Managing Carbohydrates During Pregnancy, for Women with Diabetes

Pease note: This is general information and should not replace any personalised advice given to you by your healthcare team.

Trying to eat a healthy diet to achieve the best possible blood glucose levels for pregnancy can feel challenging at times. Food choices can make a big difference to glucose levels and the following information is aimed at helping you to achieve your goals.

Which foods influence my blood glucose levels?

Your after meal blood glucose level is influenced by the amount of carbohydrate in the meal, the type of food (glycaemic index), activity and the timing of the medication (tablet or insulin) you are taking in relation to the meal. The following information will help you manage your blood glucose levels more effectively.

When you eat carbohydrate (carbs), your body digests it and turns it into simple sugars.

One simple sugar is glucose, which your body uses for energy. In pregnancy, the hormones you produce for your baby’s growth and development can make it hard for your body to use insulin properly. If you have diabetes, your body cannot regulate its glucose level and so it can be important to regulate the amount and type of carbs you eat, to help keep your blood glucose levels healthy.

Blood glucose targets

The blood glucose targets for pregnancy are:

Before meals
Less than 5.3 mmol/L

After meals
1 hour after meals, less than 7.8 mmol/L
2 hours after meals, less than 6.4 mmol/L

Which foods are carbs?

Carbs can be either sugar or starch. Both will affect your blood glucose levels. Many foods contain carbs, but the main ones are:

• Bread
• Beans and lentils
• Rice
• Sugary, honey and syrup
• Pasta
• Fruit and fruit juice
• Potato
• Milk, yoghurt and ice cream
• Breakfast cereal
• Sweets and chocolate
• Flour and oats
• Puddings, cakes and biscuits.

Carbs are recommended as part of a healthy balanced diet. It is important to eat enough carbs to provide energy and nutrition to support a healthy pregnancy, however, too much carbohydrate makes it difficult to achieve the post meal glucose targets, so try to eat small amounts at meals.

Breakfast

This can be the most challenging meal for keeping the post meal glucose in target, as carbs are not so well tolerated at this time of the day. Good breakfast choices include:

• 1 slice whole wheat/granary/sourdough bread with topping eg poached or scrambled eggs/mushrooms/tomatoes/cheese/avocado
• 1 small yoghurt (plain or no added sugar) with berries and topped with nuts/seeds
• Jumbo oats soaked overnight, or cooked in milk or water, and topped with berries and nuts/seeds.

If you still find your post breakfast blood sugar levels are above target, the following breakfast choices are carb-free:

• Fried/poached/boiled/scrambled eggs
• Omelette
• Fish eg smoked salmon
• Cheese selection.

Filling up on protein and vegetables

Eating more protein foods such as meat, fish, chicken, cheese, eggs, tofu, Quorn and pulses, together with a small carbohydrate portion, will help fill you up. Adding lots of vegetables to this will help with any feelings of hunger.

The following meals are low carb or carb-free:

• Omelettes with cheese/meat/vegetables
• Fish, tofu or meat, steamed/stewed/baked/fried
• Chilli and curry made with meat/fish/tofu/vegetables
• Stews and casseroles made with meat/fish/tofu/vegetables
• Meat, tofu or fish burgers
• Salad with avocado and meat/fish/tofu.

Avoid eating late in the evening

Eating late in the evening can impact on your blood glucose levels overnight and can cause a high blood glucose level in the morning. Try to ensure a healthy evening meal, full of vegetables and extra protein, if needed, to fill you up.

If you need a bedtime snack, choose a small carb choice or something carb-free. See below for snack ideas.

Snacks

The following foods are carb-free and will not impact on blood glucose levels:

• Olives
• Cheese
• Sugar-free jelly
• Eggs
• Meat and fish.

The accompaniments of olive oil, mustard, vinegar and butter or margarine are carb-free.

The following snacks have 5g of carb in each portion listed, so should not have a big effect on your blood glucose level. If you eat more than one portion, it will have a bigger effect on your blood glucose.

Activity

Being active helps your body use insulin more efficiently. This is particularly effective if you are active 10 to 15 minutes just after eating. This can make your post meal glucose level as much as 2 mmols/L lower and this helps achieve the post meal glucose target. The type of activity can be walking, cycling or being active around the house, such as walking up and down the stairs. Women who have pelvic pain may consider seated activity.

What is a healthy balanced diet?

A healthy balanced diet includes lots of different foods to give your body all the nutrients it needs. Carbs are part of a healthy balanced diet, but if you have diabetes, the amount of carb you eat, the type of carb you choose and when you eat it can affect your blood glucose levels. For further information on healthy eating in pregnancy visit the NHS website: www.nhs.uk/pregnancy/keeping-well/have-a-healthy-diet/

Where can I get more information?

We hope that you have found this information useful. If you have any questions, please speak to your diabetes healthcare team or ask to be referred to a diabetes specialist dietitian.

Useful websites

NHS UK – eat well advice
www.nhs.uk/live-well/eat-well/

Diabetes UK
www.diabetes.org.uk

About this leaflet

Author: Sandra Hood, Diabetes Specialist Dietitian
Written: March 2021
Approved: April 2021
Review date: April 2024
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk