Diabetes and Pregnancy – Part 4: Your goals

This week we continue discussing management of diabetes during pregnancy, either in someone who had diabetes before she got pregnant or a woman who developed diabetes during pregnancy (specifically called gestational diabetes).

Weight: Now please note that your obstetrician will set your specific goals in regard to weight. He/she will take into account many factors, including the fact that you have diabetes, but also your general health, your weight before becoming pregnant, the weights of your prior babies (if you have had any prior) and potentially other factors.{{more}} For a healthy woman who becomes pregnant at a healthy weight (not over or underweight), the standard weight gain recommendation is between 25-35 pounds if you are carrying one baby. Weight recommendations will be different if you are having twins (or triplets!). If you were underweight before getting pregnant, you may be recommended to gain a bit more, and if you are overweight before pregnancy, then you will be recommended to gain a bit less.

Blood sugar targets: This gets interesting because Endocrinologists (of which I am one) and Obstetricians do not always agree on which criteria to use as blood sugar targets in pregnancy. They do generally agree that your morning blood sugar before eating should not be higher than 95mg/dL (5.2mMol/L) in a pregnant woman. The post meal targets are a bit more variable, but most would agree with the following: On testing after eating, one hour after eating a meal your blood sugar should not be higher than 180 mg/dL (10mMol/L) and two hours after eating it should not be higher than140mg/dL (7.7mMol/L). If your sugars are higher than those, you will need nutrition/diet guidance and possibly medication to control your sugars.

What to eat: If you do have diabetes during your pregnancy, you will need to be especially careful of several things, as you know. But the more attention falls on what you already watch when not pregnant the sweets and other starches. Pregnancy is not the time to indulge because you are “eating for two!” Pregnancy is the time to watch your diet more than ever to make sure you are taking care of yourself and baby, eating what is best for the both of you! Sweets are obvious, including candy, cakes, juices and soft drinks. Starches are sometimes more difficult to figure out, but largely they include rice, breads, ground provisions and some vegetables like corn. It is also important to note that mixed foods contain starches and proteins: examples include dairy and legumes (beans). When you think about what you should be eating, you should know to include all food groups, but keep your starches to relatively lower amounts, keep away from sweets, and spread them out throughout the day instead of having one big meal at one time. Your medical team and your nutritionist, with whom you should meet several times during your pregnancy, should make more specific recommendations for your situation.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227