I know I'm on a diet, I just don't know what to eat
September 28, 2011 8:39 AM   Subscribe

I've just been diagnosed with Gestational Diabetes. What are your favorite diabetic-friendly foods/recipes? Any advice on keeping on track with my new diet?

Unfortunately, my dietician hasn't really given me a lot of guidance about what to eat specifically. She gave me great suggestions on what to eat for my snacks, but as far as meals go, she hasn't really sent me anything worthwhile (like, she just told me to add more vegetables to my dinners and to get away from starches, which...duh). When I asked her how many carbs I should aim for at each meal, she told me that's not important since I'm not on insulin. She told me to check the nutritional information on everything I'm eating, but didn't give me much guidance about what to look for--what's a good amount of carbs, protein, fiber...nothing like that. She did tell me to keep my breakfast at 300 calories, and aim for 1800-2000 calories for the day.

Anyhow, as you can tell I feel like I'm kind of flying blindly on this thing. If you're a diabetic, what are your favorite foods/meals? I'm especially looking for stuff that's on the beginner cooking scale, and doesn't take up too much time to prepare. How do you resist the temptation of cookies, creamy soups, etc?
posted by litnerd to Food & Drink (17 answers total) 4 users marked this as a favorite
I don't have GD, but quite a few people on my pregnancy forum do, and here's what I've learned from their posts:

1) find a GD community somewhere to participate in
2) monitor your blood sugar levels religiously
3) what works for other people may or may not work for you - a dietician's recommendations may be reasonable, but ultimately you need to figure out your diet based on what particular foods and eating patterns do to your blood sugar
posted by thirteenkiller at 8:52 AM on September 28, 2011

When I asked her how many carbs I should aim for at each meal, she told me that's not important since I'm not on insulin.

Facepalm. Seriously. Can you get a referral to another dietician? Or to an endocrinologist, who might then be able to refer you to another dietician? Because just...wow.

I had gestational diabetes when I was pregnant. I did not start with insulin, but I ended with it even though I was vigilant about my eating. That happens sometimes. I am not much of a cook. My favorite snack was raw veggies with peanut butter on them. I resisted the temptation of cookies, bread, pasta, etc. by not having them in the house. A keyword search on "low carb" on AskMe will yield some great snack and meal suggestions. Linda's Low Carb Menus & Recipes will likely come up in answers, but I'll link it here anyway. There have also been other good AskMes about gestational diabetes. Sorry I don't have time to look for them myself right now, though!
posted by gnomeloaf at 9:03 AM on September 28, 2011 [2 favorites]

Best answer: I was told 30 carbs for breakfast, 45 for lunch and dinner, and 15 for a snack a couple hours after each meal. I was also told that if something has more than 5 grams of fiber per serving, you could subtract half of the fiber total from the carb total. So if something has 20 g carbs and 6 g fiber, there were 17 net carbs in a serving.

I ate lots of cheese, meats and veggies. Tacos with lo-carb tortillas were really filling and great for my blood sugar. I also got barilla plus pasta (it has more protein than most pasta) and it was also easy on the blood sugar.
posted by chiababe at 9:04 AM on September 28, 2011 [1 favorite]

Best answer: IANAD -
I had gestational diabetes.

When I asked her how many carbs I should aim for at each meal, she told me that's not important since I'm not on insulin.
Your dietician's advice is concerning. Outdated. Find a new dietitian if possible. I find it odd you were not given a blood meter.

I started off managing the GD with the low carb diet and exercise, however it was not enough. I ended up going on Glyburide.

Unfortunately I do not have my GD notes in front of me, but here are some approximations to help you get started:

You will be testing your blood sugar:
When you wake up (fasting)
2 hours after every meal (it should be below 140)

Approximate Carb Counting Guide
Breakfast - Approximately 35g of carbs*
Snack - Approximately 20g of carbs
Lunch - Approximately 45g of carbs
Snack - Approximately 20g of carbs
Dinner - Approximately 45g of carbs

*It was explained to me the body takes more time in the morning to "burn" the carbs and therefore the breakfast carb count is smaller. Fructose is high carb (fruit), so I was encouraged not to have fruit for breakfast. In fact, I could not have the afternoon snack as my blood sugars never reached the desired range. This was OK with my doctor.

thirteenkiller is correct. I learned quickly even though I ate a small piece of pizza well within the carb count my blood sugars never recovered in the 2 hour window. This also occurred with cheeseburgers. Therefore, I never ate these meals while pregnant. It is my understanding this is common with high fat meals.

If you're a diabetic, what are your favorite foods/meals? I'm especially looking for stuff that's on the beginner cooking scale, and doesn't take up too much time to prepare

Oh you want "Do's" and NOT "Don'ts" Dietitians are really good with the "Don'ts"

My GD Meals
*Greek yogurt - The carb count is well below 35g, does have fruit in it but I recovered just fine in the 2 hour window.
*Pepperidge Farm's cinnamon raisin mini bagel with cream cheese
*Cinnamon toast crunch - measured for 1 serving with milk (milk does have carbs!)

