Gestational

Learn about gestational diabetes

Diabetes

By the end of this lesson:
• Participants will know the definition of gestational diabetes.
• Participants will learn the basic guidelines of eating healthy with gestational diabetes.
• Participants will demonstrate knowledge of serving sizes.
• Participants will plan a healthy meal.

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First and Last Name

Activity 1:

Has your doctor told you that you have gestational diabetes?
Yes
No

Activity 2:

What do you think gestational diabetes is?

The American Diabetes Association defines gestational diabetes as high blood sugar or high blood glucose during pregnancy. Gestational diabetes begins during pregnancy and disappears following delivery.

Has your doctor told you that you have high blood glucose or sugar? Glucose is sugar that our body uses as our main ENERGY source. Glucose comes from the breakdown of simple carbohydrate sources such as table sugar or from complex carbohydrates such as oatmeal. After we eat and digest these foods, glucose enters our bloodstream. Our body needs some help getting glucose to our muscles and tissues, so that it can get energy. Your pancreas senses a rise of glucose in the bloodstream and sends the hormone, insulin, to get glucose from your bloodstream to your muscles and tissues. If you have gestational diabetes, the glucose does not all get to your muscles and tissues and begins building up in your bloodstream - this is why you have high blood glucose (or high blood sugar). The cause of gestational diabetes is not yet known. Your doctor should check your blood glucose level between your 24th and 28th week of pregnancy.

About 3% - 5% of all pregnant women in the United States are diagnosed with gestational diabetes. During this lesson, we will discuss some tips to help keep your blood sugar level normal and we will also explain why it is important to do so! All of the information we have gathered for you was adapted from the American Diabetes Association and the National Institutes of Health.

Activity 3:
Check off each risk you have for developing gestational diabetes:

	Are you a pregnant woman who is older than 25 years of age?
	Do you have a family history of diabetes?
	According to your BMI (see class on BMI), were you obese before you became pregnant?
	Have you given birth to a baby that weighed more than nine pounds?
	Did one of your children die an unexplained death as a newborn or shortly after birth?
	Do you have lots of infections?

If you checked off one or more of these questions, you are at risk for developing gestational diabetes.

What are the risks to your baby if you have gestational diabetes?

•	Your baby could be larger than normal.
•	Your baby could be at risk for having low blood sugar at delivery.
•	Your baby may be at risk for developing non insulin-dependant diabetes later in life.
•	You may have a baby that is born early.
•	Your baby's lungs may not be fully developed.

If you follow a healthy diet to control your blood sugar levels, your chances of delivering a healthy baby are much greater!

So, what is a healthy diet during pregnancy and how can you make sure your blood sugar levels are within normal range?

Here are some guidelines to follow:

•

Eat three meals per day with 1 - 2 snacks. Try to eat meals and snacks at the same time every day; this will help keep your blood sugar level normal. Make sure one snack is before bed so your blood sugar level will remain normal throughout the night.

•	When you have a snack, you want to include a protein source from either meats, eggs, or cheese along with carbohydrates like milk, crackers, cereal, breads, tortillas, and fruit.
•	When you prepare a meal, make sure you have a variety of food from different food groups. We will discuss the food groups later in the lesson. NEVER skip meals and eat meals every 4 - 5 hours.

•

To keep your blood sugar level within normal range avoid concentrated sweets. This means avoid candy, soda, sweet drinks like Kool Aide and Sunny Delight, ice cream, cake, honey, high fructose corn syrup (look for in the ingredients), and table sugar. Fruit juice is also high in sugar so limit to about 6 ounces or less per day and drink it with your meals.

•	Ask your doctor about a safe exercise regimen. Exercise can help you stabilize you blood sugar levels.

• Consume a nutritionally balanced diet. This means eat a variety of food and try to follow the following guidelines:

FOOD GROUP	RECOMMENDED DAILY SERVINGS
Grains	7 - 11
Vegetables	4 - 5
Fruits	3 - 4
Milk & Milk Products	3 - 4 (pregnant teens need 4-5)
Meat & Meat Alternatives	3
Fats & Sweets	use sparingly

Let's take a closer look at the different food groups:

GRAINS

Grains

Grains are the largest section of the pyramid because you should have the highest number of servings from this group. Grain foods provide complex carbohydrates, the primary energy supply for your body. They are also high in fiber, low in fat, and a good source of many vitamins, especially Vitamin B that is needed for energy metabolism and tissue development during pregnancy. Grains should serve as the foundation of your meals. Grain foods include pasta, bread, rice, cereal, and oatmeal. Try to focus on whole grain products, like bread that is made from 100% whole wheat flour or cracked oats.

