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Gestational Diabetes Diet Plan Nhs

Healthy Eating For Diabetes And Pregnancy Nutrition And Dietetics Department

Healthy Eating For Diabetes And Pregnancy Nutrition And Dietetics Department

Patient information ©Barts Health NHS Trust Switchboard: 020 3416 5000 www.bartshealth.nhs.uk Name: Date: Dietitian: Contact Number: Hospital site: Patient Advice and Liaison Service (PALS) Please contact us if you need general information or advice about Trust services. www.bartshealth.nhs.uk/pals Large print and other languages For this leaflet in large print, please speak to your clinical team. For help interpreting this leaflet in other languages, please ring 020 8223 8934. Te informacje mogÄ… zostać na żądanie przedstawione w formatach alternatywnych, takich jak Å‚atwy do czytania lub dużą czcionkÄ…, i w różnych jÄ™zykach. Prosimy o kontakt pod numerem 02082238934. Macluumaadkan waxaa lagu heli karaa qaabab kale, sida akhriska fudud ama daabacaadda wayn, oo waxaa lagu heli karaa luqaddo kale, marka la codsado. Fadlan la xidhiidh 02082238934. à¦à¦‡ , ঠ। 02082238934। Bu bilgiler, okuması kolay veya büyük baskılar gibi alternatif biçimlerde ve talep üzerine alternatif dillerde de sunulabilir. Ä°rtibat için lütfen 02082238934 numaralı telefondan ulaşın. ÙˆÙØŒ میں دستیاب کرایا جا سکتا اس معلومات Ú©Ùˆ متبادل Ø´Ú©Ù„ØŒ جیسے، Ù¾Ú‘Ú¾Ù†Û’ میں آسان یا بڑے Øر ÛÛ’ØŒ اور درخواست کرنے پر اسے متبادل زبان میں بھی دستیاب کرایا جا سکتا ÛÛ’Û” Ø¨Ø±Ø§Û Ù…Ûربانی پر Ø±Ø§Ø¨Ø·Û Ú©Ø± Continue reading >>

Gestational Diabetes Screening, Examinations And Tests

Gestational Diabetes Screening, Examinations And Tests

You've had a baby previously weighing 4.5kg (10lbs) or more at birth You had gestational diabetes in an earlier pregnancy You have a close family history of diabetes You have South Asian, black Caribbean, or Middle Eastern family origins The NHS recommends every pregnant woman with one or more risk factors should be offered a screening test for gestational diabetes. Depending on your risk factors, you may be screened for gestational diabetes at varying stages of your pregnancy. Early in pregnancy a blood test measuring blood glucose will be performed and an oral glucose tolerance test (OGTT) may also be recommended. Later in pregnancy an oral glucose tolerance test is performed. What is the oral glucose tolerance test for gestational diabetes? For an oral glucose tolerance test, a sample of your blood will be tested before you have had breakfast. You will then be given a sweet glucose drink. Two hours later another blood tests is performed to determine how well your body deals with the glucose. If the tests done earlier in pregnancy show you do not have gestational diabetes, you may still be asked to have another test at around weeks 24-28. If you are diagnosed with gestational diabetes, you will be given advice about how to manage the condition and how to monitor your blood glucose levels yourself at home. Because gestational diabetes in the mum increases the baby's risk of risk of complications, additional monitoring may be arranged. Babies of mums with gestational diabetes can be larger than normal when they are born. Around weeks 18-20 of the pregnancy, an ultrasound scan may be carried out to check the baby for any heart abnormalities. Around weeks 28, 32, 36 and regularly beyond this, ultrasound scans will be carried out to check the baby's growth and the amount Continue reading >>

