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In our country, gestational diabetes develops in about 8-10% of pregnant women, which can pose a serious risk to both the mother and the fetus if not properly managed. The primary treatment for gestational diabetes is lifestyle therapy.

 

The hormone production of the placenta also affects the body’s insulin sensitivity, which typically causes temporary insulin resistance in pregnant women. According to the pregnancy care protocol in Hungary, a glucose tolerance test is mandatory between the 24th and 28th weeks, during which the expectant mother must consume a solution containing 75 grams of glucose on an empty stomach. Blood sugar levels are checked by taking blood samples immediately before consuming the solution and 120 minutes after. A diagnosis of gestational diabetes (GDM) is made if the fasting blood glucose level is above 6.0 mmol/L or if the 120-minute post-load value reaches 7.8 mmol/L.

The first step in managing gestational diabetes is lifestyle therapy, which is based on following dietary guidelines, regular physical activity and stress reduction. A dietitian can be of great help in learning and personalizing the diet.

The body’s daily energy needs are provided by three macronutrients: carbohydrates, proteins and fats. In the case of diabetes, in addition to ensuring the appropriate quantity, it is especially important to focus on the quality of these nutrients as well.

Carbohydrate

Carbohydrates are the primary energy source for our cells. Both too little and too much carbohydrate intake can lead to metabolic problems and developmental disorders. The recommended amount should be determined on an individual basis.

Depending on how quickly the carbohydrates can be absorbed, we distinguish between fast- and slow-releasing carbohydrate sources. Slowly absorbed carbohydrates are more complex, rich in fiber and have a prolonged, less intense effect on blood sugar. Thanks to the fiber they contain, they help us stay full longer. Low-fiber, refined carbohydrates are absorbed quickly and easily, causing blood sugar to rise faster and typically to higher levels.

Slow-releasing carbohydrate sources:

– Whole grain bread and bakery products (sugar-free)
– Brown, red, black, wild and basmati rice
– Oats, buckwheat, millet, quinoa, teff, bulgur, whole grain couscous
– All types of vegetables
– Certain nuts, e.g., cashews, peanuts…

Fast-releasing carbohydrate sources:

– Fruits and fruit preparations
– Milk and certain dairy products (e.g., yogurt, kefir)
– Carbohydrate-based plant milk alternatives (e.g., oat milk, rice milk)
– Foods made from refined flour or starch
– Foods containing sugar, honey, or syrups

The method of food preparation can also further influence absorption. The more processed a food is, the faster its nutrient content can be released. For example, overcooking, blending, pureeing, and flaking damage the fiber structure, thereby accelerating absorption.

Tip: A common misconception is that fruits should be avoided in diabetes. While fruits are rich in fructose, it would be a mistake to exclude them from our diet due to their high fiber, antioxidant, and micronutrient content. It is better to enjoy them as a dessert at lunch or as a snack.

Protein

During pregnancy, proper protein intake is especially important. In cases of protein deficiency, fetal development may slow down, the mother’s immune system may weaken, and symptoms such as muscle weakness, fatigue, and increased edema can occur. Meats, fish, seafood, and animal products such as eggs, milk, and dairy are rich sources of well-utilized, complete proteins. However, there’s no need to worry if we cannot consume these for any reason, as our plant-based sources are also rich in protein. It is recommended to eat a variety of these sources to properly complement the incomplete amino acid profiles they contain. Recommended plant-based sources with high protein content include grains, rice, quinoa, oats, buckwheat, legumes, tofu, seeds, broccoli, and Brussels sprouts…

Tip: Don’t forget that protein can also trigger some insulin response in the body, so snacking between meals on protein-based foods is not recommended either.

Fat

Several studies have shown that a diet high in fat increases the risk of developing diabetes and worsens the outcomes of the disease if already present. However, the type of fats we consume matters. Excessive intake of foods rich in saturated fatty acids can indeed harm our bodies, with the main sources being fatty cuts of meat, skin, bacon, pure animal fats (e.g., lard), foods fried in large amounts of oil or fat, fatty processed meats, and high-fat dairy products, as well as coconut and palm oils. In contrast, a diet rich in unsaturated fatty acids has beneficial effects. It protects the cardiovascular system, positively influences our metabolism, reduces inflammatory processes in the body, and also supports fetal brain development. Unsaturated fatty acids are abundant in cold-pressed vegetable oils (e.g., extra virgin olive oil, pumpkin seed oil, flaxseed oil), oily seeds, and the best sources are fish and seafood.

Tip: We can further slow down the absorption of carbohydrates by consuming them together with protein-rich foods and high-quality fats!

Our body appreciates predictability, so we can significantly improve our metabolism by establishing a daily rhythm in our eating habits. Try to have breakfast within an hour of waking up, and eat approximately every three hours throughout the day. It has been observed that insulin sensitivity is worse during the early morning and late evening hours compared to midday. Therefore, it is recommended to consume slowly absorbed carbohydrates during these time frames. During the mid-morning snack, lunch, and afternoon snack, we can be more lenient with fast-releasing carbohydrate sources, and the recommended proportion may vary for each meal.

Gestational diabetes typically resolves after childbirth. However, it is recommended to conduct a follow-up lab test around the 10th week postpartum to determine if any level of glucose metabolism disorder remains. Until the test, it is advisable to maintain the diet.

IVETT EDVI-KOMJÁTI

Dietitian, assistant

IVETT EDVI-KOMJÁTI

Dietitian, assistant