I have just been diagnosed with gestational diabetes and I have an appointment with a endocrinologist in a week. In the meantime, what immediate dietary changes can I make to help control the diabetes? I am 32 years old and this is my first child. I plan to start a mild exercise program of walking around my neighbourhood starting immediately. Is that okay?

The primary tools of managing gestational diabetes are nutrition and blood glucose monitoring. It is very likely that you will be started on testing your blood sugar when you see the doctor. You nutritional needs to complete a healthy pregnancy are not changed by your gestational diabetes — you still need the same amount of calories, vitamins, minerals, protein and so on. What’s different is your ability to handle very much carbohydrate at one time. Until you are testing your blood sugar and can see the actual effect of your food choices on your blood sugar level, stay away from regular soda pop, sweets and large portions of rice, noodles, pasta and bread. Avoid fruits, fruits juices, and bagels at breakfast (most women have a harder time controlling blood sugar in the morning than later in the day). Also you will probably be asked to divide your food intake up in to six small meals, having no more than 30-45 grams of carbohydrate at each one. This generally helps fit the demand for insulin to the amount your body can now make available.

Keeping your blood sugars well controlled is both essential and possible. Most women make it through to delivery by just managing their food intake. However, if at any time, your blood sugars rise above the goal range even though your food intake is appropriate, insulin will be needed until you deliver to assure the best outcome for you and the baby. I’m sure your endocrinologist and staff can answer the questions that you will undoubtedly have as the pregnancy progresses.

BB