Your Health And Wellbeing

Your Health And Wellbeing

A healthy diet is an important part of a healthy lifestyle at any time, butis especiallyvitalif you're pregnant or planning a pregnancy. Eating healthily during pregnancy will help your baby to develop and grow. You can read through this article, or go directly to the sections you want by clicking these links: You don't need to go on a special diet, but it's important to eat a variety of different foods every day to get the right balance of nutrients that you and your baby need. It's best to get vitamins and minerals from the foods you eat, but when you're pregnant you need to take some supplements as well, to make sure you get everything you need. There are also certain foods that should be avoided in pregnancy . You will probably find that you are hungrier than usual, but you don't need to "eat for two" even if you are expecting twins or triplets. Have a healthy breakfast every day, because this can helpyou to avoid snacking on foods that are high in fat and sugar. Eating healthily often means just changing the amounts of different foods you eat so thatyour diet is varied,rather than cutting out all your favourites. You can use the Eatwell Guide to get the balance of your diet right. The eatwell plate shows you how much to eat from each food group. You will need to be careful with your diet if you develop gestational diabetes your doctor or midwife will advise you. Eat plenty of fruit and vegetables because these provide vitamins and minerals, as well as fibre, which helps digestion and can help prevent constipation . Eat at least five portions of a variety of fruit and vegetables every day these can be fresh, frozen, canned, dried or juiced. Always washfresh fruit and vegetablescarefully. Find out what counts as a portion of fruit or vegetables . Starchy foods (carb Continue reading >>

Treatment

Treatment

If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. You'll also need to be more closely monitored during pregnancy and labour to check if treatment is working and to check for any problems. Checking your blood sugar level You'll be given a testing kit that you can use to check your blood sugar level. This involves using a finger-pricking device and putting a drop of blood on a testing strip. You'll be advised: how to test your blood sugar level correctly when and how often to test your blood sugar – most women with gestational diabetes are advised to test before breakfast and one hour after each meal what level you should be aiming for – this will be a measurement given in millimoles of glucose per litre of blood (mmol/l) Diabetes UK has more information about monitoring your glucose levels. Diet Making changes to your diet can help control your blood sugar level. You should be offered a referral to a dietitian, who can give you advice about your diet, and you may be given a leaflet to help you plan your meals. You may be advised to: eat regularly – usually three meals a day – and avoid skipping meals eat starchy and low glycaemic index (GI) foods that release sugar slowly – such as wholewheat pasta, brown rice, granary bread, all-bran cereals, pulses, beans, lentils, muesli and porridge eat plenty of fruit and vegetables – aim for at least five portions a day avoid sugary foods – you don't need a completely sugar-free diet, but try to swap snacks such as cakes and biscuits for healthier alternatives such as fruit, nuts and seeds avoid sugary drinks – sugar-free or diet drinks are better than sugary versions; be aware that fruit juices and smoothies contain s Continue reading >>

Assessing Pregnant Women For Gestational Diabetes

Assessing Pregnant Women For Gestational Diabetes

Assessing pregnant women for Gestational Diabetes Gestational diabetes occurs as a result of an underlying problem of insulin resistance and impaired beta cell function that is unmasked in pregnancy (Claus 1998). It is associated with increased risk of Type 2 diabetes mellitus in later life. To Identify women with gestational diabetes To reduce the potential risk to mother and baby. Reduce the chances of baby growing large for gestational age, increasing the likelihood of birth trauma, induction of labour and caesarean section All pregnant women with risk factors for developing gestational diabetes. See separate diabetes guidelines for type 1 and type 2 management and pre conception care. Patients in the following at risk groups should be offered an OGTT to screen for gestational diabetes at 26-28 weeks:- Maternal obesity (BMI >= 30kg/m2 at booking) First degree relative (sibling/mother/father) with diabetes Family origin with a high prevalence of diabetes (South Asian, Black Caribbean and Middle Eastern) Women with a diagnosis of PCOS with a BMI < 30kg/m2 can be considered for an OGTT although this is not included in NICE guidance. **Women with previous GDM are at very high risk of GDM in subsequent pregnancies. Ideally an HbA1c should be checked in the planning phase of pregnancy to ensure diabetes has not developed since the previous pregnancy. They should be offered either self monitoring or OGTT as soon as pregnancy is confirmed and if the initial OGTT is negative this should be repeated at 24-28 weeks. Glycosuria should not normally be tested for. However, if detected this should be managed as follows;- Women with glycosuria >= 1+ on more than 1 occasion or >= 2+ on 1 occasion should be referred for an oral glucose tolerance test (OGTT) within 1 week. If this occ Continue reading >>

