>From my extensive 2 months’ experience of being a gestational diabetic, I’ve put together some hints and strategies that I found useful in keeping my blood sugar levels (BSLs) within the desired range. Nearing the end of my pregnancy now, and having managed to stay off insulin by making significant diet changes, I think I’ll keep on with many of the habits I’ve created.
I should flag that, being a non-obese gestational diabetic, my aim was NOT to lose weight. It was to keep my BSLs within the preferred levels, and I had to keep my calcium levels up (therefore, still have a fair bit of dairy in my diet). The preferred BSLs I had to keep in mind:
Fasting/pre-breakfast – 5.5 mmol/L
2 hrs after each meal – 7.0 mmol/L
As always, with these things, this blogpost is based on my experiences only and not to be taken as gospel (oh, except the bit about chocolate spread below – everyone should try that stuff…).
Below, I’ll be naming actual products in Australia/Victoria because it’s the kind of information I wish I’d had when I was launched into my new ‘lifestyle’ after my glucose tolerance test back in mid-April this year. Luckily (?) for me, my mother is a Type 2 diabetic and had a few books about the key factors in keeping the diabetes under control, including the uber-useful booklet, The New Glucose Revolution: The Low GI Solution for Optimum Health (Version for ‘People with Diabetes’). For me, the most useful things about this booklet were the food tables + GI rating in the back, and the suggested snacking and meal options that they listed in the general information about what it meant to be eating a low GI diet. Never having been a carb or calorie counter EVER, getting this involved in the nitty-gritty of what I ate took some getting used to. Also being a bit of a listmaker, voila this blogpost!
The authoritative site for all GI information can be found at the USyd site, The Glycaemic Index (includes listings of publications you can get, formally ‘approved’ low GI products, FAQs, and info about how they actually test the GI of foods). Word of warning: Doing a general search online (e.g. Googling) for specific GI values of food can throw up some super-dodgey sites so remember to validate sources and only go with what’s trustworthy.
GI values (from the book I mentioned above) appear in [square brackets] below.
The major things to keep in mind when trying to keep BSLs in the preferred range:
- Small, consistent portion sizes. At the beginning, I kept having to look up what a ‘portion’ of carbs should be at a given meal/snack. Putting this kind of portion-control into practice was another thing, and sometimes a little hit/miss. For me, I was appalled at how little I needed for a ‘meal’ (e.g. three-quarters or one cup of cereal at breakfast, two tablespoons of cracked wheat at dinner, one slice bread for lunch) to stay within preferred BSL levels, and the fact that these much reduced amounts were actually fine with making me feel full. I say I was appalled because I was previously eating 2-3 times more than I needed to, with a big emphasis on white rice, breads, (processed) cereals. Proteins (e.g. a piece of lean chicken or lamb) should only be the size of your palm – I balked at this, too, when I first started, but it has turned out to be enough to sate my appetite and, really, if I’m still looking to fill myself up, I’ll tend to turn to (non-starchy) vegetables, which is all to the good.
Something I’d really recommend is changing the size of your crockery at meal-times. No, really. Don’t run away! Use smaller plates/bowls – they give you a much clearer idea of what and how much you’re putting together. I found that using the standard sizes I used before just meant that I’d tend to fill it up the way I did before (then be scraping most of it off again).
- Pay attention to the type of carbohydrate consumed. Basically, there are carbs that a quickly digested by your body and send your BSLs spiking, and those that aren’t/don’t. I found that highly processed foods were the worst things for my BSLs (basically all junk food – not that I was a big eater of such, but I did have the occasional burger/fries combo, packet of chips, etc). I’m not a sweet-craver, though, so cutting out much of the shop-bought cakes/biscuits/muffins, pies/cheesecakes, ice-creams, etc, wasn’t too difficult. Savoury stuff has been my bug-bear, being an established hot chip and sometime sausage-roll-eater.
Upping the amount of wholegrains, veges, and legumes in my diet overall made a huge difference in controlling BSLs for me. As I mentioned in another low GI post, I cut out all jasmine rice [89-109] and potato [72-101] after a few scarily high BSL readings. There are ‘better’ rices that you can have, like Doongara [54-66] or basmati [58-65], but I thought the lower GI of these rices weren’t worth the swap. Instead, I swapped to bulgur/cracked wheat  as my staple grain (and ate it with all the stuff that I’d normally have with rice) – it has worked out beautifully and I think I prefer it to rice now. This feels particularly weird, given that jasmine rice has been my household staple for almost 40 years.
