Gestational diabetes

Kia ora. Nau mai haere mai. Welcome to the session on healthy eating with diabetes and pregnancy. You'll be watching this presentation because you have recently been diagnosed with diabetes and pregnancy. I am Sam and I'm here with my colleague Molly, and we are both New Zealand registered dietitians.

In this video, we will briefly touch on blood sugar targets. We will spend quite a bit of time talking about carbohydrate foods as this is the main food group that impacts your blood sugar levels. We will then move on and discuss the different food groups and serving suggestions for pregnancy, and we will have a summary slide at the end with our take home messages.

These are some resources that are available to you online. They are not diabetes and pregnancy specific, so they won't mention things like blood sugars and when to test. But they do provide a great overview for healthy eating and pregnancy, including food safety as well.

They are weight gain recommendations during pregnancy, which you will see here on the slide. It is based off your pre-pregnancy body mass index. If you are unsure of your pre-pregnancy body mass index, please speak with your midwife or dietitians involved in your care. Healthy weight gain and pregnancy will help support your blood sugar management. These are our general blood sugar targets for diabetes and pregnancy.

Your diabetes midwife or physician will advise you if you have different targets to target. To my. We are aiming for four blood sugar tests per day. We want to do a fasting test before we eat breakfast, and for this test we are aiming for a blood sugar level of under five. Have been wanting to test two hours after starting each of our main meals, so there would be two hours after starting out breakfast meal, two hours after starting our lunch meal and testing two hours after starting out in a meal.

For these tests, we are aiming for a blood sugar level of under six. There are different things that will help you achieve your target blood sugar levels.

These include healthy eating which will be the focus of today's session. Keeping active and moving your body. Regular testing of your blood sugar levels. As this is the only way to know what your blood sugars are doing. Some people also require medication to support them with blood sugar management.

Eating well in pregnancy is trying to find a balance between eating enough so both you and baby and nourished. Well, also thinking about the types of foods you're choosing and portion sizes to try.

Keep your blood sugars in a safe range.

The first thing we want to try and achieve is a regular meal pattern, where I'm going to have three meals and snacks every day.

A regular meal pattern can help to improve energy levels, reduce feelings of hunger between meals and support healthy weight gain and pregnancy.

The three key macronutrients we eat carbohydrates, fats, and protein.

It is the carbohydrate foods that directly impact our blood sugar levels. So we'll talk about them more now.

Which of these foods have carbohydrates in them. Pause the video and have a think.

Carbohydrate containing foods include our starchy vegetables such as potatoes, Kimera Taro, cassava fruit, soft drinks, sugar, jaggery or honey. Dairy products, bread, rice, pasta, roti or noodles, as well as beans and pulses.

Carbohydrates are important for pregnancy and we need to keep including them in our diet. All carbohydrate foods are not nutritionally equal and we don't recommend them in the same amounts. We encourage you to choose the carbohydrate containing foods and the green boxes, but to limit or avoid the ones and the red boxes.

It is important to consider the type of carbohydrate food you are choosing. Ask yourself, what other goodness is this food given to me?

Here are some of the other nutrients that these carbohydrate foods contain. Fibre helps slow down the digestion of carbohydrate foods, which helps prevent quick spikes and blood sugar. This is why we encourage you to choose carbohydrate foods that are higher in fibre. Examples of these foods include brown rice over white rice or multi-grain or seeded bridge over white bread.

Well you also need to think about the amount of carbohydrate we have with each of our meals. Ideally you would have a similar amount of carbohydrate at each meal.

We should aim to have one large first or a quarter of our plate per meal. For a snack we aim for one small handful.

The plate model is a great example of how you could design a meal. We aim to have a quarter of our plate to be made of carbohydrate foods, a quarter of our plate to be made of protein foods, and half of our plate to be made up of non-starchy colorful vegetables.

Here are some other examples of what the plate model can look like for different meals.

