I was diagnosed with gestational diabetes at 18 weeks for my second pregnancy, and then again at merely 11 weeks for my third pregnancy. For both pregnancies, I managed to avoid using insulin by using diet control and went on to have a smooth, uncomplicated vaginal birth.
If you have recently also been diagnosed with GDM, or know someone who has, I’m here to share with you practical tips that I personally discovered which helped me on my diet-controlled journey with GDM.
1) Rule of Thirds
When you have your appointment with the dietician to plan your meals to manage GDM, chances are they won’t be very specific. Either that or you’re left with a very sad-looking meal plan that doesn’t offer much variety and meal times will become increasingly stressful and unenjoyable for you.
I’m here to tell you to forget the meal plan (sorry, Mr Dietician) and eat whatever you want, but follow a very basic rule – the Rule of Thirds. Make sure your plate/bowl consists of only one-third of carbs (e.g rice, pasta, bread) and two-thirds should be veggies and meat.
This is because carbs are the main source of glucose and they are the culprits that send your blood sugar level spiking up. However, carbs are crucial for baby’s growth so it is important not to eliminate them entirely.
For example, if I want a chicken schnitzel burger for lunch, I’ll get that damn burger, but just eyeballing the portions, if I can see that the two buns make up more than a third of the burger, I will remove the top bun and eat only the bottom one.
2) 75% is the new 100%
If you’re the kind of person who usually eats till she’s stuffed and has no room for desserts, you’ll need to get into the habit of only eating up to roughly 75% of your full stomach capacity.
When you’re constantly eating to 100%, it’s very easy to overeat and thereby send your blood sugar levels shooting through the roof. It’s much easier to control your blood sugar levels if you eat till you’re JUST starting to feel full (which is usually around 75%) and then wait till you’ve taken your prick test before having a light snack (I call it dessert) to celebrate, which brings me to my next tip.
3) Reward yourself
Many recent studies have shown that the more one deprives oneself of food cravings, the more likely their diet will fail. It is emotionally healthy for you to satisfy your cravings in moderation.
In my case, I gave myself three or four mini rewards every day, once for each successful prick test where my results are within the safe range. Here’s an example: For breakfast, I might have a slice of sourdough toast with egg and smashed avo, plus a light coffee. Two hours later I will need to do a prick test, and if the results are good, I might have a quarter of a blueberry muffin to celebrate.
The important thing to remember is that the diabetes nurses and doctors won’t be too fussed over a few high readings a week. Usually, they’ll only consider putting you on insulin if you consistently get more than three or four high readings weekly.
This means that if you occasionally “let up” on your diet – maybe a family dinner, or friend’s party – it’s totally fine, don’t stress over it! For me, my family have brunch at cafes on weekends, so on those days, I don’t worry about my diet and just order whatever I want to eat.
4) 15g carbohydrate = 1 serve
During one of my appointments with the diabetes nurse, she told me that a rough guideline is to keep my carbs to 2-3 serves for main meals, and just 1 serve for snacks. If you look at the nutritional labels, take note of how many grams of carbohydrates are in 1 serve.
For instance, Arnott’s Cruskits Rye contains 8.6g of carbs per serve, and each serve is two biscuits. So I can have roughly four biscuits as a snack. Or, if I want a drink with it, I might just have two biscuits, so I have a bit of leeway for some coffee or tea.
Below an image of the cheat sheet, the nurse provided me. You would notice that there is no meat and hardly any veggies on it, that’s because meat (or protein), seafood and leafy veggies do not have carbohydrate, so you can have as much of those as you like.
Hurray, steak and steamed veggies for dinner!
5) Low, Low, Low
Low sugar, low GI, low carb is the way to go. When in doubt, like choosing between Nescafe Instant Hazelnut or Vanilla Latte, always go with the one with lower sugar and carb content.
Many supermarket foods now come labelled as low GI so you can make quick easy decisions. If you do your shopping online, you can search “low GI” on the Woolworths Online website and it’ll show you everything that is labelled low GI. They have also recently added a new feature to their online shopping experience and you can now see nutritional content for every product.
Pretty nifty! Wish they had this back when I was pregnant, so I didn’t have to look like an idiot picking up every box and staring at its label.
6) Burn it off
If you’ve had a big night out and know without a doubt that you’ve blown your blood sugar levels, I’ve found that exercising for a solid 20 mins helps bring it right down. I particularly enjoyed swimming, because it’s physically less demanding and it’s super effective in lowering blood sugar levels.
So for instance, if I had a big dinner at 6pm, I will wait till 7:30pm, then go for a 20mins swim, and then take my prick test at 8pm. In most cases, my sugar levels would become extremely low after a swim, as low as 4.1.
Note: This didn’t work for me during my third pregnancy, because I was on one hour testing, instead of two hours, so I wouldn’t have enough time after meals to exercise properly before testing.
However, I did try walking instead, and it did also help. Just a 10 mins walk can help bring down your sugar levels.
7) Know your triggers
Everyone has slightly different triggers foods which can send a spike in their blood sugar levels. Generally, though, greasy food like most takeaways will be your biggest nemesis. To combat that, you can order extra greens so you’re having fewer carbs and also keep your takeaway portions small.
Occasionally, due to hormonal changes further along pregnancy, your triggers can change too. I was initially fine with having decent amount of basmati rice (which is a low GI rice), but as I progressed in pregnancy I realised the amount I could have had to be reduced in order to control my sugar levels.
This isn’t a cause for concern unless your triggers alter to a point where you are constantly feeling hungry because you are restricting yourself and dare not eat too much.
If this is the case, it is important that you call your diabetes clinic as soon as possible to discuss the next steps. As much as you may want to avoid using insulin, sometimes pregnancy hormones make it near impossible to handle glucose without the help of it.
8) There’s only so much you can do
At the end of the day, the important thing is to stay happy and healthy. If you’re finding managing GDM with a controlled diet extremely stressful, unsatisfying, and not producing results, it could be that you need insulin injections.
There is absolutely no risk to the baby if you take insulin injections, although it does mean you will have to be monitored more closely during labour and could mean a lower chance of natural birth.
I hope you’ve found the above information helpful. Please bear in mind that these are things that I’ve personally found to be useful in managing my GDM, but by no means should replace any medical or professional advice given to you by your healthcare providers.
GDM is not an easy condition to manage and does require some sacrifice and discipline. But I like to think of it as a blessing in disguise because it forced me to adopt a healthy diet and lifestyle, which is beneficial for both myself and baby.
Here’s wishing you a healthy happy pregnancy!