Managing gestational diabetes in pregnancy
Do I need to take insulin for gestational diabetes? continued...
When using insulin, a 'low blood glucose reaction' (hypoglycaemia) can occur if you do not eat enough food, miss a meal, do not eat at the right time of day, or if you exercise more than usual.
Symptoms of hypoglycaemia include:
Hypoglycaemia is a serious problem that needs to be treated straight away. If you think you are having a low blood sugar reaction, check your blood sugar. You'll be advised to have a sugary snack or drink in these cases. Record all low blood sugar reactions in your log book, including the date, the time of day the reaction occurred, and how you treated it.
How will my diet change with gestational diabetes?
If you have gestational diabetes, a dietitian will usually be part of your diabetes care team and may make specific recommendations.
These may include:
- Don't skip meals
- Pick balanced meals with a lower glycaemic index (GI) to stop blood sugar levels rising too quickly
- Get your 5-a-day, but the NHS advises against having more than one portion of fruit at a time, and limiting fruit to 3 portions a day. Although fruit juice can usually count as one of a person's 5-a-day, this should be avoided with gestational diabetes as it can cause blood sugar to rise too quickly
- Limit sugary food, including sugar in drinks and cooking
- Healthy fat choices make sense. Polyunsaturated and monounsaturated fats are better for you than saturated fats.
- Limit calories if you've been advised to
- If you have morning sickness, smaller snacks, such as crackers or cereal may help
How much exercise is safe for gestational diabetes?
Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue.
The NHS advises that women with a body mass index (BMI) of 27 or more before pregnancy may be advised to aim for moderate exercise in pregnancy of at least 150 minutes a week.
Always carry some form of sugar with you when exercising, such as glucose tablets or boiled sweets, in case blood sugar levels go too low.
Eat snacks as advised before exercise.
Pregnancy weight gain
The recommended amount of weight gain during pregnancy depends on your pre-pregnancy weight, whether there is more than one foetus, and the trimester. Typically more weight gain is expected during the second and third trimester.
It is not necessary to "eat for two" during pregnancy. It's true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally only need to consume around 200 more calories a day than you did before you became pregnant to meet the needs of your growing baby during the last three months of pregnancy.
Ask your doctor 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 doctor recommends.
In general, you should gain about two to four pounds during your first three months of pregnancy and a pound a week for the remainder of your pregnancy. However, according to the NHS there are no formal evidence-based guidelines from the UK Government or professional bodies on what constitutes appropriate weight gain during pregnancy.
Where the weight goes
Fat stores for delivery and breastfeeding
25 to 35 pounds