*Wheat bread sandwiches - chicken salad, ham, turkey
*Progressive soup - various
*Left over dinners

*Rachael Ray Get Real Meals

*Cheese and crackers
*Crackers and pepperoni

You are going to be given outdated advice by people who will have no problem telling you how should you be managing your GD. According to them - clearly you go it because of something you did. People have an image in their head what a "diabetic looks like". I am a petite woman who had a very healthy weight before I got pregnant and still after. I did not overeat my way into GD. Type II diabetes runs in my family.

More Advice
*If you have to go on medication it is because of your placenta - not you. Don't view going on medication as a failure.
*You probably put it together that people love to give unsolicited advice to pregnant women. I am one of them - GD does not automatically mean you need to get a cesarean. I delivered my son naturally. He weighed 5lb 11oz. This is because I maintained control of the GD closely.
*A big concern with GD (other than large birth weight) is the baby going hypoglycemic once the umbilical cord is cut. This did not occur with my son. I attribute this to my tight control over the GD.
*I allowed myself to enjoy cake at the baby showers only. My son was born healthy with this allowance.
*Something no one told me - Babies born to mothers with GD have a higher risk of jaundice. Other risk factors are the baby being a boy, the mother having a certain blood type - so many. I found out later my son with lined up nicely to get jaundice. I had no idea this was a concern. He was jaundice, and was in the NICU for a few days. He is just fine now. With the help of lactation consultants at the hospital I was able to breastfeed him just fine. I had to use the Supplemental Nursing System (SNS) to help at first.

posted by BuffaloChickenWing at 9:33 AM on September 28, 2011 [5 favorites]

Best answer: I went through this exact thing (right down to the totally not helpful dietitian) when I was pregnant. It makes a big difference how close to 'normal' your numbers are, particularly your fasting numbers. If they're super high, they'll make very different recommendations than if they're borderline normal. (There are also a number of comparative studies between the US and Canada showing that GD is over-diagnosed here in the US, but we'll leave that conversation to another time.)

What worked for me was this:

- I did some research on the web for websites focusing on the glycemic index of foods, and built my menu around that data. (I'd love to give you a link, but with the recent del.icio.us changes I can't seem to find anything. There are ton of sites out there, though.) I found the GI data for foods to be much more helpful and useful than the carbs approach. It's what a lot of "true" diabetics use to manage their food intake.

- More than dietary changes, exercise is what helped me the most. It wasn't anything fancy - just a nightly walk around the block a few times - but it is the single thing that made the biggest change in my numbers.

- I bought a food scale and was super meticulous in weighing and recording everything I was eating, so I would have good data on what worked and what didn't.

This is slightly out in "woo" territory, but the other thing I think helped me personally was to add a heaping helping of cinnamon to my diet. There are a few studies (link to the totally non-woo Mayo Clinic) that seem to suggest (American Diabetes Assoc) that cinnamon can help with metabolizing glucose in folks with Type II diabetes, and as it was any easy change to make in my diet I did it, and I do think it helped quite a bit.

She did tell me to keep my breakfast at 300 calories, and aim for 1800-2000 calories for the day

This, in my humble non-doctor opinion, is plain old bad advice. Calories ingested have only a passing relationship to what the foods will do to your blood sugar numbers. Based on this alone I'd suggest you find a new dietitian (who actually knows what they're talking about).

How do you resist the temptation of cookies, creamy soups, etc?

For me, it was super easy, because if I couldn't get it 'under control' I would be bounced out of my (terrific) birth center and forced to go the hospital route, which I wanted to avoid at all costs. However, given that you don't have that kind of pressure on you, I'd say:

- don't keep them in the house
- find a diet that works for you and stick to it very religiously. I actually only had four meal plans that I rotated through. I figured I could deal with any restrictive diet for three or four months if it meant a birthcenter vs. hospital birth.
- I also had really rigorous daily meal plans -- I ate something just about every 2 hours and 20 minutes. Many small meals through the day helped me to a) avoid craving things, and b) avoid eating whatever was around just because I was hungry.

Feel free to metamail me if you want to talk more about this.... Trust me, I've been there.
posted by anastasiav at 9:36 AM on September 28, 2011

See another dietitian, or an endocrinologist. Your current dietitian sounds ignorant to me.
posted by chinston at 9:36 AM on September 28, 2011 [3 favorites]

Best answer: Your dietitian is smoking crack. Here's a thread with specific advice. Here's a comment I wrote in that thread.

