Diabetes in Pregnancy Diet Planning

Pregnant woman touches abdomen while listening to doctor

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Meal planning is important when you are pregnant with diabetes, whether with gestational diabetes or pre-existing type 2 diabetes. Women with diabetes are often asked to obtain tighter control of blood sugar levels in pregnancy. There are extra diet challenges and considerations when you have diabetes in pregnancy.

Pre-Planning Your Diet During Pregnancy with Diabetes

Ideally, you should have your blood sugar levels within good control three to six months prior to pregnancy. Good planning means following a diet and exercise plan and getting your blood sugar levels in good control.

It's also important that you are receiving management and diet education from your doctor, dietitian and a diabetes educator. During this time, your healthcare team will also assess your current medication regimen. Some of your medications might not be safe to take during pregnancy. Your doctor will make any adjustments necessary.

If you're already pregnant, talking to your healthcare team about how to meet your dietary needs and control your blood glucose levels will be a priority. Even making small changes can help lower the risks to your pregnancy.

Remember that your situation is unique and will require a tailored plan. It might take some trial-and-error and tweaking throughout pregnancy. In fact, it won't hurt to get started while you're still trying to get pregnant.

Maintaining good control of your blood sugar levels pre-conceptually can help lower the risk of birth defects. It also gives you an empowered and prepared standpoint to begin pregnancy with diabetes.

Challenges of Managing Diabetes During Pregnancy

  • A bigger appetite and need for extra nutrients. When you're pregnant you typically need more protein, iron, calcium, folic acid, and vitamins. It's not uncommon to feel hungrier but you'll need to ensure that what you are eating is nutritious—particularly, that you're getting plenty of foods that are rich in the micronutrients needed to sustain a healthy pregnancy.
  • Morning sickness. If you are being treated with insulin, it is important to eat all your meals and snacks to help avoid hypoglycemia. However, this can be difficult when you are nauseated and vomiting from morning sickness.
  • Insulin resistance. As your pregnancy progresses, your glucose levels may become harder to control—even if they were previously under good control. The hormonal changes of pregnancy can make it more challenging to keep your levels steady.
  • Overweight or underweight. If you fall into one of these weight categories, your diet plan will need to address your pregnancy weight gain needs.

What You Need to Know for Your Diet During Pregnancy

Here are some topics to discuss with your healthcare team when planning your diet for managing diabetes in pregnancy.

  • Best food choices for your situation
  • Blood sugar level goals
  • Dealing with illness, travel, high or low blood sugar levels
  • Foods to avoid
  • Prenatal vitamins
  • Total calories, carbohydrates, protein, and fat per meal and snack
  • Total daily calories, carbohydrates, protein, and fat
  • Weight gain goals

With regard to specific meals, breakfast can be a challenging meal to navigate if you have diabetes. Fasting blood sugar levels before breakfast can be difficult to control and your levels might seem to be the most reactive in the morning.

If you have already identified daily patterns in your blood sugar levels (such as when they tend to be the lowest and highest) bring this information to your doctor.

Understanding your patterns and discussing them with your healthcare team will help guide you through the process of planning meals from preconception through pregnancy and beyond.

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  • For Women with Diabetes: Your Guide to Pregnancy. National Institutes of Health.

By Elizabeth Woolley
Elizabeth Woolley is a patient advocate and writer who was diagnosed with type 2 diabetes.