hello and welcome to video 5 of healthy eating with gestational diabetes
in this video we will be answering some frequently asked questions sharing useful links to access
further information and providing the best contact details for the diabetes dietitians
here is a list of the questions which are discussed throughout this video
you can take a moment to pause the video to see which questions may be most relevant for you
i've been advised to take fresh orange juice with my iron medication what should i do it is common
to be advised to take fresh orange juice along with iron medication this is because fresh orange
juice contains a high vitamin c level and vitamin c helps with the absorption of non-meat sources
of iron in the body however fresh fruit juices get absorbed by the body quickly meaning blood glucose
levels can increase too quickly and can become too high we would therefore advise to only have one
small glass of fresh orange juice a day which will limit its effect on your glucose levels it is also
best to have this along with a meal as your meal will help slow down the absorption of the juice
alternatively you could choose other sources of vitamin c to have along with your iron medication
including potatoes or one portion of vitamin c rich fruit such as an orange
or a handful of strawberries or blackcurrants some foods and drinks can reduce iron absorption and
are best to not have at the same time as your iron medication having these within a couple of hours
of your medication may affect its absorption these can include tea coffee and milk as a few examples
can i still take medication that contains sugar it is important to not stop taking any medication
without firstly speaking to your gp or health care team
some medication may contain sugar but the amount and effect of this on blood glucose levels is
most commonly negligible and is therefore safe to continue to take there is sometimes a high
sugar content in medication in liquid form such as cough remedies or laxatives however
there are often sugar-free versions available it is therefore worth asking your gp or pharmacist
about any medications you're prescribed if you would like further information and advice
is it okay to use seasoning in cooking or at the table herbs spices including pepper and salt
do not contain carbohydrates so using these will not affect your blood glucose levels
but for general health it is important to avoid having too much salt in our diets
if you are using pre-made sauces such as a tomato or creamy sauce from a jar these may
increase your glucose levels as they may contain some carbohydrates you do not need to avoid these
sauces but it is always best to choose the reduced sugar or no added sugar options for your glucose
control and the reduced fat reduced salt or no added salt options for general health benefits
should i be concerned if i can't manage a regular eating pattern
having a regular eating pattern is a good way to provide a steady supply of energy
to your body throughout the day it can also be helpful in keeping blood glucose levels steady
you're not alone however if you find that this is not always achievable in pregnancy it can
be common to have a variable appetite or to suffer from conditions such as reflux nausea and vomiting
if you are experiencing such conditions be sure to mention this to your midwife doctor or diabetes
team as there may be further advice or medication which could help alleviate your symptoms i've seen
some sugar-free items in the supermarkets are these good alternatives to full sugar versions
sometimes as it depends on what it is instead of adding sugar to hot drinks or cereals
or having full sugar fizzy drinks we suggest switching to use artificial sweeteners available
in tablet or powder form or diet sugar-free or zero options for fizzy drinks if you wish
the type of artificial sweeteners within these products contain little or no calories and
contain little or no carbohydrates meaning that they do not affect your blood glucose levels
and are deemed perfectly safe alternatives however we generally do not recommend
for you to have products such as sugar-free biscuits sugar-free sweets or sugar-free chocolate
this is because they tend to use different types of artificial sweeteners which we suggest to avoid
although these items have no table sugar in them they can still contain a high amount of fat
and calories and they may still affect your blood glucose levels eating large amounts
of these can also have a laxative effect cause bloating flatulence and diarrhea
i was overweight before becoming pregnant should i try to lose weight now
achieving a healthy weight has many health benefits but losing weight during pregnancy
is not recommended we also strongly advise against trying any fad diets
whilst you're pregnant instead it is best to follow the dietary advice as in video 2
and video 3 on how to achieve a good balance to your diet and optimize your blood glucose control
this will provide you and your baby with the nutrients you both need during pregnancy
and keep you both as healthy as possible if you want to lose weight after having your baby nhs
greater glasgow and clyde have a range of services which could support you on your
weight loss journey if your bmi was more than 25 at the start of your current pregnancy you will be
contacted around six months following the birth of your baby to offer you weight management support
i've heard that carbohydrates are fattening and are not good for people with diabetes
should i be avoiding them some people are concerned about carbohydrates being fattening
but gram for gram they contain less than half the amount of calories than fat in the diet
carbohydrates are one of the main nutrients in the diet providing the main source of
energy for the body along with several other vitamins minerals and fiber it is therefore
important that carbohydrates are included in our diets for this reason although all
carbohydrates increase blood glucose levels it is only simple sugars we recommend to avoid in
gestational diabetes for all other carbohydrates it is simply important to be aware where they are
in the diet and to not have too many of them all at the one time too many carbohydrates at once
will increase glucose levels more than smaller amounts spread throughout the day
spreading your carbohydrate intake throughout the day can be helpful in keeping your blood glucose
levels stable as well as providing a steady supply of energy how much carbohydrate should i be having
if you're eating between meals we advise to keep to a maximum of 10 grams of carbohydrate you
will find suggestions of both 10 gram carbohydrate snacks and carbohydrate-free snacks in video three
you can also check the carbohydrate content of foods and drinks on food labeling to figure out
if something is suitable for a between meal snack you would look at the total carbohydrate number
as opposed to the of which sugar's number on the label in this example for crisps the labeling
tells us that there is 7.5 grams of carbohydrate in each packet as this is less than 10 grams
of carbohydrates we know that we can have one packet of these crisps for our between meal snack
there is not a specific number of grams of carbohydrate
recommended at meals but as a guide you can refer back to the hand portions chart in video 3
which shows you how you can estimate a recommended portion size with your hand reflecting on your
results is another helpful way to figure out appropriate portion sizes of carbohydrates for you
