Healthy eating in pregnancy, for women with type 2 diabetes
A healthy eating plan is essential for you and your baby and is an integral part of your diabetes management and general health. It is recommended that you make an appointment with a dietitian to discuss your individual requirements for pregnancy.
Your food choices are important for providing nourishment for both you and your baby, and can help with managing your blood glucose levels. Your dietitian can advise you on weight gain targets for your pregnancy, carbohydrate counting and the best carbohydrate food choices for managing blood glucose levels. If you are taking insulin, discuss how to adjust insulin to match your carbohydrate intake.
Aside from carbohydrates, there are other nutrients that need special attention in the lead-up to and during your pregnancy, including protein, iron, iodine, calcium and folate.
Your dietitian can guide you on the best food choices to meet these extra nutritional needs for pregnancy.
Folate (folic acid) is a vitamin that is very important to reduce the risk of certain birth defects of the brain and spine. A varied diet that includes green leafy vegetables, fruit, breads and cereals, nuts and legumes can provide folate. However, it is difficult to get enough folate for pregnancy from your diet alone. Taking folic acid supplements has been shown to reduce the risk of birth defects for all women, not just those with diabetes. Ideally, you would start taking your folic acid supplement at least one month before your pregnancy, and continue taking it throughout the first trimester (the first three months of pregnancy).
It is recommended that women who have diabetes take a higher dose of folic acid than other women because of the increased risk of birth defects. In Australia current guidelines recommend 5mg of folic acid per day, but talk to your doctor, they may suggest you take one 5mg tablet each day or just half, depending on other pregnancy supplements you may be taking.
Talk to your diabetes health professionals about taking a folic acid supplement. You do not need a prescription to buy folic acid, but make sure you tell the pharmacist you need to buy the 5mg tablet, not the usual 0.5mg tablet.
In addition to folic acid, it is recommended that all women take an iodine supplement of 150 micrograms when planning for pregnancy, during pregnancy and breastfeeding (unless you have an overactive thyroid or Graves disease).
Your doctor will also check the amount of iron in your blood and advise whether you need to take an iron supplement (most women will in the later part of their pregnancy). If you are concerned about other nutrients, speak to your dietitian about your usual dietary intake and ask whether you need multivitamins or other micronutrient supplementation.
Protecting yourself from exposure to high-risk foods that can cause infections and harm your developing baby is very important. These infections can be caused by listeria, salmonella and toxoplasmosis which can be present in high risk foods. Certain types of fish also need to be limited during pregnancy due to their high mercury content. Seek advice from your dietitian and/or state health department on guidelines for food safety during pregnancy.
Alcohol can cause damage to an unborn baby, and should be avoided throughout your pregnancy.
A dietitian can discuss the most appropriate foods for you during your pregnancy, provide information on foods to avoid or limit and work with you to help manage your diabetes during pregnancy.