Our household now bakes most of its own bread, with my ‘low GI’ bread being quite heavy with wholegrains, added fibre mixes and seeds (pumpkin, sunflower). It’s delicious: nutty, dense and flavourful, and toasts well. I usually only want/need one slice of it at any meal.
We also bake our own biscuits, muffins and cakes. Where possible, we’re using LoGIcane (low GI sugarcane ) or yellowbox honey ; wholemeal/wholegrain flours; and margarine/plant butters rather than standard butter (this is more for S., who’s aiming for low cholesterol). It has been fun experimenting, mostly because the baked stuff tastes fab and I can eat caramelly ANZACs without living in fear of the glucose monitor’s readings.
- Shake off the food myths associated with diabetes (e.g. Sugar as the ultimate evil – actually not true at all. White rice and boiled/mashed potatoes are more your diabetic Lucifers…). Read up properly about what a ‘diabetic’ diet is all about – you may well be surprised. I was. Never having had to know much about it, I found that most of the info is commonsensical and part of what recommended healthy diets are these days anyway: eating less more often, reduce fats/sugars/salts (esp processed foods), increase veg/fruit servings, + keep up the hydration with good old water. The main thing with diabetes in particular, of course, is the carb/blood sugar dynamic (mentioned above).
Right now? I’m eating a LOT more veg, salads and non-starchy veg in particular. I’ve never been a salad fan – in fact, abhorred it for a long time. Something about cold vegetables just didn’t appeal. Now, I’m finding combinations that I love and it has become a staple part of my ‘going out’ eating strategies (where portions are always so huge). I’m also making hearty salads at home as meals in themselves; I’d always previously associated salads with deprivation and feeling hungry 10 mins later.
Random other hints for your gestational diabetic phase (or Type 2 diabetic lifestyle in general):
- I found it really useful to keep a food diary (of all meals/snacks) in the first few weeks. This allowed me to monitor what gave ‘good’ and ‘bad’ results, and change my diet accordingly. It also gives you a good idea of the kind of variety you’ve got in your eating plans – and to change this accordingly, if necessary! Getting bored with your food isn’t any fun. I kept mine for over a month, then stopped because I felt that I had a good enough idea of what to eat/not eat, + a broad enough foundation in the basics of what works for me that I can get creative without worrying that I’ll send my BSLs too high.
- ALWAYS wash your hands before checking your BSLs. Not only is this for hygiene reasons (you are about to break skin/draw blood), but it ensures that there are no sugary contaminants on your hands to skew your reading. When I started doing the regular checks, I’d sometimes forget to wash my hands and had some bizarre readings that caused the endocrinologist to frown and make comments about putting me on insulin. Now, if I get an odd reading (i.e. what I’ve eaten shouldn’t have spiked my BSL that much), I’ll re-check after washing my hands again, or on another finger. It’s been surprising the number of times my blood reads as ‘normal’ the second time. Another factor to keep in mind is that the portable blood glucose monitors most of us use all the time are NOT the most accurate things in the world. Some of my readings, taken within a minute of each other on different fingers, have been different by 0.5-0.9. Given that my diabetic doctor has raised eyebrows/threatened insulin at readings that happened to be 0.2 higher than preferred levels, let’s just say I’m more than a little sceptical about the overall level of monitoring that goes on in the public hospital system…
- Work in more exercise and movement into your everyday life. I know this is easy to say and a bugger of a thing to put into practice, but it makes a huge difference. As one gets increasingly waddly and huge at the tail end of a pregnancy, working in exercise isn’t that easy or possible. Still, a regular short walk (10 mins), some household stuff (e.g. the dreaded vacuuming), and low-impact aerobic workouts (e.g. wall pushups – which don’t feel like you’re doing anything at all initially but once you get to about 100 a time, it starts making a difference) can make the difference between having more consistent, lower BSLs and not.
