten in very large amounts.

Also have freely: Herbs, spices, vinegar, lemon juice

What about meat and protein foods?

Meat, chicken, fish, seafood, eggs and cheese. These foods are very low in carbohydrate, so
they will not raise your glucose. You can eat them at any time of the day.

Even so, you may need to limit some of these foods to control your weight. Cold meats, soft
cheeses and some types of fish should be avoided in pregnancy. Ask your dietitian or
midwife, if you are not sure.

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 Should I eat more or less fat during pregnancy?
Fats in your foods will not raise blood glucose, but they can easily put on weight and can
make you more insulin resistant. You may benefit from eating less fat:

 if you were overweight before you fell pregnant, or

 if you have already gained too much weight in your pregnancy

You may benefit from eating more fat:

 if you were underweight before you fell pregnant

 If you are not putting on enough weight in your pregnancy

 If you are having twins

In these cases, increase ‘healthier’ fats, such as canola oil & margarine, olive oil &
margarine, nuts and avocados.

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 After you’ve had baby, be careful
with high fat foods.
GDM usually goes away once baby is born. Even so, you have a high risk
for Type 2 diabetes later in life. To lower this risk, avoid putting on weight
as you get older. Throughout life, you will need to stay physically active, eats lots of vegetables,
and continue being careful with limiting fatty foods.

 Limit or avoid animal fats like butter, dairy blends, ghee, lard, full fat dairy foods
and fatty meats. Eating hard (saturated) fats can lead to high blood cholesterol.

 Use oils and margarines that do not increase blood cholesterol (for example,
canola and olive oil). But try not to eat more than 1 tablespoon per day.

 Buy lean meats. Remove the fat from the meat and the skin
from the chicken before cooking.

 Eat fish often. Limit fish that is fried.

 Choose lower fat milks, yoghurts, custards, ice-creams and cheeses

The foods listed below are very high in fat. Have these
rarely, or not at all. Cheeses
Many dips, salad dressings and
Cakes mayonnaise
Chocolates Coconut milk
Many biscuits eg cream, Garlic breads
cheese and chocolate types Potato and corn chips
Cream and ice-creams Most processed meats e.g. sausages,
Pastries devon, salami
Deep fried and crumbed foods
Instant noodles
Most takeaway foods e.g. hot chips, pies,
hamburgers, pizza, fried chicken

Nuts, avocados and oily fish are

high in fat, but may reduce the
risk of heart disease when eaten
in small amounts.

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Frequently Asked Questions . . . .
What should I do if my glucose is high after a meal?
Don’t panic!!

 Do not skip your next snack or meal. This could lead to hunger and
overeating at a later time. Most of the time, high glucose will come back to
normal on its own over the next 30 minutes.

 Stay active if you can.

 There is no need to test again to see if the level has come down.

 In your glucose book, write down what you ate and drank the meal before the test.

To prevent more high readings

 Make sure you avoid carbohydrate foods between your meal and post meal blood sugar testing.
Wait at least 90minutes before eating again after a meal.

 Eat your meal within 30 minutes.

 Wash and dry your hands before testing.

 Always test 2 hours from the start of the meal

 Are you eating too much carbohydrate at some meals? Reduce down to 2-3 portions at main
meals.

 Check that your snack is not too close to your next meal.

 Try having earlier meals.

 Try being more active after meals.

 Try replacing ‘higher glycaemic index’ carbohydrates with ‘lower glycaemic index’ carbohydrates.
This can make a big difference.

What if I do all this and my readings are still high?

You may need medication with tablets or insulin if you are following all the advice above, and are still
getting more than 2-3 high readings per week after meals. This does not mean you have failed! It just
means your body is not making enough insulin, due to pregnancy hormones.

Cutting out carbohydrate is not the answer! This will cause other problems, such as:
 excess hunger and food binges
 lack of energy
 poor weight gain
 constipation
 high blood ketones (which may not be healthy for baby)

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What if my morning (fasting) glucose is high (more than 5.0) ?
1. Make sure you are not eating or drinking carbohydrate in the 8 hours before your test. If you
wake up hungry, eat only non-carbohydrate foods. Stop night-time hunger by eating enough
through the day.

