Gestational Diabetes Diet and Nutrition Guidelines

Everything you need to know to keep you and your baby healthy throughout your pregnancy 

During pregnancy, hormones fluctuate as the baby grows and develops. During weeks 24-28, an uprise in these hormones start which can impact the normal hormones found in a woman’s body. Insulin produced by the mom’s body can become less effective as the pregnancy hormones from the placenta increase to support the baby. This causes a decrease in insulin sensitivity and an increase in blood glucose levels. It is not seen in every pregnancy and can be identified through a screening process. It is during this time, weeks 24-28 of your pregnancy, that you will usually go for gestational diabetes testing.  

If you get diagnosed with gestational diabetes, managing blood sugars in pregnancy is important as the impacts it can have on the baby are significant. Elevated blood sugar levels during pregnancy are related to an increase in baby weight, still birth, need for cesarian birth, high blood pressure during pregnancy and pre-eclampsia.  

Although these outcomes seem severe, managing gestational diabetes can be done through nutrition, exercise and potentially the use of medication to help manage blood sugar levels during pregnancy, so fear not.  

Let’s look at some of the recommendations for managing sugars in pregnancy and what a gestational diabetes diet looks like.

Testing Your Blood Sugars 

It is recommended that you test your blood sugars a minimum of 4 times a day. First thing in the morning, this is called your fasting blood glucose, and 2 hours after you start to eat your 3 main meals.  

The targets you are trying to achieve are:  

These values help guide us to know where to make adjustments to your daily routine and intake to reduce the impact on your sugar levels.  

5 Tips on How to Manage Gestational Diabetes Through Nutrition

 1. Aim to eat throughout the day by including snacks – 3 meals and 3 snacks – and ensure meals are balanced.

This helps to spread your intake over the whole day, keeping your blood sugar more stable, preventing you from getting too hungry, and helps with managing food choices when it comes time to eat. 

Eating balanced allows for the proper distribution of your food, ensuring you get all the nutrients you require for both you and your baby and helps regulate blood sugars.  A balanced meal could look like:

Note that often dairy fits into the meat and protein alternatives for breakfast or is consumed as a snack. Same with fruit, often it is consumed as a snack or can be a part of a meal. 

2. Spread the carbohydrates you eat over those 6 interactions with food

This helps keep a steady supply of sugar in the blood to meet the needs of you and your growing baby. It is also important as it prevents overconsumption of carbs at any given time which could lead to elevated blood glucose levels. Carbohydrates foods, when broken down in our body produce glucose (blood sugar). Even though these are the types of foods to monitor when trying to manage gestational diabetes these foods are also very important in the health of your pregnancy. It is important to not eliminate them. Focusing on good quality carbs and as this tip suggests, spreading them throughout the day is important.  

Carbohydrate foods are foods that contain sugar, starch and fiber. For example: 

• Grains and grain products, rice, oats, barley, quinoa etc. 
• Beans and lentils  
• Fruit 
• Starchy vegetables  
• Milk and yogurt  
• Sugar and sweet foods  

But how much carbohydrates should you actually eat?  

Everyone needs a different amount of carbs per day to help support you and your growing baby. Working with a Registered Dietitian can help you find the amount that is right for you.  

When discussing the amount of carbs we refer to how many carb choices to have per meal or snack. 15 grams of carbs is one choice. Below is an example of how to spread your carbs throughout the day.  

Examples of 15g, or 1 choice, serving of carb:  

1 piece of whole-grain toast  

½ cup beans, lentils,  

½ cup corn or potato (baked, boiled or mashed) 

½ cup cooked pasta  

½ cup cold cereal  

1 small homemade muffin  

½ cup cooked quinoa  

1 medium fruit  

½ large banana  

1 cup mixed fruit   

2 cups berries  

1 cup milk or fortified soy beverage  

¾ cup plain yogurt  

1/3 cup flavoured yogurt  

Learn more about carbohydrates in this ultimate guide to carbohydrates.

3. Manage cravings and interactions with sweet foods and foods or drinks with added sugars.  

Even though these foods have a place in our diet if desired, these are the foods that will quickly raise blood sugar. Working with a Registered Dietitian can help with navigating portions and timing to help reduce the impact on blood sugars.  

4. Choose high-fiber options

Fiber is a complex carbohydrate that is not digested by our body. This means, that the more fiber in a meal the longer it takes for our body to digest the other elements, specifically starchy carbohydrates, thus regulating the release of glucose into our bloodstream. This is important as it prevents a rise in blood sugars and creates more of an arch of energy release. Fiber is also important in maintaining gut health and bowel movements. It will help with pregnancy constipation, a common symptom.  

Higher fiber options are: 

• Whole grains  
• Beans and lentils (dried or canned)  
• Nuts and seeds  
• Fruit and vegetables  

5. Ensure each meal and snack also contains protein

Protein, like fiber, helps regulate the release of blood sugar from a meal. It doesn’t raise blood sugars as it doesn’t contain carbohydrates and helps with the feeling of being full and satisfied. It is also important for your immune system and the development of your baby.  

Good protein sources to choose from:  

• Beans and lentils  
• Meat, poultry, pork  
• Fish  
• Eggs 
• Dairy – Cottage cheese, cheese, Greek yogurt 
• Tofu + other meat alternatives  
• Plant-based proteins

Note: ensure you are taking a prenatal multivitamin. As we all eat a little differently every day it is important to ensure your body is getting the vitamins and minerals it needs. It is also important to focus on getting enough calcium and vitamin D – from the vitamin as well as from the foods and beverages we have every day. Aim to have at least 2-3 servings of dairy or fortified beverages per day.  

Stress, lack of sleep (who doesn’t sleep poorly in pregnancy) and other factors can also impact blood sugar levels during pregnancy. Trying your best to manage external stressors as best as you can, seeking support when needed, and aiming for a good night’s sleep can really help with sugar levels on top of what we can do nutritionally. 

How to Manage Gestational Diabetes Through Exercise  

It is important to keep moving. Not only is movement beneficial to help prepare your body for delivery, but it is also important in regulating your blood sugar levels. It is recommended, if you are able, to do some form of physical activity for 10 to 15 minutes after your 3 main meals. This could be walking, going up and down stairs, doing house chores, or planned exercise. By doing this, you will use some of the sugars coming from the carbs eaten in your meal that are beginning to digest and are entering into the bloodstream. This can help keep sugars within target range at the 2-hour testing mark.  

Gestational Diabetes Medication  

There are specific medications used in pregnancy to help regulate blood sugars if nutrition and physical activity aren’t enough. Note that if you require medication during pregnancy to help manage your sugars, this does not mean you failed, didn’t try hard enough or your baby is at risk. Sometimes our hormones are too strong for us to manage on our own and we need medical support. This is okay! The medication is safe in pregnancy, and it is more beneficial to manage blood sugars to support the baby than it is to be scared of the medications. Remember, it is often short-term that these medications are required. As soon as the baby is born blood sugars often return to normal state as pregnancy hormones and the placenta are no longer present in the mom’s body. If you are concerned talk to your health care provider, OBGYN, or registered dietitian on how you can get more support in this area.   

There is a lot going on in pregnancy to begin with, and it can feel overwhelming if you get a diagnosis of gestational diabetes. However, know that there are ways to manage and that you don’t have to go through this alone. Focus on the above tips and if you are struggling reach out to your health care team and a diabetes dietitian for more information and support on a gestational diabetes diet. Lots of people who are diagnosed with gestational diabetes go on to have healthy pregnancies and happy little babies! Congratulations momma! 

References: 

Gestational Diabetes