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June 23, 2007

Meal Planning, Food and Diet, Pregnancy

Question from Sacramento, California, USA:

I was diagnosed one month ago, at the age of 28, with type 1 diabetes. My husband and I were trying to conceive at the time and were sent to the perinatology department of our HMO. (We are currently preventing pregnancy until my blood sugar is in tight control.) The perinatologist wants me to follow their diet for gestational diabetes, which is quite strict, necessitates eating six times a day from specific food groups, and allows no sugary foods ever. Everything I'm reading about type 1 seems to indicate that special diets are not necessary, just good carbohydrate counting and proper insulin dosing. Is this not also true during pregnancy? Is there any reason a type 1 diabetic needs to follow the same diet as a gestational diabetic?

Answer:

An essential part of managing diabetes in pregnancy is good glucose control. This is achieved through both diet and insulin management. The basis of a good diet is a balance of protein, carbohydrates and fats. For a diet to be reasonable, it has to be palatable. My experience is that if the diet is not tolerable, then it will not be followed. Thus, I feel that reasonable guidelines for a diet along with carbohydrate counting and frequent blood sugar testing achieves the best results. I will emphasize the importance of good glucose control prior to conception to minimize the risk of fetal abnormalities. I would also recommend folate supplementation (5 mg/daily) to reduce the risk of spina bifida.

OWJ