2. If you have not been having a snack before bed, start doing this. A pre-bed snack improves
morning glucose in some people. A glass of milk often works well. Also make sure you are
having at least 2 carbohydrate portions at your evening meal.

3. If you have been having a snack before bed, reduce this down to 1 portion of low glycaemic
index carbohydrate, such as a glass of milk, 100 grams of flavoured yoghurt or 1 slice of
Burgen™ bread. Eat enough through the day, so you are not too hungry in the evening.

4. Do some physical activity in the afternoon or evening.

If you try these ideas, and are still getting 2 or more high morning readings a week, you might need
insulin. Speak with your diabetes educator.

I’m hungry! What else can I eat?

If you are hungry at a meal, add foods that are unlikely to cause high glucose, such as:
 meats and vegetables
 soup (low carb)
 nuts
 eggs
 cheese

Excess hunger and ‘sugar cravings’ are mostly caused by poor eating at other times of the day. If this is
happening:
 Try eating more for breakfast, whether you feel like it or not. Aim for 3 foods, such as
1). Wholegrain bread or cereal 2). Milk or yoghurt 3). Protein food like egg, meat, baked beans
or nuts.
 Don’t miss your healthy snacks in between meals.
 Have 2 portions of carbohydrate at each snack. For example, 1 fruit and 1 glass of milk, not fruit
alone.
 Check you are having 12 carbohydrate portions over the whole day.
 Check you are eating a balanced diet. Aim to have fruits, vegetables, wholegrains, milk and
protein foods every day.

Poor eating is serious in pregnancy!

Please tell your diabetes educator, dietitian or doctor if you have any of these signs:
 You feel hungry most of the time
 You often get hungry in the 2 hours between your meal and glucose test
 You are waking up hungry in the night
 You have lost weight for more than 2 clinic visits in a row
 Your urine test has shown ‘ketones’ at 2 or more clinic visits
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 You are over 20 weeks pregnant, and have not gained weight over the last month

These signs are not normal or healthy!

Am I putting on too much or not enough weight?
The following chart can help you work this out.

Weight before pregnancy Target weight gain for the whole pregnancy
Obese 0-6 kg
Overweight 7-11 kg
Normal weight 11 – 16 kg
Underweight 12 – 18 kg

Your midwife, doctor or dietitian can help you work out which weight group you were in before
pregnancy, if you are not sure.

If you are putting on too much weight: Try eating less fat and doing more physical activity. You could
also reduce carbohydrate, but don’t have less than 12 portions per day. Always have a good breakfast,
eat lots of vegetables and don’t skip your healthy snacks.

If you are not putting on enough weight: Try eating more protein food and ‘healthy’ fats, such as
canola oil & margarine, olive oil & margarine, nuts and avocado. Don’t forget your 3-4 cups of milk or
yoghurt each day. Full fat is fine for now. Don’t skip meals or snacks, and make sure you are getting at
least 12 portions of carbohydrate per day.

Can I breastfeed after having GDM?

Yes, try to breastfeed if you can. There are many benefits for mum and baby. Breastfeeding may even
lower the risk of Type 2 diabetes. Breastfeeding may help you lose weight as long as you keep up
healthy eating.

How can I prevent diabetes later in life?

To reduce your risk, maintain a healthy lifestyle, and avoid gaining weight as you get older. Weight
gain, particularly around the ‘tummy’ area, is linked with Type 2 diabetes.

 Stay physically active

 Eat regular meals and snacks
 Eat plenty of vegetables and fruits
 Eat wholegrain/high fibre breads and cereals, rather than white breads and refined cereals
 Limit high fat foods, particularly saturated fats such as fatty meats, chicken skin, butter, cream,
cakes and takeaways.