Diabetes, Type 2

Diabetes, Type 2

Diabetes is a long-term (chronic) condition caused by too much glucose (sugar) in the blood. It is also sometimes known as diabetes mellitus. Brought to you by NHS Choices Overview Introduction Diabetes affects two million people in England and Wales. It is also thought that there are a further 750,000 people who have the condition but are unaware of it. How does diabetes occur? Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland that is located behind the stomach). When food is digested and enters the bloodstream, insulin helps to move any glucose out of the blood and into cells, where it is broken down to produce energy. However, in diabetes, because there is either not enough insulin, or because there is a poor response (resistance) to insulin, the body is unable to fully use the glucose in the blood stream. There are two types of diabetes: diabetes type 1 and diabetes type 2. This article focuses on type 2 diabetes. See Useful links for information about type 1 diabetes. What is type 2 diabetes? Type 2 diabetes occurs when not enough insulin is produced by the body for it to function properly, or when the body’s cells do not react to insulin. This is called insulin resistance. Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body does not produce any insulin at all. Around 95% of all people with diabetes have type 2 diabetes. If you have type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, and monitoring your blood glucose level. However, as type 2 diabetes is a progressive condition, you may eventually need to take insulin medication, usually in the form of injections. Type 2 diabetes is often associated with obesity. Ob Continue reading >>

What Is Gestational Diabetes?

What Is Gestational Diabetes?

Patient Information - 1 - Maternity Services GESTATIONAL DIABETES Gestational diabetes (GDM) is the term used to describe diabetes that is first diagnosed during pregnancy, usually through a blood test at 24–28 weeks into pregnancy. Usually it will disappear after the baby is born but will usually re-occur in any later pregnancies. With good management of gestational diabetes, you can increase your chances of having a healthy pregnancy and baby. WHY DO WOMEN DEVELOP GDM The hormones produced during pregnancy can make it difficult for your body to use insulin properly, putting you at an increased risk of insulin resistance. And, because pregnancy places a heavy demand on the body, some women are less able to produce enough insulin to overcome this resistance. This makes it difficult to use glucose properly for energy, so the glucose remains in the blood and the levels rise, leading to gestational diabetes. Women most at risk of developing gestational diabetes are those who:  Are overweight or obese  Have a family history of diabetes  Have had a previous ‘big’ baby, over 4.5kg.  Are from certain ethnic backgrounds HOW DOES GDM AFFECT MY BABY? If your blood sugar levels are consistently high sugar will cross over to the baby via the placenta. Baby will produce high levels of insulin which will make him or her grow rapidly. They can get very large around the middle and the top half of their body this can make delivery of the baby difficult and can mean that the shoulders get stuck during delivery. You are more likely to have an Induction of your labour or a caesarean birth. As a result of the baby producing too much insulin before he/she is born, they may have a low blood sugar until they regulate their own insulin production. Continue reading >>

Gestational Diabetes Diet

Gestational Diabetes Diet

Making lifestyle changes to follow a good gestational diabetes diet will mean achieving lower blood sugar levels which will ultimately benefit your baby hugely and reduce the risks and complications associated with gestational diabetes. But what is a good gestational diabetes diet? Our golden rules to eating The best approach to food we have found is to stick to these 8 golden rules: Eat little & often, ideally 3 meals and 3 snacks a day 'Pair' foods so that they will be tolerated better, "food pairing" is a term that we use in relation to the GD diet Eat high protein Eat good, natural fats Eat low amounts of unrefined complex starchy carbohydrates at every meal Bulk up meals with lots of vegetables & salad Drink plenty of water Go for a stroll We explain all these points in more detail below... #1. Eat little and often Ideally we want blood sugar levels which look (if we were to draw a picture) like rolling hills, rather than huge spikes and crashes. The best way to achieve good control over levels is to choose sensible foods and to eat little amounts often. We advise aiming for 3 meals and 3 snacks a day. Avoiding to eat is something that many mothers do when they are first diagnosed with gestational diabetes as they are unsure or too scared over what to eat. This can actually have a detrimental effect on blood sugar levels. If a meal or snack is missed then blood sugar levels can drop low and when this happens the liver dumps glucose into the bloodstream to give us energy and keep us going. The glucose can raise our levels high and then when eating our next meal, as levels are higher than they should be, they raise even higher. Following a big spike in levels, the body will signal the pancreas to produce insulin, but with gestational diabetes we may not be able to pr Continue reading >>

