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Gestational Diabetes Care Guidelines

Gestational Nutrition Guidelines
Carbohydrate Choices
Caffeine Content of Beverages

Gestational Nutrition Guidelines

Gestational diabetes appears for the first time during pregnancy. It occurs in 1 to 14% of all pregnancies. Gestational diabetes is usually found in the 5th to 6th month of pregnancy. Gestational diabetes may occur because hormones produced by the placenta in all pregnant women make insulin less effective. These hormones increase as pregnancy progresses.

All women with Gestational Diabetes should be testing fasting blood sugar (FBS) and 2-hour postprandial (pp) blood sugars. Target blood sugars for pregnancy: Fasting < 95 and 2-hour postprandial blood sugars < 120 mg/dl.

Breakfast
Due to hormones made by the placenta that are released during the night, blood glucose levels may be especially elevated following breakfast. Try the following suggestions to keep blood sugar levels within a normal range after breakfast:

Avoid fruits and fruit juice at breakfast.
Carbohydrate foods such as cereals, large bagels, and sweet rolls should usually be avoided.
Limit carbohydrate at breakfast to 2 choices or 30 grams total.

Meal Plan
It is important to include all of the basic food types, including starches in your meal plan. The meal plan that you get from your dietitian will help you balance your meals, especially the amount of starches that you need, throughout the day.

Exercise
If you have difficulty achieving the blood sugar goal after meals, exercise - a walk can often help lower blood sugars. You will need to meet with your dietitian diabetes educator to help develop a meal plan to be certain that adequate weight is gained during pregnancy and to keep your blood sugars within the target range.

Goals of the Meal Plan

Adequate calories for both you and your baby
Blood sugar levels within target zone (< 95 fasting and < 120 two hours after meals)
Slow and gradual weight gain of 24-30 pounds during pregnancy (If you were overweight before, you may need to gain less but this is NOT a time for weight loss!)
Bring in a food record to discuss with the dietitian. Limit caffeine to < 300 mg/day

Frequent phone contact will help your diabetes educator evaluate your blood sugars.

Call your Diabetes Educator on: __________________________________

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Carbohydrate Choices

AMOUNT	FOOD ITEM	STARCH	FRUIT	MILK	CHOICE
2 oz	Bagel	2			2
½ cup	Orange Juice		1		1
1 cup	Milk			1	1
1 cup	Mashed Potatoes	2			2
8 oz	Artificially-sweetened yogurt			1	1
1 large	Banana		2		2

Combination Foods – Exchange Value Available
1 cup	Potato Salad	2		2
1 each	Ice Cream Bar	1		1
2 cups	Spaghetti and Meatballs	4		4
8 oz	Nonfat Vanilla Yogurt		1	1

Combination Foods – Exchange Value Not Available
16	Cheese tidbits = 8 gm CHO	½
1 each	Oreo Big Stuff^® cookie = 33 gm CHO	2
8 oz	Stouffers Vegetable Lasagna^® = 28 gm CHO	2
1 each	Big Mac^® = 43 gm CH	3

Carbohydrate Containing Foods
Food Group	Food
Starch	Bread: Bagels, English muffins, rolls, pancakes, tortillas, Naan, bread sticks, crackers, popcorn, and pita bread Pasta: noodles, spaghetti, and macaroni Cereal: dry or cooked Legumes: lentils, dried beans, (garbanzo, pinto, kidney, black-eyed, white, split), lima beans, and miso
Fruit	Apples, oranges, bananas, and all fruit – fresh, frozen, canned, or juiced (sweetened or unsweetened)
Milk	All milk (fat-free, low- or reduced-fat, and whole, Goat’s, and soy) Yogurt (plain or artificially sweetened)
Vegetable	Carrots, green beans, broccoli, greens, and all other crunchy vegetables (only if 1 ½ cups or more)
Other	Foods that include any of the above items, such as: Casseroles (lasagna, tuna casserole, mac & cheese) Soups (bean, chicken, vegetable beef, cream) Stews (pot pie, beef) Snack foods – chips, pretzels, and French fries, pizza Desserts – ice cream, frozen yogurt, cake, cookies, pie

*Exchange Lists for Meal Planning, Academy of Nutrition and Dietetics, formerly the American Dietetic Association, 2003

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Caffeine Content of Beverages

-According to the National Soft Drink Association

Milligrams per 12 oz of soda
Jolt - 71.2	Mello Yellow - 52.8
Mountain Dew - 54.0	Coca-Cola - 45.6
Diet Cola - 45.6	Shasta Cola - 44.4
Shasta Cherry Cola……44.4	Shasta Diet Cola - 44.4
Mr. Pibb - 40.8	Dr. Pepper - 39.6
Pepsi Cola - 38.4	Diet Rite - 36.0
Diet Pepsi - 36.0	RC Cola - 36.0
7-Up - 0	Diet 7-Up - 0

Milligrams per 7 oz cup of coffee
Drip - 115-175	Espresso (1.5-2 oz) - 100
Brewed - 80-135	Instant - 65-100
Decaf/brewed - 3 - 4	Decaf, instant - trace
Tea, iced (12 oz) - 70	Tea, brewed imported - 60
Tea, brewed - 40	Tea, instant - 30