GD Question - Food Labels

[TripleB]

Hi there

I was diagnosed with GD yesterday when my GTT came back at 8.8 . After a lot of tears and guilt last night I have decided to be positive today and get started on my new lifestyle. While I'm waiting for an appointment to see the Dietician, can any of you give me any basic guidance on how to pick foods that are ok?

I've read that 3 small meals with snacks in between is the way to go (a big change from my usual 3 meals a day and no snacks approach to diet!). I'm confused about the carb thing - some articles I've read say carbs are good, others say to limit - confusing...

Also is there any golden rules I should stick to by looking at food labels? I am used to calorie-counting so don't mind analysing labels in the supermarket - what do I need to look for? A maximum per/100g amount of carbs, sugars, fat?

xxx

 

[Newky]

Hi TripleB, I was diagnosed last Monday, I havn't seen the dietician yet (am seeing her next Tuesday) but I have seen the diebetic midwife who gave me some guidelines. She didn't mention anything about checking food labels though, so I would be interested to know if anyone else has any info on this?

What she basically told me was to eat 6 times a day,with a bedtime snack being particularly important. Obviously I have to cut out sugar, cakes and choc etc are a complete no no. Need to switch to diet drinks (artificial sweetners are ok), and choose low fat yogurts and spreads. RE carbs the midwife told me that it was still very important to have carbs at every meal, but I had to limit the portion size, i.e have only 3 potatoes or a couple of tbsps of mash. A third of your plate should be carbs, (according to the picture in the leaflet I got given!).

The 'rules' really arn't as strict as you would imagine actually, so far I havn't had to change my diet drastically at all (apart from all the snacking!) and apart from this morning's after brekkie reading, which was 7.4 my readings have always been in normal range. x

 

[TripleB]

Thanks Newky, that's really useful - especially the evening snack advice. Diabetic midwife just called and I'm seeing her and the Dietician on Thursday afternoon. I've just been around Tesco filling the trolley with wholegrain goodness - start as I mean to go on I suppose.

How often are you testing your blood and are you using the finger prick test (I hate needles!)?

Glad your readings have been normal - its so upsetting isn't it .

xxx

 

[Newky]

That's great that you have gotten an appointment on Thursday, you will definetly come away feeling a whole lot better about everything When the midwife broke the news over the phone I was an absolute wreck, you just don't expect anything to be wrong do you? But after I had an appointment with her and she had explained everything I felt sooo much better.

I have to test 4 times a day, first thing in the morn and then 2hrs after each meal. It is a finger prick test but it's not too bad really, it's not a big needle or anything and it's in a pen thingy so you don't actually see the needle going in. x

 

[TripleB]

Me too - she called last night and I spent the whole evening sobbing about it and scaring myself silly on the internet. I'm glad you felt better after your appointment and I'm sure I will too. The DM told me on the phone that I shouldn't be too worried as my numbers weren't outrageously high but that I need to make some changes to keep it under control. The thing that worries me most is being induced (my midwife who called me with the results said its normal practice to be induced at 38 weeks). It makes me feel like a failure that I can't keep the baby inside me until he/she is ready for the world .

Glad the finger prick thing isn't too bad - I suppose you get used to it. Can you check your results straight away?

xxx

 

[Newky]

That's really rubbish that they induce at 38 weeks at your hospital, they don't at mine , at least not if your only food controlled. My trust only induce at 38 weeks if you have to go on insulin, and even then they are open to suggestion if your controlling your sugars. As long as I keep sugars under control with diet they won't think of inducing me until 41 weeks, and they usually induce at 42 weeks anyway! And my GTT reading was 9.2, so a bit higher than yours.

When you have your appointment I would query their induction policy, I know all trusts are different, but it seems unfair to automatically say you will have to be induced when you might be able to control completely with diet and have no problems whatsoever! Please don't feel like a failure though if it does come to that, 38 weeks is classed as full term, so baby will fine. I do know where your coming from though, as early induction is something that I was worried about myself. x x x

PS yes you get the results straight away, just have to put a little testing strip into the machine and put a drop of blood on it and the results come up in 5 secs. x

 

[TripleB]

Thanks hun, so good to talk to people going through the same thing. I will question the induction policy, New Years Eve is not appealing!

Have done well on the diet today and I don't know if it's in my head but I feel really good - not as tired as I have in the last few weeks. There could be a silver lining to this I suppose!

xxx

 

[sarafused]

Im on a second pregnancy with GD (this one has needed a dose of nightime insulin), there are other reasons they induce besides just the mothers sugar control.

Firstly its down to the growth of baby, they can have measurments off scale especially when it comes down to the tummy size which can cause problems during birth.

The placenta also suffers more. In worse cases patches of calcification though they can check for this during growth scans (I wouldnt google this though). Its not common but its something they will check for.