Gestational Diabetes And Giving Birth

Gestational Diabetes And Giving Birth

The latest guidance from NICE, published in 2015, has extended the time by which women with gestational diabetes should give birth to 40 weeks, 6 days – not much less than the general guidance for all pregnant women, which is 42 weeks. If you have not gone to birth at this point, induction of labour will be recommended. "When I was in the hospital, I felt I didn’t know what was going on. I would have liked more information about that part so I could have been better prepared." Gemma, mum of one The main reason for induction is to prevent stillbirth. For all women, the risk increases when their pregnancy goes past 42 weeks. However, one study has shown that women with gestational diabetes may be at risk earlier. So for this reason, the guidance in England and Wales states that if you have gestational diabetes, you should not go beyond 40 weeks, 6 days. An induction or caesarean may also be advised if your baby is very large (macrosomia) – as this may cause difficulties during the birth. On the other hand induction may also be recommended if the team detects poor growth in your baby. In Scotland, most women with diabetes in pregnancy are induced within 40 weeks. The guidance says that this decision should be determined on an individual basis. If you are taking diabetes medication or insulin, it recommends that you should be assessed at 38 weeks and delivered by 40 weeks. Choices you might need to make for labour and birth Most women with gestational diabetes have a healthy birth. But before you make your birth plan, you may need to take some things into account to make sure you and your baby are safe during and after the birth. If you have gestational diabetes, you will have less choice about where to deliver your baby. This is because you will need to deliver your Continue reading >>

Diabetes, Gestational

Diabetes, Gestational

Introduction Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. It can occur at any stage of pregnancy, but is more common in the second half. It occurs if your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet the extra needs in pregnancy. Gestational diabetes can cause problems for you and your baby during and after birth. But the risk of these problems happening can be reduced if it's detected and well managed. This page covers: Who's at risk of gestational diabetes Any woman can develop gestational diabetes during pregnancy, but you're at an increased risk if: your body mass index (BMI) is above 30 – use the healthy weight calculator to work out your BMI you previously had a baby who weighed 4.5kg (10lbs) or more at birth you had gestational diabetes in a previous pregnancy one of your parents or siblings has diabetes your family origins are south Asian, Chinese, African-Caribbean or Middle Eastern If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy. Symptoms of gestational diabetes Gestational diabetes doesn't usually cause any symptoms. Most cases are only picked up when your blood sugar level is tested during screening for gestational diabetes. Some women may develop symptoms if their blood sugar level gets too high (hyperglycaemia), such as: But some of these symptoms are common during pregnancy anyway and aren't necessarily a sign of a problem. Speak to your midwife or doctor if you're worried about any symptoms you're experiencing. How gestational diabetes can affect your pregnancy Most women with gestational diabetes have otherwise normal pregnancies with healthy babies. However, gestationa Continue reading >>

