Lifestyle Changes to Manage Gestational Diabetes
With gestational diabetes, the first approach your doctor will take is management through lifestyle changes. Many women have been able to successfully control their blood sugar levels by eating a carefully planned diet and engaging in an exercise program. By avoiding high blood sugar levels will reduce the risk of macrosomia, promote good fetal growth as well as reduce the risk of complications during labor.
A nutritionally balanced diet alone can sometimes keep your blood sugar levels in the normal range. This is generally the first method of treatment that your doctor will try. To help plan your meals, you should work with a registered dietitian. Your doctor or the local chapter of the American Dietetic Association ( http://www.eatright.org/ ) can help you find one.
When you are pregnant, it is important to eat the proper foods to meet both your and your baby’s nutritional needs. But if you have gestational diabetes, you have one more focus—to keep your blood sugar level as normal as possible. In general, daily caloric intake should be between 2000 to 22oo calories with 40% carbohydrate, 29% protein and 40% fat.
During pregnancy, your need for calories and protein increases. And, most vitamins and minerals are also needed in greater amounts.
The following tips are designed to help you keep your blood sugar level within a normal range:
Limit sugar and foods high in sugar. —Foods that usually contain high amounts of sugar include cookies, pies, cakes, ice cream, soft drinks, candy, doughnuts, and jams. There are many forms of sugars used in food processing; look on the food label for names such as corn syrup, high fructose corn syrup, honey, turbinado (also known as raw or rough) sugar, molasses, and most ingredients that end in “ose”—like sucrose and dextrose. Noncaloric sweeteners should be used in moderation.
Emphasize the use of complex carbohydrates. —Examples of complex carbohydrates are vegetables, cereal, grains, beans, peas, and other starchy foods.
Emphasize foods high in dietary fiber. —Foods with high fiber include whole grain cereals and breads, fruits, vegetables, and legumes.
Keep your diet low in fat. —Some fat is needed to provide your developing baby with the essential fatty acids necessary for growth and to help your body absorb fat-soluble vitamins. Try to stay away from saturated fats, which are found in bacon, butter, cream, and whole milk cheeses, choosing instead foods rich in unsaturated fats, like fish, olive oil, nuts, and avocado—but do so in moderation.
Include a bedtime snack. —This snack should be a good source of protein and complex carbohydrates. It will help stabilize your blood sugar throughout the night. Some examples are:
- 1 ounce low-fat cheese and 5 whole-wheat crackers
- 2-3 ounces of chicken (without the skin) on whole wheat bread
- 3 cups unbuttered popcorn and 1/4 cup nuts
Most women with gestational diabetes need three meals and a couple of snacks, including a bedtime snack, each day. Try not to go for long periods of time (more than 5 hours) without eating. Working with a registered dietitian is the best way to develop a meal plan that is right for you.
A daily exercise program is an important part of a healthy pregnancy. For women with gestational diabetes, it is especially important. Regular exercise increases the efficiency of your body’s own insulin as well as lowers your blood sugar levels. In addition, it can help you to maintain a healthy weight during your pregnancy.
Before you begin an exercise program, it is very important that you discuss it with your doctor.
Choose exercises that don’t require your body to bear any extra weight. Good examples are:
- Stationary cycling
- Walking (at least 3-4 times a week)
- Low-impact aerobics
Be careful to avoid contact sports or vigorous sports, or any exercises that increase your risk of falls or injury. It is also important to avoid becoming over-heated; if your body temperature rises too much, it can be dangerous for your baby. Also, drink plenty of fluids, even if you are not thirsty.
Exercising frequently, 4 to 5 days per week, is necessary to have an effect on your blood sugar level. Start with a 5- to 10-minute warm up and always end with a 5- to 10-minute cool down.
Stop exercising if you experience:
- Shortness of breath
- Back or pelvic pain
- Vaginal bleeding
When to Contact Your Doctor
Contact your doctor if you experience any of the following:
- Vaginal bleeding
- Shortness of breath
Symptoms of low blood sugar, including:
- Anxious feeling, nervousness, shakiness
- Behavior change similar to being drunk, slurred speech
- Blurred vision
- Cold sweats
- Confusion, difficulty in concentrating
- Fast heartbeat
American Diabetes Association website. Available at: http://www.diabetes.org/home.jsp .
National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/ .
Oken E, Ning Y, Rifas-Shiman SL, et al. Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol. 2006;108:1200-12007.
Reader DM: Medical Nutriton Therapy and Lifestyle Interventions. Daibetes Care 2007;30(suppl 2)S188-S193).
Tieu J, Crowther CA, Middleton P: Dietary advice in pregnancy for preventing gestational diabetes mellitus. Cochrane Database Syst Rev . 2008;16:CD006674.
Last reviewed June 2008 by ]]>David Juan, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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