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Gestational diabetes and nutrition (EN)

What are you allowed and not allowed to eat and drink?

​Nutritional advice is part of the treatment of gestational diabetes. Often only a few adjustments in your diet are needed to prevent adverse health consequences for both mother and child. This leaflet will tell you about food intake when suffering from gestational diabetes; what should you avoid, and what are you allowed to eat and drink.

Explanation

Nutrition consists of three important energy-supplying nutrients: carbohydrates, fats and proteins. Carbohydrates and fats are the fuels in nutrition, proteins are mostly important as building materials. Carbohydrates play a big role in gestational diabetes.

Carbohydrates are an umbrella term for:

  • starch: bread, pasta, rice, potatoes, legumes
  • fructose: fruit, fruit juice
  • lactose: milk, buttermilk, yoghurt, custard, cottage cheese
  • sugar: biscuits, candy, sweet sandwich filling, all sugar varieties.

Glucose and insulin

Carbohydrates are broken down to glucose (blood sugar) in the digestive system. The glucose is absorbed by the blood in the intestines. Glucose is the energy source of all cells in the body. Cells require a hormone called insulin to be able to absorb glucose. Insulin ensures that glucose can access the cells. In case of gestational pregnancy the pregnancy hormone opposes the insulin. As such, a large part of the glucose is left in the blood, which results in a blood glucose level that is too high.

Target of the diet

Normally, your body makes sure that the amount of insulin matches the amount of carbohydrates you ingest. If you eat more carbohydrates, your body will produce more insulin, and if you eat less carbohydrates, your body will produce less insulin. In case of gestational diabetes your body is having trouble controlling this. By eating carbohydrates regularly and spread out over the day, you will make it easier for your body, resulting in the carbohydrates being processed more easily.

Nutritional advice

When suffering from gestational diabetes, the most important nutritional advice is:

1. Avoid fast, liquid sugars

Examples of fast, liquid sugars are soft drinks, lemonade, fruit juices and sugar in coffee and tea. These sugars are absorbed very quickly by the blood, which leads to a blood glucose level that is too high. Do not drink diet fruit juices either. Because fruit juice is made of fruit, it still contains fructose.

You can take: water, tea/coffee without sugar, sugar-free lemonade (such as Slimpie, Burg Limo Light, Teissiere), diet soft drinks (such as diet cola or diet orange soda), Crystal Clear and Rivella.

The Voedingscentrum (Nutrition Centre) recommends drinking a maximum of 7 glasses of diet drinks per day, because of the sweeteners.

2. Make sure to spread carbohydrates

You do not have to eat completely sugar free. Make sure you eat carbohydrates regularly and spread them out over the day. It is not necessary to calculate very precisely. It is mainly important to mind the amount of carbohydrates you eat. In the list of carbohydrates on this page you will find the amount of carbohydrates in various products.

Blood glucose level < 7 mmol/L
If your blood glucose level is less than 7 mmol/L after a meal, the balance between the amount of carbohydrates in the meal and the amount of insulin produced by your body is good. In other words: if the blood glucose level after the meal remains under 7 mmol/L, you will not have to change your diet.

Blood glucose level > 7 mmol/L
If your blood glucose level remains above 7 mmol/L, it may help to spread carbohydrate intake over the day. Try to discover how many grams of carbohydrates are needed to keep the blood glucose level below the 7 mmol/L. You will not have to eat less, but you will be able to spread carbohydrates over the day. Or you can use other products, such as eating savoury sandwich filling instead of sweet.

3. Eat and drink sufficiently

Healthy nutrition is extra important during pregnancy, as your baby depends on it. This means you should not eat and drink less in order to maintain a proper blood glucose level. You need a certain amount of foodstuffs a day to in order to get all the required vitamins, minerals and energy.

Recommended amount per day

With these amounts you and your baby will receive sufficient nutrients.

Product/foodstuffRecommended average amount per day
Bread6 slices
Potatoes, rice, pasta or legumes4-5 potatoes/serving spoons (200-250 grams)
Vegatables4 serving spoons (200 grams)
Fruit2 pieces (200 grams)
Dairy450 ml dairy products and 30 grams (1.5 slice) of cheese
Meat (products), fish, egg and meat substitutes125-150 grams (cooked weight)
Low-fat margarine, margarine, baking products and grill products30 grams of low-fat margarine/margarine (5 grams per slice); grill in liquid bake, grill or fry products or oil: 1 table spoon
Drinks1.5 to 2 litres (milk included)


Additional vitamins and minerals
Do you want to take more vitamins and minerals in addition to the extra vitamin D (10 micrograms a day) and folic acid (400 grams a day)? Take a multivitamin designed for pregnant women. If you do, you will no longer have to take any additional vitamin D and folic acid (also see www.voedingscentrum.nl (in Dutch)).