Meal Planning For Pregnant Women With Diabetes

Meal Planning For Pregnant Women With Diabetes

Your meal plan for diabetes needs to be modified when you are pregnant. The total calories you need are based on your prepregnancy weight, age, activity level, and whether you are carrying more than one baby. Dieting to lose weight during pregnancy is not recommended, because you may not receive enough nourishment for you and your baby, and it may increase your risk for premature delivery. Follow these guidelines for your meal plan during pregnancy. Carbohydrate Inadequate carbohydrate intake can result in low blood sugar (hypoglycemia) for women taking insulin and in ketone production for women who have gestational diabetes. Excessive carbohydrate intake can result in elevated blood sugar levels. Make sure your meal plan contains: Complex carbohydrate, especially foods high in fiber, such as oatmeal, brown rice, bran cereal, whole wheat bread, whole wheat pasta, and beans. Fresh fruits. Milk. Fresh or frozen vegetables. Limit these carbohydrate foods in your diet: Refined sugar and foods with a high content of refined sugars (sweets) Refined starches, such as highly processed breakfast cereals, instant potatoes, instant rice, or instant noodles Fruit juice Protein If your kidney function is impaired, your protein allowance may be lowered. Fat Monounsaturated fats and omega-3 fats, rather than saturated fats, should continue to be the primary source of fat in your diet. Fiber Get enough fiber each day. Fiber can help stabilize your blood sugar levels and relieve constipation, which is common during pregnancy. Most people get far more sodium than they need. Talk to your doctor about how much sodium you should eat. Vitamins and minerals Take a prenatal vitamin with folic acid and iron to meet your body's increased need for these micronutrients. Folic acid is needed for th Continue reading >>

Gestational Diabetes Some Of Your Questions Answered

Gestational Diabetes Some Of Your Questions Answered

What is gestational diabetes? Gestational diabetes is due to raised blood sugar (glucose) levels picked up in pregnancy. It is usually diagnosed in the middle of pregnancy. Usually gestational diabetes is due to the pregnancy hormones stopping your own insulin working as well. Insulin lowers blood sugars. So if it does not work as well, your blood sugar levels rise leading to gestational diabetes. How will it affect my baby? If the sugar levels in your blood stay too high, your baby may grow too big. This can make delivery more difficult. Sometimes a baby can be smaller than they should be or they may have a few difficulties such as breathing problems or jaundice when they are born. They may respond to high sugars in the mum by producing lots of insulin and so their sugars can be low after birth. Controlling your blood sugar levels reduces these risks. Gestational diabetes will not cause your baby to be born with diabetes, but your baby may be at greater risk of developing diabetes in later life. How do I control my sugars? A healthy diet (see page 3) and being active during your pregnancy will help to keep your sugars normal. You will see a dietitian and be supported to make simple changes. Sometimes, even with your best efforts to change your diet, your blood sugars remain high and you may need to take tablets and rarely insulin. Do I have to check my blood sugar levels? Yes. You will be given a meter and shown how to check your sugar levels. A diary will be given to you to record the results. Wash your hands before doing the blood test. You need to check/monitor your sugars up to 7 times during the day: ï‚· Before each meal ï‚· 1 hour after each meal ï‚· Before bed You need to aim for your blood sugar levels to be: ï‚· Less than 5.3 in the morning ï Continue reading >>

Induction Of Labour For Low Risk Gestational Diabetes

Induction Of Labour For Low Risk Gestational Diabetes

In obstetrics the decision to induce Gestational Diabetes is the honour of the Obstetrician. Is rather individualised. In my experience, a woman who has been diet treated is placed in Midwife-led care pathway and care is provided in the community. The final review is at TERM with the Obstetrician who will make the decision for induction. Otherwise this woman has the choice of choosing to deliver in the Birth Centre. The normal plan of care for our ladies with diet controlled gestational diabetes is to stop blood sugar testing around 36 weeks and treat the lady as normal - IOL at T+14 - the same as any other low risk lady. The normal plan of care for our ladies with diet controlled gestational diabetes is to stop blood sugar testing around 36 weeks and treat the lady as normal - IOL at T+14 - the same as any other low risk lady. The Obstetrician at my unit will induce all women with gestational diabetes before term ,if diet managed then as close to term as possible , however if needs Metformin or insulin then from 38 weeks as with the women with Type 1 and 2. Hi, In my units women with gestational diabetes are all reviewed by theobstetrician and those who are diet / metformin controlled then have shared care for the remainder of their pregnancy. As in Heather's unit, if blood glucose is well controlled by diet and growth is anticipated to be normal, IOL normally takes place at around 40 weeks. If on metformin IOL is generally between 39-40 weeks and if on insulin 38-39 weeks. It is interesting to see that in Sue's unit women who are diet controlled stop testing their BG at 36 weeks and they revert back to midwifery led care. Are there any figures from this unit to support this pattern of care because it would be a very useful tool to use if they are all good! We are cur Continue reading >>

