Diet-controlled gestational diabetes

by - November 27, 2023

There are three main ways that gestational diabetes seems to be managed:

  1. Not at all - pregnant woman ignores medical advice, goes rogue and eats whatever she wants and doesn't test her blood glucose levels.
  2. Diet-control and exercise - Moderating blood glucose levels through balanced meals and snacks, with moderate movement/exercise after each main meal to help process the blood glucose.
  3. Diabetes medical intervention with insulin injections or Metformin pills, or a combo of both.

So far, I have been on Option 2: Diet control and movement. On bad days, I wish I could do option 1 and indulge in hot chips and ice cream without the crippling guilt I know I'd feel after. On exhausted days, I consider asking my diabetes team to stick me with multiple daily needles already so I can be less strict with my diet. Then I remember that I am doing option 2 for baby and get back to it!

Going on insulin, I'm told, risks placental deterioration while taking Metformin pills passes through the placenta and impacts baby's insulin production and growth. Both are safe enough to be used on pregnant women, obviously, but diet-controlled is what the medical teams prefer if you can to avoid further medical interventions that come from going on medication. Diet control doesn't always work especially towards the end of your pregnancy because of wild pregnancy hormones produced by the placenta.

I am writing this at Week 30 when the placenta starts to kick up its insulin-resistant hormones so I may write about insulin and metformin experience in future. But for now, I am diet-controlled.

I went from two meals a day, and an afternoon snack of fruit to:

  1. 3 main meals a day - breakfast, lunch, dinner - 30g-45g carbs
  2. 2 snacks - 2-3 hours after breakfast and lunch - 15g-30g carbs
  3. Supper right before bed - 15g or less carbs

I focus on low-GI carbs that take longer to break down into blood glucose, and adding lots of veggies and protein will also help slow the conversion to glucose. Some women find it easier to go low-carb because there's little to no risk of spiking your blood glucose levels (BGLs), but my dietitian recommended 175g minimum a day for baby's development so that's what I target.

I have this with low GI brown rice that's not pictured

For those on diet control, this generous Melbourne dietitian is a godsend - Robyn Compton shares her GD expertise and I couldn't have figured out my new, balanced diet without her. Even my hospital dietitians recommended her to me after I'd found her through an online support group: The hospital dietitian's few pages of info on carb portions and whole foods vs processed foods is not enough to build meal plans for however many months until baby arrives. But with Robyn Compton here to save the day, I have plenty of meal and snack options from here until I deliver.

The Gestational Diabetes Australian Support Group on Facebook is also really helpful:  Lots of women sharing their personal experiences and supporting each other through this often baffling diagnosis and treatment. I don't normally have a good time with Facebook groups because I find people get catty, judgemental or sarcastic when they're allowed to post anonymously. But this group is full of pregnant women who genuinely care and are trying their best to navigate the murky areas of gestational diabetes management.

I also binged the Gestational Diabetes Club podcast by nutritionist, Helena. There is one particularly helpful Q&A episode with a GD educator that I wish they'd recorded a couple months earlier when I was starting my GD learning. It's super helpful:  

I've found my 'safe' meals after about 4 weeks of a crash course on how my body processes different food combinations. I'll occasionally try something new now I'm 11 weeks into my new diet but often I don't want the anxiety of eating something different and waiting two hours to test my BGLs to see if it's within limit. My diet is getting boring and I have another 9-11 weeks to go if baby arrives around the estimated due date, but better safe than sorry. I talk Baby Pham through our daily menu each morning so he's prepared for yet another bland day of eating.

I have a few 'cheat' meals coming up for Babymoon and over the holiday season where I'm pretty sure I'll spike so I want to avoid having too many spikes now. Consistent spikes over time is the real danger to baby whose body then gets used to producing more insulin to compensate for my high glucose diet so I don't feel so bad about the odd cheat meal I have coming up in the next couple months.

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