It is important to spread your carbohydrate intake out across the day. We are aiming to have carbohydrates with all meals and snacks when having a meal with two different carbohydrate foods, like the dinner meal here, it is important to be mindful of our portion sizes of the carbohydrate foods. When there are two different carbohydrate foods on the plate. It can easily become a large carbohydrate meal, which may elevate your blood sugars.

In summary, when choosing carbohydrate foods, we want to remember three things one. The type of carbohydrate we are choosing. Ideally choosing wholegrain or high fiber options two the amount of carbohydrate we are having with a meal, aiming for one large first or quarter of our plate, and three the timing of our carbohydrate intake.

Aiming to have carbohydrates with all meals and some snacks.

Kia ora, I'm Molly, the dietitian who will be doing the second part of this presentation.

Eating a variety of foods every day from each of the four food groups is an important part of meeting you and your baby's nutritional needs. Meeting these needs helps protect the long term health of both you and your baby.

The Ministry of Health recommend aiming for two servings of fruit per day. What is a server fruit? A serving fruit is equivalent to one handful or one medium sized piece of fruit, such as a medium sized orange or half of a large banana.

If it is a smaller fruit such as kiwi fruit, two kiwi fruit are considered one of you can opt for fresh, frozen or canned fruit. If you are choosing canned fruit, be mindful of those in sirup. If you are choosing frozen fruit, remember to follow food safety recommendations, which will be outlined in the booklet Sam mentioned earlier to support your blood sugar control.

Spread your serves of fruit throughout the day rather than having both at once. We also recommend limiting fruit juice, as it tends to be lower fiber and higher carbohydrate than Holford.

The Ministry of Health also recommend aiming for five plus sieves of colorful, non-starchy vegetables per day. As you can see, one sieve is equivalent to two handfuls. Fresh, frozen or canned vegetables are all good options include a variety of different vegetables. Choosing seasonal varieties can help with this. Colorful vegetables provide fiber, vitamins, and minerals, and they are low in fat, so they are a great food group to support your overall nutrition and help you feel full.

The next food group is meat and meat alternatives. These foods are a good source of protein, iron, zinc, and several other nutrients. The Ministry of Health recommends aiming for three servings per day to help guide your serving sizes. You will see the hand models on the screen. If you are choosing red meat, aim for your portion to be similar to the size of your palm.

If you are choosing fish, aim for your portion to be similar to the size of your whole hand.

Lastly, the Ministry of Health recommend aiming for two servings of milk and milk products per day. This food group is high in calcium and a source of protein.

It is important to include this food group in pregnancy as calcium requirements increase. As you can see, one sieve is equivalent to one glass of milk or one glass of buttermilk, two slices of hot cheese, or one bottle of yogurt. If you are choosing nondairy milk, be sure to check that it is calcium fortified.

As a reminder, when building your savory meals, aim to start with quarter of your plate being wholemeal or whole grain carbohydrates quarter of your plate, lean or lower fat protein. And be sure to add plenty of those colorful, non-starchy vegetables.

If you would like some inspiration for snacks, pause the video and have a look at some of the examples we have put on the screen.

In terms of fluids. Be sure to drink plenty of fluids each day just like we would recommend outside of pregnancy. Water is best limit fizzy drinks, fruit drinks and cordials because these are low in nutrients and high in sugar. If you were choosing artificially sweetened beverages. Be sure to check that the sweeteners used are okay to consume in pregnancy.

The Ministry of Health do recommend keeping below 200mg of caffeine per day. There is evidence that high caffeine intake may affect your baby's growth during pregnancy. Caffeine is naturally occurring in tea, coffee, and chocolate and is present in many cola type drinks. In some fermented drinks, such as kombucha. Limit your intake of caffeinated drinks while pregnant.

In summary, be sure to do your blood sugar testing. Aim for regular meals and snacks. Sam discussed. Aim to eat from all of the food groups as they all provide important nutrients. And please do not cut out carbohydrates. Have a think about the type, the amount and the timing.

That is all from us today. Thank you for your time. We wish you all the best.