Foods and products that worked for me:
(These are presented here with the caveat that they worked FOR ME. YMMV)
Cafe/restaurant meals that usually kept me within range –
- Pasta with non-starchy veges and protein – you don’t need to finish the plate and, chances are, half the pasta should stay on your plate. I’m partial to creamy pastas and have often had smoked salmon/capers/roasted tomato combos.
- Grainy bread sandwiches/wraps (if the servings are gargantuan, I usually take half home with me, or for a snack later).
- Grilled/roasted/baked meat or fish, + majority non-starchy salads.
- Freshly made small pizzas (again, I tend not to have whole servings and will either share with someone or take some with me).
- Most breakfast stuff (e.g. bacon + eggs, mushroom + eggs) won’t send you over because there isn’t much carb in evidence at all. I love going out for breakfast, but don’t do it often so have no guilt about indulging in these kinds of things once in a while (as well as the occasional French toast + bacon + maple syrup).
Food franchises that have good choices –
- Sumo Salads. Fantastic place, this one. I’m a total convert. They even offer specifically “low GI” salads and sensible portions (a ‘small’ is actually small). There are many things one could choose from their line-up that would suit a diabetic/low GI diet, and it’s all super-fresh and delicious. I’ve been there a lot these past couple of months and it has all been good. And, no, I’m not getting a commission for this plug. I was excited when I found the chain (esp having avoided it in the past – see aversion to salads above).
- Subway. Heaps of choices – avoid sugary sauces and white breads, and you can have pretty much what you like…as a 6-inch sub, that is…
- Any kebab place. A standard-sized kebab with meat/protein + non-sweet sauce + non-starchy veges is pretty safe. I’ve had quite a few of these. Many kebab places are even offering gluten-free wraps and low-fat meat options (e.g. grilled chicken breast). I never really went with those because the standard ones are darn tasty and keep me within the range (it’s all about the range, eh?).
- Sandwich bars. Pretty basic, but one of the places I tend to overlook because they are so ubiquitous. Hopefully, if you can tell someone exactly what you want on your grainy roll/sandwich, you can’t go too far wrong.
I should note here that I avoid all rice- and potato-based things, so a sushi place for me was out (though others who don’t get as much of a spike with rice could well do this).
Supermarket/grocery products that have become pantry staples –
- Vita-weat ‘9 grain’ biscuits. I’ve always avoided these because, frankly, I’d always thought them hard and inedible (+ ppl at school used to eat them with Vegemite and I thought that was altogether a bad thing). Now, again, I’m a convert. I could eat these things all day: crunchy, so toasty with the seeds, and super with a smear of peanut-butter.
- LoGIcane sugar. As mentioned above, for baking and other cooking.
LoGIcane sugar  – substitute for normal sugar 
- Sweet William Chocolate Spread. This is perfect if you want a nut-, gluten-, and dairy-free chocolate spread. Plus it’s a chocolate spread with a GI of only 43. I’ve had this quite a few times with my homemade grainy bread… *Homer drool*
Even if you’re not following a low GI diet, this stuff is delish. If you’re cool with nuts, dairy, gluten: Nutella has a GI of 25, so a fairly good snack topping once in a while!
Sweet William dairy-, nut-, gluten-free chocolate spread 
- Yellowbox honey. One of the lowest GI honeys around at 43. Stringybark and Ironbark are also quite low [44 and 48 respectively].
- Bags and bags of wholegrains, and wholegrain products. We make up our own porridge mix, which we have most mornings (rolled oats, rye, triticale, barley), and (as mentioned before) we do most of our own baking now. All biscuits contain wholegrains (mostly oats) and wholemeal flour (this flour usually added as half of the flour for pikelets, muffins, breads, etc).
- Bags and bags of whole dried fruit. Also for baking our breads/snacks. Mostly sultanas, currants, apricots, prunes, + dates.
- Bulgur/cracked wheat. My rice substitute.
- Cashews and peanuts. These are good as snacks, and eminently portable for work and outings with the munchkin (er, not that she gets any – just me).
- Pinenuts. In salads, these toasted little fellas are love. I also tend to make my own semi-dried tomatoes for pastas and salads (from mini-Romas) – highly recommended and so tasty.
Well, that got long, eh? May tinker with this post as I remember other things, but this is it for now.
We’ll be returning to the normally eclectic topics on this blog next…