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September 5, 1999

Gestational Diabetes

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Question from Columbia, Mississippi, USA:

I am 32 years old and 28 weeks pregnant with identical twin boys. I just failed my 1 hour test and I am very concerned. I have been looking everywhere for a list of foods that I should and shouldn’t eat. I would like to know if I should handle this as if I weren’t pregnant or if it is completely different because I am. Please ease a worried mother’s mind soon.

Answer:

From: DTeam Staff

The diagnosis of gestational diabetes is not confirmed until you have an abnormal 3 hours, 100 gram glucose tolerance test. If the 3 hour test is abnormal, then you will at least need a special diet (consult with a dietitian) or possibly insulin. This condition is most likely due to pregnancy and should resolve after you deliver.

OWJ
Additional comments from Betty Brackenridge, diabetes dietitian:

I can understand your concern. It’s important to take diabetes seriously and
I congratulate you for taking action so quickly to get the information you
need to assure a great outcome for you and your sons!

To answer your question about what to eat, it’s important to understand
first, that having GDM does not change the nutritional needs related to
pregnancy. You still need adequate calories, protein, vitamins and minerals
for yourself and your growing twins–not an easy thing in itself when you’re
carrying twins! So strictly cutting back on overall intake to improve your
blood sugars is not an option.

Instead, the key to control comes from distributing the foods you need
throughout the day. We recommend 6 small meals a day for our GDM moms. The
purpose is to reduce the amount of insulin required each time you eat — big
meals require more insulin than little meals, hence the six small meals. It
is most important to break up the carbohydrate foods you eat
(starches like breads, pasta and potatoes; and sugar containing foods like fruits, fruit
juices, milk, and sweets) so that you are getting no more than two small
portions at any one meal. We also ask our GDM moms to not eat fruit,
fruit juice or other “quick carbohydrates” at breakfast–morning is generally the
time when GDM moms have the greatest difficulty controlling the blood sugar
level.

The way you tell if this is working is through testing your blood sugar level
before and after eating. (If you have not been started on blood glucose
testing, I will be glad to send you that information as well.) If, at any
point, dividing up your foods into six small meals does not keep
your blood sugar in or quite near the range that is normal for pregnancy, you will need
to take insulin until after the baby is delivered. This is very important
since blood sugars higher than the normal range during pregnancy cause the
baby to grow too large, leading to a difficult delivery and other possible
problems.

BB