List of carbohydrates

With the list of carbohydrates you can look up how many carbohydrates your food/meal contains. You can also check the product's packaging to determine the exact amount of carbohydrates it contains.
Please note: The lists does not state whether a product is healthy or unhealthy.

You can also find the amount of carbohydrates in the Eettabel (Food Table), a useful booklet that is available for purchase at the desk of the Dietetics Department and the Voedingscentrum. Ask your dietician where you can find reliable online carbohydrate tables.

FoodstuffUnitCarbohydrates (in grams)
Bread and breakfast products
Rusk1 piece7
Soft/hard roll​1 piece​23
​Brinta (Wheat flour)​1 table spoon (5 grams)​3
​Bread (whit/brown)​1 slice (35 grams)​16
​Corn flakes​1 table spoon (4 grams)​3
​Cracker bread​1 piece (5 grams)3
​Cream cracker​1 piece (10 grams)​7
Croissant​​1 piece​18
​Granola​1 eetlepel (10 gram)​6
​Italian roll​1 roll (100 grams)​52
​Crispbread​1 piece​7
​Currant bun​1 piece​26
​Currant loaf​1 slice​18
Muesli​​1 table spoon (10 grams)​6
​Rice cracker​1 piece​3
​Rye bread dark​1 slice (45 grams)​16
​Rye bread light​1 slice (25 grams)​9
​Baguette​1 slice (10 grams)​5
Sandwich filling
All types of sweet filling (such as jam/honey/syrup/sprinkles/aniseed comfits)​1 slice (15 gram)​9
​Diet jam​15 grams​5
​Cheese/cheese spread​1 slice (20 grams)​0
​Peanut butter​15 grams​2
Salad (such as chicken curry, cucumber)​1 slice (30 grams)​2
​Sandwich spread​1 slice (15 grams)​2
​Meat products​1 slice (15 grams)​0
​Fruit-flavoured sprinkles​15 grams​15
Potatoes and substitutes
Fried potatoes​1 serving spoon (50 grams)​8
​Cooked potatoes (the size of an egg)​1 piece (50 grams)​8
Lasagna (depending on preparation)per 100 grams (2 serving spoons)​​12
Oven dish (depending on preparation)​per 100 grams (2 serving spoons)​10
​Pasta (done)​1 serving spoon(50 grams)​10
​Chips​1 serving spoon(50 grams)​19
​Chips​1 bag (150 grams)​57
​Pancakes plain​1 piece (70 grams)​20
Legumes (green peas, lentils, beans, marrowfat peas)1 serving spoon (60 grams)​​10
​Pizza (vegetables/cheese/tomato/meat)​1 piece (350 grams)​90
​Rice (done)​1 serving spoon(50 grams)​18
Wrap​​1 piece (60 grams)​32
Fruit/vegetables/purée
Strawberries, fresh​1 small dish (100 grams)​5
​Apricots, dried​1 piece (3 grams)​2
​Abricots, fresh​1 piece (20 grams)​2
​Pineapple, fresh​1 slice (100 grams)​17
Apple, fresh​1 piece (125 grams)​15
​Apple sauce (from a jar/can)​1 small dish (200 grams)​34
​Apple sauce without added sugar (from a jar/can) or home-made without sugar​1 small dish (200 grams)​22
​Banana, fresh​1 kid banana (75 grams)​16
​Blackberries, fresh​1 small dish (125 grams)8​
​Dates, candied​1 piece (5 grams)​4
​Dates, fresh1 piece (5 grams)​2​
Grapes, fresh​1 bunch(125 grams)​19
​Raspberries, fresh​1 small dish (100 grams)​7
​Fruit cocktail in syrup (from a can/jar)​1 small dish (125 grams)​18
​Grapefruit, fresh​1 piece (150 grams)​10
​Cherries, fresh​1 small dish (200 grams)​26
​Kiwi, fresh​1 piece (75 grams)​7
Mandarin oranges in syrup​100 grams​20
​Mandarin oranges, fresh1 piece (55 grams)​​5
​Melon, fresh​1 portion(125 grams)​8
​Nectarine, fresh​1 piece (90 grams)​6
​Pear, fresh​1 piece (130 grams)15​
​Peach, fresh​1 piece (110 grams)9​
Plum, fresh​1 piece (40 grams)4​
