Pregnancy

Whether you have diabetes before pregnancy or develop gestational diabetes during pregnancy, you will want to pay special attention to the food you eat. Eating healthy during pregnancy really isn't all that different from a healthy diet for anyone.

However, you will find that you and your growing baby require more nutrients than you did before your pregnancy. For example, you will need more protein, calcium, iron, and vitamins while you are pregnant. Your appetite may increase, especially in the last months of pregnancy.

It is important to talk to your provider and dietitian before you decide to become pregnant, because good nutrition starts even before conception. For instance, your provider or dietitian will advise you to take folate as a precaution against neural tube defects, which can occur early in the baby's development.

Having near-normal blood glucose levels before conceiving is another safeguard against birth defects. If you are overweight, a calorie-restricted diet may be recommended before you conceive.

TIP You may be advised to eat a small breakfast because blood glucose is more likely to be high first thing in the morning.

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Once you are pregnant, your dietitian, your diabetes care provider, and your obstetrician can assess your dietary needs and work with you to develop a meal plan that you can use throughout your pregnancy. You will need to take into account your overall health and nutritional status.

Here's what you'll need to know:

• how many calories you need to eat each day
• whether you will need a prenatal vitamin supplement
• how to divide your daily calories and carbohydrates between meals and snacks
• goals for your blood sugar readings throughout the day

Portion Control: Another Step toward Weight Loss

• Invest in a set of measuring cups and spoons and a food scale that weighs food in ounces or grams.
• Serve yourself your usual portion. Now measure it. Is it more or less than you expected?
• Weigh a piece of bread or a bagel. One serving of bread is one ounce. How does yours compare?
• Try dividing and weighing portions of different meats and seafoods before cooking. One serving of meat is four ounces raw (three ounces after cooking).
• Practicing portion control at home will help you estimate how much of your meal to set aside for a doggy bag when eating out.

Your dietitian and other members of your health care team can also help you ease into making lower-fat food choices if controlling weight gain is one of your goals. If you are suffering from nausea, your dietitian can teach you how to incorporate snacks at certain times. If you are taking insulin, you will also need to learn how to adjust your insulin doses to match the changes in your diet. As your pregnancy proceeds, insulin resistance increases, and you'll need more insulin. Ask your dietitian and doctor about the use of caffeine, alcohol, and artificial sweeteners during pregnancy. Unless you have special needs, it is safe to use the artificial sweeteners aspartame and acesulfame-K during pregnancy. You need to avoid saccharin during pregnancy and when breastfeeding. Alcohol is generally not recommended for anyone during pregnancy and can increase the risk of hypoglycemia among women with diabetes.