Try to return to the weight you were before pregnancy. This could take up to 12 months. Avoid short-
term ‘diets’, as they often cause more harm than good.

Will my children get diabetes?

Having GDM shows us that the risk for diabetes is in your family. You, your parents,
brothers and sisters should have regular checks for diabetes. Your children will not
be born with diabetes. But they may get diabetes later in life, particularly if they
become overweight.

Childhood is the best time to teach healthy eating and physical activity. Takeaway foods,
lollies, chips, cakes, soft drinks and juices should be for special occasions only. Most of
the advice in this booklet is healthy for the whole family. Please note though, that
children under 2 should have full fat dairy products.

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What should I look for on food labels?
Please don’t look at the level of ‘sugars’ on food labels. It is better to look at ‘Total Carbohydrate’.

‘Sugars’ means sweet tasting sugars, whereas ‘Carbohydrate Total’ is the true amount of sugar that will
enter your blood. Carbohydrate Total already includes the sweet sugars, so don’t add the two numbers
together!

For a food,
 if the Carbohydrate Total per serving is 15-30g, this is usually OK for a snack, if no other
carbohydrate foods are eaten at the same time.

 if the Carbohydrate Total per serving is 30-45g, this is usually OK for a meal, if no other
carbohydrate foods are eaten at the same time.

Compare the product’s serving size to

the amount you would eat.

NUTRITION INFORMATION
Servings per package: 3
Serving size: 150g

Quantity per serving Quantity per 100g

Energy 608 kJ 405 kJ

Protein 4.2 g 2.8 g

Fat, total 7.4 g 4.9 g

- saturated 4.5 g 3.0 g

Carbohydrate, total 18.6 g 12.4 g

- sugars 10.1 g 8.3 g

Dietary fibre 0.9 g 0.6 g

Sodium 90 mg 60 mg

Total Carbohydrate
15 g total carbohydrate = 1 carb portion = snack size
30g total carbohydrate = 2 carb portions = snack or small meal size
45g total carbohydrate = 3 carb portions = meal size

If labels are confusing, use your common sense and blood test results. When a food is mostly made of
grains, flour or sweet sugar, it may cause high glucose if you eat too much. Eat a small portion, and
test glucose in 2 hours.

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 Example Meal Plan for Gestational Diabetes

Breakfast
Milk (1 cup) or yoghurt (200 g)
Plus
High fibre cereal (1 small bowl) or wholegrain toast
(2 slices)
Optional: margarine, vegemite, jam (thin scrape),
egg, cheese, meats, vegetables, tea, coffee
Not enough Too much
carbohydrate: carbohydrate:

 1 slice of bread Morning snack  4 slices of toast

for breakfast Wholegrain crispbreads (4) with reduced fat cheese plus orange
(no cereal, fruit Plus juice for
or milk) Fresh fruit (the size of your fist) breakfast

 Vegetable soup  Rice plus 1

for lunch (no Lunch Lebanese bread
bread, rice or Wholegrain bread (2 slices or 1 roll) plus fruit for
pasta) Plus lunch
Tuna or salmon and salad
 Chicken plus Plus  Potato curry +
salad for dinner Fresh fruit (the size of your fist) rice + 2 roti
(no bread, rice (Indian bread)
or pasta) for dinner

 Cucumber and
Afternoon snack 1  2 slices of
carrot sticks for 200 g yoghurt
bread plus 1 tub
a snack of yoghurt just
before bed

Evening Meal
1 ½ cups of pasta or sweet potato or 1 cup of basmati rice
Plus
Lean meat or chicken or fish
What about Plus Please note: This plan
may not suit everyone.
Lots of vegetables or salad
drinks?
Water or milk (best choices) For a plan that suits your
Tea or coffee needs, see your dietitian
(no added sugar) Before Bed
Milk (1 cup)
Sugar-free (‘Diet’) soft-drinks The carbohydrate foods
Low-joule (‘Diet’) cordials are underlined.
Preferably no juice

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