Guideline Development Groups, Acknowledgements And Stakeholders

Guideline Development Groups, Acknowledgements And Stakeholders

Guideline development groups, acknowledgements and stakeholders PubMed Health. A service of the National Library of Medicine, National Institutes of Health. National Collaborating Centre for Women's and Children's Health (UK). Diabetes in Pregnancy: Management of Diabetes and Its Complications from Preconception to the Postnatal Period. London: National Institute for Health and Care Excellence (UK); 2015 Feb. (NICE Guideline, No. 3.) Guideline development groups, acknowledgements and stakeholders Clinical Director ( Perinatal Epidemiology ), Confidential Enquiry into Maternal and Child Health (CEMACH), London Development Officer, Fair Share Trust, Community, Foundation for Shropshire and Telford Consultant Physician and Honorary Senior Lecturer in Metabolic Medicine, Imperial College Healthcare NHS Trust, London Robert Fraser Reader in Obstetrics and Gynaecology, University of Sheffield General Practitioner, Nuneaton, and Senior Lecturer in Primary Care, University of Warwick Consultant Neonatologist, University College Hospitals London NHS Foundation Trust Consultant in Maternal and Fetal Medicine, Liverpool Women's Hospital Programme Manager, Building Schools for the Future, London Senior Work Programme Coordinator, NCC-WCH Research Fellow, London School of Hygiene & Tropical Medicine (formerly Research Fellow, NCC-WCH) Guideline methodologist (NCC-WCH project director) Reader in Anaesthesia, Imperial College London, and Honorary Consultant Anaesthetist at Chelsea and Westminster Hospital, London Ophthalmologist with an interest in diabetic retinopathy Professor of Medicine and Metabolism , University of Newcastle, and Honorary Consultant Physician, Newcastle Acute Hospitals NHS Trust and Newcastle Primary Care Trust Diabetes physician with an interest in diabetic re Continue reading >>

Nhs Diet Advice For Diabetes

Nhs Diet Advice For Diabetes

Tweet In the UK, current 2016 NHS diabetes diet advice is that there is no special diet for people with diabetes. Many people with diabetes focus on the carbohydrate content of their meals and prefer a low-carb diet for tight blood glucose level control. The NHS (and Diabetes UK) recommend a healthy, balanced diet that is low in fat, sugar and salt and contain a high level of fresh fruit and vegetables. This guide reviews the diet advice the NHS gives to people with diabetes and discusses to what degree the advice is sensible. What does the NHS advise? The NHS provides the following diet advice for people with diabetes: [147] [148] Eat plenty of starchy carbohydrates with a low glycemic index (low GI) Increase the amount of fibre in your diet Eat plenty of fruit and vegetables - at least 5 portions per day Cut down on fat and saturated fat in particular Choose foods with unsaturated fat instead - such as vegetable oils, reduced fat spreads, oily fish and avocados Choose low-fat dairy products Choose lean meat - such as skinless chicken Avoid fatty or processed meat Eat fish at least twice a week and ensure you have oily fish at least once a week Eggs and beans are other good sources of protein Cook food by grilling, baking, poaching or steaming instead of frying or roasting Avoid fatty or sugary snacks - such as crisps, cakes, biscuits and pastries Eat snacks such as fruit, unsalted nuts and low-fat yoghurts Cut down on sugar Eat less salt - have less than 6g of salt (2.4g of sodium) per day Cut down on alcohol Don’t skip breakfast Keep hydrated - aim to drink between 1.6 and 2 litres of fluid each day Is the NHS advice sensible? Whilst a number of these points are undoubtedly sensible, some of the recommendations have been criticised by patients and some leading UK h Continue reading >>

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