video 3 describes how you can keep a food mood and blood glucose diary which can be helpful
in identifying if there are trends in your blood glucose levels with particular meals
you do not have to have carbohydrates at every single meal but it is recommended to do this
the majority of the time it is also important to not cut back too much on your carbohydrate intake
if you are significantly restricting your carbohydrates or completely avoiding them
in order to meet your blood glucose targets this may suggest that medication or a change
to medication is required starting or changing medication can help control blood glucose levels
whilst ensuring you're still able to eat adequate portions of carbohydrates
what is pairing will it help me with my blood glucose control painting is a term used to refer
to when you eat foods that are higher in fat along with your carbohydrates fat slows down digestion
so the logic with pairing is that having fats along with your carbohydrates will slow down the
speed at which it gets digested and slow down the speed of your blood glucose levels rising
pairing is not something that we specifically recommend but it is something that you may be
doing to some extent already following the healthy eating advice in video 2 and video 3 you will have
seen the benefit of having a mix of the food groups at meals and across the day which will
naturally mix in some sources of fats and proteins both of which can slow down the absorption speeds
of your carbohydrates it is worth mentioning that some people advise to choose high fat
products to slow down digestion but we would not recommend this adequate fat intake can be achieved
by following the advice in the previous videos where we recommend and provide suggestions on how
to cut down on saturated fats and choose more unsaturated fats for overall health benefits
if i'm hungry after a meal do i have to wait at least two hours before i can have something to eat
if you're eating in between meals we advise to keep to a maximum of 10 grams of carbohydrates
if you're eating before you have done your 2 hour check after a meal it is best to
avoid carbohydrate foods until after your test however you can always have carbohydrate-free
snacks before your test instead as these will not affect your blood glucose results you will
find suggestions of both 10 gram carbohydrate snacks and carbohydrate free snacks in video 3.
what should i do if my blood glucose level is above target 2 hours after a meal you
may find that you're in target after some meals but above target with others
this can suggest that there may be an appropriate amount of carbohydrate at
some meals but too much carbohydrate at others think about the meals that put you above target
and think about whether you're able to cut back on the carbohydrate portion size of that meal
keeping a food mood and blood glucose diary as mentioned in video 3 can be helpful a few spoons
less of pasta or rice may make all the difference you can refer back to the hand portions chart in
video 3 which guides you on the recommended amount of carbohydrates to have at a meal
my fasting blood glucose levels are above target but i am in target two hours after my evening
meal the night before how can this be there are several reasons fasting blood glucose levels can
go above target keeping a food mood and blood glucose diary could be helpful for this reason
and details on this are provided in video three here are a few points worth considering to help
you figure out what the cause may be are you having anything to eat or drink overnight
for example a carbohydrate snack or glass of milk which could be increasing your blood glucose level
if so try to choose carbohydrate-free options such as protein vegetables or water
instead are you having any carbohydrate foods or drinks before going to bed
even if your blood glucose level is in target after your evening meal
having extra carbohydrates after this time could increase your blood glucose levels before bed
without you being aware and make your fasting blood glucose level higher the following morning
reducing the amount of carbohydrate you have before bed may help whatever you choose to
snack on it is advised to keep the carbohydrate total to around 10 grams some appropriate snack
options could include two cream crackers with butter cheese and tomato one small thin slice
of bread toasted with low-fat spreads or low-fat cream cheese some vegetable sticks with humus
sugar-free jelly a small pot of diet yogurt a portion of fruit or even a ham and mushroom
omelet with or without one small slice of toast further snack ideas are also shown in video 3.
could medication or a change to medication be needed
even when you're not eating the body still produces some insulin
which keeps the blood glucose level steady if you're not having any carbohydrates since
you're eating a meal the night before your diet is likely not the cause of a higher fasting level
and it may be that your body's insulin is struggling to control your blood glucose levels as
well as it previously did medication or a change to medication may therefore be needed to help
but your diabetes nurse will discuss this with you if they think that that is required
i'm eating the same things now as i did a few weeks ago but my blood glucose readings
after meals are higher than they used to be why has this happened and what should i do
as pregnancies progress it is very normal to become even less sensitive to the insulin
in the body meaning it is working less well than it did earlier in the pregnancy
this can be noticed with an increase in your blood glucose levels even if there has been no
change to what you have been eating if you think you can reduce your portion size of carbohydrates
you could give this a try and see if it helps you can refer back to the hand portions chart in
video 3 which guides you on the recommended amount of carbohydrates to have at a meal
what about special occasions to keep you and your baby as healthy as possible during pregnancy
it is important to keep your blood glucose levels within target range
it is also important however to still be able to take part in and enjoy celebrations
if for example your birthday is approaching or you are attending a wedding please allow
yourself to treat of some food from the buffet and a piece of cake as a suggestion you could
try to avoid having too many carbohydrate foods from the buffet all at once and just have a small
slice of cake to limit the effect on your blood glucose level you can anticipate there is a chance
of your blood glucose levels being above target the next time you check them
however at least you will know the reason why this is the most important thing is to enjoy yourself
and then get back on track afterwards to keep the rest of your readings where you need them to be
here are some links we hope you will find useful to access further information
these are the email contact details for the diabetes dietitians you can contact
us if you need any further dietary support to help you manage your gestational diabetes
please use the contact details for the maternity hospital you attend
we have now come to the end of video 5 and to the end of healthy eating with gestational diabetes
videos these were produced by registered dietitians from the nhs greater glasgow
and clyde diabetes service you're welcome to watch these videos as many times as you wish
we hope you have found the information helpful and we wish you a happy healthy pregnancy