Gestational Diabetes 101
September 7, 2016 6:00 PM   Subscribe

Just diagnosed. Can't get nurse appointment for at least a week, the handout they gave me was incomplete, and I have some questions. Help?

I'll be 32 weeks on Saturday and was just diagnosed with GD. They won't be able to get me in to see a nurse for at least a week, so I am winging it until then. They gave me a handout which was comically incomplete; it said 'Page 2' at the top and the first heading was 'PM Snack' but the admin swore that was the whole thing. So...

1) I'd like to find the handout online, but my Google-Fu is failing me. What it had, for the limited portion of the day it gave me, was specific meal suggestions. Like, under PM Snack, it says '1 slice bread OR 1 granola bar OR 1 medium piece fruit.' I'd like a format like this for all the meals of the day.

2) I'm not sure what the difference is between a carb and a sugar. My husband brought home a bag of diabetic candy to cheer me up. It had 2 g of sugar but 9 g of carbs. Can I eat this? What number is most important?

3) A few times, I have eaten what I thought was a balanced meal based on what they told me preliminarily, and then been sleepy afterward. Is this a bad sign? Both times this occurred involved meals with bread. And protein, yes. But bread. So, until I am on a proper monitor and test protocol, should I cut out the bread?

4) They told me to eat a bedtime snack, which I have been doing. This has led to me retaining water overnight due to the extra salt content, I am guessing, and I am waking up with indentations on my wrist and ankles. How alarmed should I be?

Other notes; I have only gained about ten pounds so far (lost weight first trimester due to morning sickness, gained it back and then some but my net gain has only been ten pounds. Am vegetarian but have already seen the dietician for that, pre the diabetes thing, and have been eating eggs, peanut butter, seeds and legumes. Am generally in good health and have had an uneventful pregnancy so far.

Tl;dr: can't get in to see the nurse format least a week, have incomplete information and don't want to hurt myself or the baby while I'm waiting. YANMD but I welcome all advice!
posted by ficbot to Health & Fitness (12 answers total) 3 users marked this as a favorite
I just googled "Gestational Diabetes Meal Plan" and got a bunch of results that read very similar to the handout your OB's office gave you. I'm on my phone so no link, but give it a go, I think you'll find exactly what you want on the InterMountain Healthcare site.
posted by PorcineWithMe at 6:08 PM on September 7, 2016 [1 favorite]

I'm not sure what the difference is between a carb and a sugar. My husband brought home a bag of diabetic candy to cheer me up. It had 2 g of sugar but 9 g of carbs. Can I eat this? What number is most important?

Sugar is a subset of carbs. Sugar will spike your blood sugar the most, but you have to watch out for all carbs: potatoes, rice, white bread, fruit, etc. will all also affect you. (Fiber is an exception. Google "net carbs" for more information.)

The upshot is that fat, protein, and fiber either won't raise your blood sugar or won't raise it as much, so the higher a percentage of your food comes from those things, the better. They'll also buffer your carb intake: a spoonful of honey on its own will raise your blood sugar more than a spoonful of honey with a spoonful of peanut butter.
posted by asterix at 6:51 PM on September 7, 2016

I don't have a food list for what fits in these counts, but you should be able to google that part / read lables. Here were my carb targets when I had GD last year:

Breakfast - 30
AM Snack - 15-30
Lunch - 30-45
PM Snack - 15-30
Dinner - 30-45
Evening Snack - 15-30

Key tips from my nurse and dietitian:
- spread eating out as evenly as possible (eg 7am, 9:30, noon, 2:30, 5:30-6, 8:30-9)
- when reading labels, subtract the fiber from the carbs
- evening snack is really important for good morning numbers and they recommended a half cup of real, plain vanilla ice-cream
- make sure to get a good mix of protein and fat in with each meal
- don't start the day with fruit
- watch dressings and sauces for carbs too

Good luck!
posted by MandaSayGrr at 7:14 PM on September 7, 2016 [2 favorites]

My recommended number were the same as Manda's. Also, blood sugars were helped by walks after meals. If you do dairy, I swore by cottage cheese with a little fruit every morning for breakfast. Good luck!
posted by gryphonlover at 7:20 PM on September 7, 2016

Grams of carbohydrate are what you need to track. Once in your digestive system, all carbs are treated equally regardless of whether they came from processed sugar, bread, pasta, fruit, milk or whatever else.

My recommended ranges were:
Breakfast 45
AM Snack 15
Lunch 60
PM Snack 15
Dinner 60
Bedtime 15 - 30

... which is a lot of carbs. About 3 times more than my non-pregnant, non-diabetic usual diet. When I ate that many carbs I gained a lot very quickly, so I cut back to about 80 gm per day, which upset my dietitian but made me and my OB very happy. However, I was, and am, very carb-sensitive. After about 32 weeks, no amount of carb-restriction or exercise kept my fasting glucose low enough and I had to go on a small daily dose of insulin.
posted by subluxor at 8:39 PM on September 7, 2016

Just a warning that the diabetic candies contain sugar alcohols which don't completely digest and can cause diarrhea if you eat too many.
posted by oneear at 9:24 PM on September 7, 2016 [3 favorites]

Just try to eat whole grains, dark bread, long grain pasta, protein and vegetables. Fresh is best. Fruit isn't great. Dried fruit is a killer.

The quick and the easy theory. Google low gi diets.
posted by taff at 9:40 PM on September 7, 2016

Long grain rice! Sorry.
posted by taff at 9:47 PM on September 7, 2016

Just a warning that the diabetic candies contain sugar alcohols which don't completely digest and can cause diarrhea if you eat too many.

Yes. This is an actual thing. Found this out the hard way after I had a bag of sugar free chocolates once. For sugar cravings, the water trick helped, and if that didn't satisfy it? A couple of sections of really high quality dark chocolate does the trick for me.
posted by spinifex23 at 12:49 AM on September 8, 2016

This diet plan seems fairly straight forward.

The thing that is concerning is that your OB practice isn't able to see you for a week or even give you a phone call.
posted by sciencegeek at 2:45 AM on September 8, 2016 [3 favorites]

You may find this patient advice leaflet interesting. It doesn't have the strict formulaic meal plan that you're looking for, but it does have lots of high quality information.

Here's some more good information from the American Diabetes Association
posted by DrRotcod at 2:47 AM on September 8, 2016

I'm on my second go round of GD and it's a pain. In general dairy and fruit are no goes for breakfast. I've been eating 2 slices of toast with butter and either ham, turkey sausage, or hard boiled eggs. Be aware that if you can't control it via diet and exercise, they'll either want to put you on glyburide (which I did my first pregnancy) or insulin (which I chose to go straight to this time at 10 weeks).

The 2nd registered dietitian this time gave me this Lilly pamphlet, which lists food options and serving sizes for a variety of categories including carbs, proteins, fats. Nonstarchy vegetables are considered freebies -- eat as much as you want.

The 1st registered dietitian gave me this book by IDC and it's very good if you feel like you don't have enough info after meeting with the nurse.
posted by bluesapphires at 4:20 AM on September 8, 2016 [2 favorites]

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