The baby can also require more treatment/care from birth. They can struggle to stabalise their own blood sugar levels (my first baby was fine after 12 hours and one tiny dose of formula) and they can have other problems such as jaundice. So just be prepared to stay in hospital a little longer if baby needs it.

 

[TripleB]

I know you're right sara, best to be prepared. I hope they do consider these things when recommending induction though, rather than automatically opting for 38 weeks for the fact of GD alone. I'm not sure how many growth scans I'll get, should find out Thurs. xxx

 

[Newky]

Thanks Sara! Do you definetly get extra growth scans, cause the midwife never mentioned this to me? I really hope I do! She did mention about checking the baby's blood sugar after birth and the higher risk of jaundice though, and I will be in hospital a min of 24hrs, but not too fussed about that really. x

 

[TripleB]

It's so confusing that there isn't clear guidance from the NHS - postcode lottery as usual. My usual midwife told me on the phone about the growth scans when she gave me the GTT results - although to be honest I wasn't thinking clearly by this point, was trying not to burst into tears! Yesterday when the diabetic midwife called me to arrange my appointment she didn't mention scans - although I assume this will be discussed when I see her tomorrow.

The only thing they mentioned about the baby is higher birth weight (hence the scans I suppose) - I had to consult Dr Google to find out about the potental jaundice and blood sugar issues for the baby. I assumed I would be in for at least 24 hours anyway so that's ok.

Did the diabetic midwife test your blood sugar at your appointment Newky? And will you continue to see your usual midwife or will she take over your appointments now?

xxx

 

[Newky]

Yes the midwife tested my blood at the appointment, more to show me how to do it myself really. She told me to cancel the appointment that I had for my GP based midwife, I will see only her and the dietician from now on. To be honest i'm thrilled about that, not only is the diabetic midwife lovely (I seriously had to fight the urge to give her a cuddle!) but pre-diagnosis I had never seen the same midwife twice, which was a bit rubbish.

Your right about the postcode lottery, my trust follows the NICE guidelines, although they do generally judge on case by case basis. I do have a website address for the relevant section of the NICE guidelines, i'll try and dig it out and post a link. x

 

[TripleB]

That's good to know - felt like I woud be spending all my time with one midwife or another! I vaguely recall something (on that first telephone call) about seeing an endocrinologist and a consultant too - in fact my GP-based MW told me I would need a day off work to seee everyone I needed to and yet the diabetic MW booked me an appointment for 3pm! I hope she is nice enough to bring on the cuddle-urges too!

The NICE link would be fab - thanks.

xxx

 

[destinyfaith]

hi i was told i have GD told on monday, and well your reading at GTT was nothing to mine mine was 16.9 and well i was put on metaformin and due to start insulin fri along with the metformin, i test my blood 7 times aday, before breakfast 1 hr after breakfast before lunch 1 r after lunch before dinner 1 hr after dinner then before i go to bed, my readings even on low sugar and metformin is still about 12 after meals , *big sighs* anyhow i have the nurse fri at 10am to start insulin and the 1.30 monday hope they start a diet plan ! i went to tesco also filled my trolley with what i thought was right, i acually was a xtra hr shopping but loads stuff id love to know like what yughurts and juice and stuff, hard being GD wish you all the luck x p.s are you ust diet controlled? x

 

[andrea675]

Hi all,

Thought I'd leave some food ideas etc

You will see a dietician soon and they tend to go through a typical day looking at how you adapt your diet, the emphasis is generally on changes to your diet and cutting out the really high sugar stuff as opposed to a seperate diet altogether. You want to be aiming for a balanced diet with low GI foods and complex carbs.

Simple changes - brown bread as opposed to white, wholemeal pasta rather than white, brown or basmati rice, potatoes are ok - just smallish portions and the less refined the better - e.g. mash breaks down to sugars much quicker than a jacket potato. Good amounts of protein as part of meals break down slowly - oily fish, red meat, pulses/lentils, chicken, eggs.

If you look at the nutritional info boxes anything with lots of sugar is generally a no. Remember some labels look at a whole box or 100g or a portion. Try thinking of sugar in grammes, 5 grammes is a teaspoon full. Lots of supposedly healthy foods have heaps of sugar in, this can include diet and low fat foods (low fat is often high sugar or salt instead). Also foods with lots of fruit in will be horrifically high sugar because of the fruit, so no fruit juices and check things like flavoured water. The worst thing I found so far was someone at work offered me a "healthy" mini size cereal bar - 45 grammes of sugar - that's 9 teaspoons!

Beware of specific "diabetic" foods, some are actually higher sugar than normal versions, others are just very expensive for no good reason.

Porridge or weetabix tend to be good breakfast things, or wholemeal toast, lots of breakfast cereals are again full of hidden sugars. I got to a point where even weetabix spiked my sugars 1st thing, I have a couple of boiled eggs and toast now or scrambled eggs.