Here are examples of one serving from the grain group:

1 slice of bread (1 ounce)	1 small tortilla
1 cup of ready-to-eat cereal	½ cup of cooked cereal
½ cup cooked rice or pasta	½ of an English muffin
3 graham cracker squares	4 – 6 crackers

Activity 4:
Select the food that equals 2 servings of grain

	½ cup of oatmeal
	1 cup of rice
	1 piece of French toast

Did you choose the cup of rice? The oatmeal and French toast are only one serving.

FRUITS & VEGETABLES

Both fruit and vegetables are considered nutrient dense foods because they contain many vitamins and minerals with few calories and little fat. Vegetables are a good source of folate and zinc needed for new cell growth and development, and iron for a greater blood supply. Fruits are rich in Vitamins A and C and potassium. These vitamins support cell growth of a developing fetus. Both fruits and vegetables also contain fiber, which helps reduce constipation.

Here are examples of one serving from the fruit and vegetable group:

1 medium fruit	½ cup of small or cut-up fruit
¾ cup of 100% fruit juice	¼ cup dried fruit
½ cup of raw or cooked vegetables	1 cup of raw leafy vegetables (such as lettuce, spinach)

Activity 5:

Select the food that equals 2 servings of a vegetable.

	½ cup of cooked carrots
	½ cup of lettuce
	1 cup of raw broccoli

Did you choose the cup of raw broccoli? The ½ cup of cooked carrots is 1 serving while the ½ cup of lettuce is only ½ serving.

MILK & MILK PRODUCTS

Dairy

Milk and other dairy products supply your developing baby with important sources of calcium, phosphorous, Vitamin D, magnesium, and protein. Your baby needs calcium for proper bone and tooth development. Phosphorous is vital for building muscle tissue, while magnesium helps aid cell development. Milk products are a good source of protein, which is needed for the overall growth of the fetus. Milk and milk products include any kind of milk, cheese, and yogurt.

Here are examples of one serving from the milk group:

1 cup of milk or fortified soy beverage	1 cup of yogurt
1 and ½ to 2 ounces of cheese	2 cups of cottage cheese

MEAT & MEAT ALTERNATIVES

steak beans

Meat and meat alternatives such as eggs, seafood, nuts, peanut butter, tofu, dried beans, and legumes are great sources of protein. Protein is needed during pregnancy to support tissue growth and development of the unborn baby. Iron and zinc are important minerals found in meat.

Here are examples of one serving from the meat and meat alternatives group:

2 – 3 ounces of cooked meat, poultry, or fish (about the size of the palm of your hand)	½ cup of cooked dried beans, peas, and lentils
4 tablespoons of peanut butter	2 eggs

FATS & SWEETS

Sweets

Fats and sweets are not considered a food group, but they are represented at the top of the pyramid. These foods provide additional calories but do not contain significant amounts of vitamins and nutrients. Fats and sweets include candy, cakes, potato chips, salad dressings, mayonnaise, and soda pop. Pregnant women with gestational diabetes should avoid SWEETS altogether because the sugar in these foods will significantly increase their blood glucose levels.

Activity 6:
How are you doing? Think back to what foods you ate yesterday and answer the following:

FOOD GROUP	YOU ATE	YOU NEED
Grains	servings	servings
Vegetables	servings	servings
Fruits	servings	servings
Milk & Milk Products	servings	servings
Meats & Meat Alternatives	servings	servings

Be proactive! Check your blood sugar levels often with your obstetrician.

Let's Review:

1. Choose the bedtime snack that will help stabilize blood sugar levels:

	apple slices with peanut butter and 6 ounces of orange juice
	chocolate chip cookie and 8 ounces of milk
	3 ounces of cheese and 4 crackers

2. Choose the whole grain:

	tortilla chips
	100% whole wheat bread
	saltine crackers

3. How many meals and snacks should a woman with gestational diabetes consume during one day?

4. List three examples of concentrated sweets that women with gestational diabetes should avoid:

5. Give an example of a well balanced meal:

Answers:
1. 3 ounces of cheese and four crackers - protein and carbohydrate group
2. 100% whole wheat bread - make sure to read the ingredient list
3. 3 meals with 1 - 2 snacks (make sure 1 snack is before bed)
4. soda, cookies, table sugar (answers will vary)
5. make sure you try to represent each food group

For more information on gestational diabetes please visit the American Diabetes Association website.

Which WIC Office do you go to?

AK Regional Hospital
Eagle River
L Street
Providence Hospital

Where are you taking today's lesson?

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Revised: 06-13-2008