When You Have Diabetes in Pregnancy

Transcription

1 When You Have Diabetes in Pregnancy Nutrition and Dietetic Service Children and Families Community Services Mental Health Secure Services Specialist Services Nutrition and Dietetic Service Page 1

2 Contents Page Introduction A Balanced Diet The Way to Healthy Eating Do I Need to Avoid Sugar Carbohydrates Portion Control Suggested Meal Ideas Action Plan Using Your Food Diary Food Diaries Page 2

3 Introduction The way you eat is an important part in the treatment of gestational diabetes. The food you eat needs to provide suitable nourishment for both you and your baby, whilst helping to stabilise your blood glucose levels. This leaflet will give you information to get started. In the Joint Diabetes and Antenatal Clinic you will have the opportunity to discuss the food you eat with a registered dietitian. Your Dietitian is: Telephone No:... Page 3

4 A Balanced Diet It is important to try to balance your meals. The Eatwell Plate below shows how much of what you eat should come from each food group. This includes everything you eat during the day, including snacks. Look at the eatwell plate to see how much of your food should come from each food group. You don t need to get the balance right at every meal, but try to get it right over time, such as over a whole day or week. Aim for one third of your plate to be starchy carbohydrate foods. Try to choose options that are lower in fat, salt, and sugar when you can. Page 4

5 The Way to Healthy Eating Try and do the following when you can to help you to achieve a healthy diet: Base your meals on starchy carbohydrates. Eat lots of fruit and vegetables. Eat more fish. Cut down on saturated fat and sugar. Try to eat less salt. Get active, and try to be a healthy weight. Drink plenty of water. Don t skip breakfast. Page 5

6 Do I Need to Avoid Sugar? A healthy eating plan for gestational diabetes can include some sugar. However, having sugary foods in large amounts, or regularly, will affect your blood glucose readings. High energy foods such as sweets, lollies, and regular soft drinks should be avoided. Foods such as sweet biscuits, jam and honey can be eaten in small amounts. Instead Of These: Sugar, glucose powder, honey, gur. Use These: Artificial sweetener,eg Canderal, Hermasetas Sugar and chocolate-coated cereals, sweetened muesli. Ordinary jam, marmalade, honey, syrup, lemon curd, treacle, molasses. Cakes, pastries, chocolate and creamfilled biscuits. Tinned fruit in syrup. Sweetened puddings, e.g. rice pudding, custard, instant whips and mousses, yoghurt, flavoured ice cream. Sweets, chocolates, mints, fudge, toffee. Ordinary squash and fizzy drinks, e.g. Ribena, lemonade, Lucozade, cola. Weetabix, Shredded Wheat, porridge, corn flakes, bran flakes, unsweetened muesli. Reduced sugar / extra fruit jams and marmalade. Plain scones, muffins, crumpets, currant/ fruit buns, plain biscuits, e.g. digestive, rich tea, morning coffee. Tinned fruit in natural juice, fresh fruit. No added sugar rice puddings and custard. Sugar free jellies, instant whips, and mousses. Plain ice cream. Small amounts of sugar free mints and chewing gum. Sugar free and diet drinks. Diabetic Products. There is no need for any special foods when you have diabetes. Diabetic foods are not recommended. Page 6

7 Carbohydrates Carbohydrate foods are the best energy sources for your body. When they are digested, they break down to form glucose in the bloodstream. If you eat regular meals spread out over the day, you will help maintain your energy levels without causing large rises in your blood glucose levels. Where are carbohydrates found? Carbohydrates are found in the following types of food: Sugar, and sugary foods. Such as sweets, chocolates, sweetened drinks, cakes, Puddings, and sweet biscuits. After eating these foods, they are quickly absorbed into the bloodstream, making the blood glucose levels rise. Starchy carbohydrate foods. Bread, potatoes, rice, pasta, chapatti, yam, and breakfast cereals. After digestion, these foods can be slowly absorbed into the blood, which ensures better blood glucose control. Milk and fruits. Milk, yoghurt, and fruit juices all contain natural sugars. Page 7

8 Portion Control The amount of carbohydrate you eat will affect how high your blood glucose levels rise after a meal. A large serving can mean too large a rise. Meals that often cause this are ones which contain more than one source of carbohydrate at a time, e.g. pie and chips, potato curry and rice, or curries with rice and chapatti. Also, some meals we have consist of mostly carbohydrate, e.g. pizza, pasta, risotto, biryani / biriani Have these in small amounts and fill up with salad/vegetables. Plating your meals as shown below can help you to get your portions balanced. rice, pasta, bread, potato, chapati, roti or other starchy food meat, fish, eggs, beans, cheese or vegetarian alternative - choose low fat varieties Page 8 fruit or vegetables