I struggled most with snacks and some suggestions I got were 1-2 biscuits (rich tea or ginger nuts), a teacake or crumpet, a small piece of fruit (some fruit will be too high sugar - very sweet fruit might be just a handful -eg a few grapes - bananas send my sugars too high - but I eat loads of apples!) some ladies on here like the sugar free jellies, some low fat yoghurts can be ok - the dietician I had suggested they need to be less than 10g total carbs per pot, the fruit often makes them very sweet. She also said lots of women turn up for the first appt living on babybel cheeses for snacks!! There is a recent post somewhere around with snack ideas. The diabetes UK website has a small section on GD but lots about diabetes and diet in general.

Lastly, be careful with sugar free stuff that contains sorbitol. This tends to be fake sweet stuff like diabetic chocolate, diabetic sweets and some sugar free chewing gum. Sorbitol is a sweetener in small amounts, in larger amounts it has a really nasty laxative effect! I have missed chocolate, not as much as I thought I would, but diabetic choc sucks, very dark chocolate in small quantities is ok for some people, I just have the other half on strict instructions, repeated often, to bring a box of my very favourite chocs to the hospital as soon as possible after delivery!

Hope this helps,

Andrea

 

[destinyfaith]

thanks for this info andrea! its a great help but seriously all over coming me .. what a change in a life im glad its only a few weeks .. i even might drop a few pounds lol x

 

[TripleB]

destiny - sounds like you're getting good care though. Its such a shock isn't it then a mixture of feeling guilty and worrying about your little one. I just had a feeling when they did the GTT that it was going to come back high - everything was just going too smoothly with this pregnancy!

Thanks so much Andrea, that is some fantastic advice. So far I have been looking at the sugars content on the labels and not going for anything too high. The worst I have had is a cereal bar with 6g of sugar as an afternoon snack - do you think that's ok in the context of everything else being low i.e. under 2g? Trying to balance the proteins, carbs and veg. I was quite proud of my shopping trolley in Tesco!

I'll report back tomorrow ladies after I have seen the diabetic MW and dietician - I am sort of looking forward to it and sort of dreading it at the same time (especially the finger-pricking business and the standing on the scales bit!)

xxx

 

[andrea675]

I'm at clinic tomorrow too, It might seem a bit overwhelming at the minute but it will become routine pretty quickly! I was dreading the antenatal clinic the most with GD as last pregnancy they ran on a completely parallel version of time but this time they have been much more organised, in some ways it has been better than seeing the GP midwife as she had really awkward clinic times!

I can't post the NICE link but if you google nice guidance and gestational diabetes, it is CG063Guidance.pdf, most trusts use it as the minimum standard, for example it advises growth scans every four weeks from 28 weeks but my trust do them every two, some things will vary depending on individuals too. There is a table somewhere near the end which outlines what visits and appointments should be offered.

Good luck tomorrow triple B! Destiny - I think I might have dropped some overall weight from having to eat properly!! Although from the front I look like a space hopper with limbs........ Everyone says I look far healthier this time than last, and last time I was diet controlled! How annoying is that?!

Andrea

 

[destinyfaith]

tripleb- i had that feeling also i really knew it would come back positive, but i never thought id have to be tablets and insulin, saying that my sister is a type 1 diabetic she always has been so it was high risk for me anyhow! i do worrie so much about my little one but loads care giving makes me feel alittle safer, lots of monitoring and stuff x

andrea- lol @ space hopper! im close behind you hun!! i dont think you can tell if you dropped weight till LO has been born and everythings settled?? my doc said have you lost weight?? thats a indicator of GD i jsut looked at him with my hugeeeeeee belly lol, i wouldnt know as i have a baby in my tummy n no1 has weighed me since i was 8 weeks pregnant lol ah doctors, thing is im worried as my reading was so high at 16.9 that he said it looks like you had diabetes before your pregnancy! i think i would of knew?? i felt fine and really still do i had no symptoms of GD so i relaly hope it goes and he is wrong! x

 

[Newky]

Hi Ladies, This is the link to the NICE guidelines, the first part deals with pre-existing diabetes, then it moves onto gestational. It's fairly vague though, which is why I think each trust has their own procedures.

https://www.nice.org.uk/nicemedia/live/11946/41342/41342.pdf

TripleB what on earth is an endocrinologist?? Good luck at your appointment today

Thanks for the info Andrea, that's really helpful, i'm also struggling the most with snack ideas. I hate eating the same foods day in day out but trying to keep it varied is a challenge! So far I have been having fruit mid morning (apple/pear/plums) and in the afternoons a mullerlight yogurt, houmous and crudites or a couple of wholegrain crackers and low fat philadelphia. For supper I have been having a toasted fruit teacake which seems to work well, or a couple of rich tea.

Destinyfaith we have the same due date!! x