​Raw vegetables​1 small dish (70 grams)​1
​Redcurrant berries, fresh​1 small dish (100 grams)5​
Raisins​1 table spoon (10 grams)​7
Orange, fresh​1 piece (120 grams)​13
​Mixed dried fruit​1 small dish (80 grams)​47
Dairy products
Chocolate milk/fruit milk​1 cup (250 ml)​30
​Ice cream, cream/soft/sorbet​1 scoop (50 grams)​15
Milk/buttermilk/Optimel drinking yoghurt*​1 glass (150 ml)​7
​Optimel yoghurt*​1 small dish (150 ml)​7
​Optimel custard*​1 small dish (150 ml)14​
Porridge without sugar​1 small dish (150 ml)​15
Pudding​​1 small dish (150 ml)​30
​Custard (vanilla/various flavours)​1 small dish (150 ml)21​
Fruit-flavoured yoghurt/Fruit-flavoured cottage cheese​1 small dish (150 ml)​21
Meat/fish/chicken or substitutes
Meat croquette​1 piece (65 grams)​11
​Vegetarian hamburger​1 piece (75-100 grams)​9
​Fish fingers​1 piece (25 grams)​3
​Meat/fish/chicken without bread crumbs​1 portion (100 grams)​0
Soup
Broth or clear soup without vermicelli​1 cup (250 ml)​1
​Cup-a-soup, various flavours​1 cup (175 ml)±14 (depending on the flavour)
Cream soup or clear soup with vermicelli​1 cup (250 ml)±7 (depending on the variety)
Main course soup​1 cup (250 ml)​15
Drinks
Crystal Clear (in carton)*​1 glass (150 ml)​1
Diet soft drink (diet cola, diet orange soda, Rivella, Crystal Clear, etc.)*​1 glass (150 ml)​1
Sugar-free lemonade (Slimpie, Burg Limo Light, Teissiere 0%, AH 0%, Diaran)*​1 glass (150 ml)​1
​Tea/coffee/water​1 glass (150 ml)​0
Fruit juices, normal soft drinks, Roosvicee (all kinds, including diet), Lessini, diet Lessini, lemonade, unsweetened fruit juices, iced tea, diet iced tea, Roosvicee 50/50​1 glass (150 ml) with syrup per 35 ml undilutedAdvise against it because of the fast liquid sugars (4/20 grams)
* The Voedingscentrum (Nutrition Centre) recommends drinking a maximum of 7 glasses of diet drinks per day, because of the sweeteners.
Various
Marie biscuit1 piece (5 grams)​4
​Wholemeal biscuit​1 piece (10 grams)​7
​Cube of cheese/sausage​1 piece​0
​Chocolate​1 piece (15 grams)​10
​Cocktail nuts​1 handful(25 grams)​12
​Crisps​1 handful (25 grams)1​
Mini bag of crisps​25-30 grams​5-16
​Chocolate (dark/milk/white)​1 piece (5 grams)​3
​Liquorice/candy/marshmallow​1 piece (5 grams)4​
​Spiced gingerbread​1 slice (25 grams)​18
​Liga Evergreen​1 package (2 pieces, 2x20 grams)​26
Chocolate éclair​1 piece (65 grams)​12
​Gingerbread​1 piece (25 grams)​18
​Peanut sticks/salty sticks​10 pieces(10 grams)​7
​Peanuts/nuts, various​1 table spoon (20 grams)2​
​Snack-a-jacks​1 piece (10 grams)​8
Snack-a-jacks specials​​1 piece (15 grams)​13
​Snelle Jelle (spiced gingerbread)​1 slice (70 grams)​49
​Snelle Jelle (gingerbread)​1 slice (55 grams)​40
​Spiced biscuit​1 piece (10 grams)​7
Sultana biscuits​1 package (2 pieces)​20
​Cake: cottage cheese, whipped cream, flan​1 piece (100 grams)​30
​Pie: apple​1 piece (100 grams)​41
​Water ice​1 piece (50 grams)​11
Salty biscuit (Tuc)​1 piece (4 grams)​3


In conclusion

Do you have any questions about your nutrition or do your blood sugar levels remain too high (above 7 mmol/L, an hour and a half after the meal)? Then please contact your dietician, at telephone number +31 (0)38 424 53 27. Available on weekdays from 8:00 to 17:00 and at diabetes.dietist@isala.nl.


27 juni 2016 7202 Nee Nee

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