As to what foods I ate - normal food! Seriously! There's nothing magical about diabetes diets. You could search Atkins & South Beach recipes. I ate salads, chicken, tilapia, salmon, pork, lentil soup, fruits, veggies, cottage cheese, oatmeal, turkey bacon, nuts, nut butters, cheese, olives. Lots of yummy stuff.

You just have to count carbs and test. It was kind of cool and sciencey once I got over the initial shock and anger.
posted by peep at 11:17 AM on September 28, 2011 [1 favorite]

I went No Carb.

Yes, monitor your blood sugar religiously because you will learn more from that than anything we can tell you. Monitoring my blood sugar was what led me to go pretty much no carb throughout my pregnancy - that cookie/bread/fruit/potato just wasn't worth it!!!
posted by jbenben at 11:34 AM on September 28, 2011

jbenben, no carb, seriously? Like zero? Because even vegetables have carbs! If someone had told me that when I was first diagnosed, I think I would have said "fuck it" and totally given up.
posted by peep at 11:40 AM on September 28, 2011

Best answer: Calorie counting instead of carb counting? "Check the nutritional information" with no clue given about what you're looking for? Were you even given a blood glucose monitor?

You should not have to fly blind. You should have been given a ton of info, including a list of foods with their effect, portion guidelines, meal suggestions, etc. Nthing another appointment with a different dietician.

There's some really good advice above about food GIs, rough carb guidelines, and exercise. I ate pretty much the same things I ate before, just with limited carb-food portions. I handled some carb foods better than others, regardless of their official GI and carb count. What I ate with my carbs mattered. Bagels and burgers were a no-go for me, and I had to be extremely conservative for breakfast, even with exercise. I was motivated by considering the effect of my blood sugars on my baby girl.

You should know that you'll have an increased risk of developing Type II diabetes later in life (I was told 60% of women with GD get Type II). Your baby will have an increased risk of Type II and obesity. My doc checks me annually, and I'm careful (but reasonable) with our diets.
posted by moira at 4:29 PM on September 28, 2011

See a good nutritionist, for your sake as well as the baby's. Also, fiber helps your body process carbs and sugar, so factor that in. I didn't quite have GD, but still had a 10 lb + baby. Chubby, adorable, and topped the weight charts for the 1st 2 years. He's now healthy and height-weight appropriate. My back got so strong, so fast when he was a baby, once I recovered from having him surgically removed. Good luck.
posted by theora55 at 4:42 PM on September 28, 2011

Response by poster: My doctor prescribed me a glucose monitor, and I'm going to start using it tomorrow--today's the first day I've been able to really try out my diet, or rather, the diet as I understand it from the interwebs (rather than from my dietician). Thanks everyone for your support, your suggestions, and for making me realize I wasn't just being hard on her. She works directly with my OB...what are my chances of success in going back to my OB (a single-doctor practice) and asking for someone else? Or should I just seek out a different dietician on my own?
posted by litnerd at 5:13 PM on September 28, 2011

I was an unusual GD patient because Mr. BuffaloChickenWing is a Type I diabetic. Very different, but I understood the diet and how to measure my blood sugar already. My doctor allowed me more freedom than other patients because of our family history.

what are my chances of success in going back to my OB (a single-doctor practice) and asking for someone else?
Only you can answer this. If you love your doctor you have to consider now their experience with this type of pregnancy. The best for you is to find a doctor who has knowledge in this area or can put you in touch with experts that can help you. Given what you have said, the dietician is not one of those experts.
posted by BuffaloChickenWing at 7:45 PM on September 28, 2011

If your insurance allows such things and your OB has no alternate suggestions, I would vote for asking for a referral to an endocrinologist, or calling one and asking for a recommendation. Endos are more likely to be current on GD and type 2 research and treatment, and are therefore more likely to know of dieticians whose advice doesn't border on irresponsible.
posted by gnomeloaf at 7:50 PM on September 28, 2011

Best answer: I do not have GD, but I did try the beef stroganoff from this website and it was delicious: http://www.gestationaldiabetesrecipes.com/

FULL DISCLOSURE: My friend started this website (it's the only reason I'm even aware of GD). I hope I haven't gone against any MF policy by linking to it.
posted by mooza at 9:12 PM on September 29, 2011

I wanted to add, don't go blaming yourself if you have a large baby. My lil' girl was big, and I managed my diabetes perfectly.
posted by moira at 7:14 PM on October 1, 2011

Response by poster: Update: I brought four weeks' worth of testing figures to my doctor yesterday, and he's very pleased with my numbers--so pleased he's letting me drop my testing down to once a day. I couldn't have managed my diet without the many resources in these answers. Thank you so much! Baby will be here in about 7 1/2 (hopefully unremarkable) weeks, and then I'm hoping to never have to prick myself again.
posted by litnerd at 6:32 AM on October 25, 2011 [1 favorite]

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