9 Suggested Meal Ideas Breakfast Porridge and milk or Hard boiled egg and wholegrain toast or Baked beans and one slice of toast or Wholegrain/Mutligrain cereal and milk or Fruit smoothie or Toasted bagel Lunch Sandwich (two slices of bread or small barm) with salad or Small jacket potato and tuna or Bowl of soup and small bread roll or Meat/fish/egg curry with one medium chapatti or Lentil curry with salad and half a chapatti or One wrap with meat, fish, or cheese filling and salad Evening Meal Small bowl of pasta with salad or Roast meat/chicken, two to three potatoes, and lots of vegetables or Chilli con carne and one third of a plate of rice with salad or Meat/Chicken/fish or Quorn Stir fry with a small bowl of noodles or Two slices of pizza and salad or Meat kebab, salad, and pitta bread or Small bowl of biryani and salad or Cooked salmon, new potatoes and vegetables Page 9

10 Action Plan Try to pick three things to try and achieve before you go to the joint diabetes and antenatal clinic. Tried Changed Start having breakfast Have smaller portions at mealtimes Have more fruit and vegetables Use diet or no added sugar drinks Have snacks between meals Be more active Stop skipping meals Include a supper bedtime Page 10

11 Using Your Food Diary Recording everything you eat and drink can be useful for you and your dietitian. It can help you see where you may be able to make changes to your diet. Write down everything you eat and drink until you come to clinic again. This includes snacks, cups of tea and coffee, soft drinks and alcohol. Include at least one day when your routine is different e.g. a weekend or a day you do not work. Be specific about what you ate, was it grilled or fried, low-fat or standard, tinned or fresh. Write down how much you ate or drank. You do not need to weigh food, but record amounts in portion sizes, e.g. Tablespoons, teaspoons, slices etc. Finally, remember to bring this diary with you to your appointment with the dietitian. Please fill in the questionnaire below about the types of food you use:- Milk: Full-cream Semi-skimmed Skimmed Sugar: (per drink) Spread: Butter Margarine Low fat spread Bread: White Wholegrain Multigrain Cooking Fat: Oil Lard/Dripping Ghee Dietary Supplements: Page 11

12 Example of how to complete a food diary Day: Date: Time Food/Beverage taken Portion 8.30 am am Bran Flakes Semi-skimmed milk Toast Margarine Tea - milk/sugar Kit Kat Coffee - milk Small bowl 1 cup 1 slice Scraping 2 cups 2 fingers 1 cup 1.00 pm 6.00 pm 9.30 pm White bread Butter Cheddar cheese Crisps Yogurt - Muller Lite Diet Coke Chicken - Roasted (with skin) Mashed potato with milk Carrots Gravy Apple Crumble Ice Cream Toasted teacake Margarine Tea 2 large slices Scraping 2 small portions 1 packet 1pot 1 can 1 leg 2 tablespoons 1 tablespoon 2 tablespoons 2 tablespoons 1 scoop 1 small Scraping 3 cups over evening Page 12

13 Day: Date: Time Food/Beverage taken Portion Page 13

20 Nutrition and Dietetic Service, Minerva Health Centre, Lowthorpe Road, Preston, PR1 6SB Website: Other sources of information: The Mental Health Helpline This provides an information and listening service for people in Lancashire. It is available between 7:00pm and 11:00pm Mondays to Fridays and from 12:00 noon until 12:00 midnight on Saturdays and Sundays. Freephone Customer Care If you wish to pay a compliment about the Trust s services, make a comment, raise a concern or complaint, please contact the Customer Care Department on , freephone or customer.care@lancashirecare.nhs.uk If you have problems reading the print we can provide this leaflet in large print, audio book or Braille. W przypadku jakichkolwiek problemow z odczytaniem tekstu z przyjamnoscia dstarczymy Panstwu ulotke z duzym drukiem, tasme do odluchu lub tekst w jezyku Braille. Lancashire Care NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright owner. Data Protection Lancashire Care NHS Foundation Trust adheres to The Data Protection Act The Trust will endeavour to ensure that your information remains secure and confidential at all times. For further information regarding data protection please visit the Trust s website or ask a member of staff for a copy of our leaflet entitled Sharing Information With Us. Copies of this leaflet are available from: Lancashire Care NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston PR5 6AW Tel: communications@lancashirecare.nhs.uk Website: Date Produced: Review Date: Leaflet Code: Name of Leaflet: March 2012 March /2012 When You Have Diabetes in Pregnancy Page 20