While keeping your blood glucose levels within safe limits is a hugely important part of managing your diabetes, the guidance to staying healthy in pregnancy is similar to that for staying healthy at any other time of life with diabetes.
Your diet in pregnancy with type 1 or 2 diabetes
When you are pregnant you may find that you need to make changes to your diet to help curb spikes and dips in your blood glucose levels. Try to aim for a varied diet that includes a combination of:
- carbohydrates such as breads, rice, pasta, grains and potatoes. Choose wholegrain varieties where possible
- fruit and vegetables
- pulses, such as baked beans, butter beans or lentils
- dairy products such as milk, hard cheese and yogurt
- lean meats and fish.
The amount of carbohydrates you eat has the biggest impact on your blood glucose levels after eating. Ask to be referred to a dietitian if you have not seen one already. Pregnancy is not a time to be on a calorie controlled diet so speaking to a dietitian will help you to make small changes to your diet that are safe for you and your baby.
'I did have cravings while I was pregnant – I did really want some chocolate and so I would buy myself just really dark chocolate so I could have just something.' Maria, mum of one
No need to 'eat for two'
It is all too easy to over-eat during pregnancy, but the phrase ‘eating for two’ is a myth. In fact, your baby will grow well for the first two trimesters of pregnancy without you eating any extra calories at all. During the last trimester of your pregnancy you may need up to 200 extra calories per day – the equivalent of a small snack. Find general guidance on safe exercising in pregnancy here.
You must take 5mg of folic acid, which you should receive on prescription, from when you start trying for a baby until you are 12 weeks pregnant.
All pregnant women are recommended to take 10mcg of vitamin D through your pregnancy and when breastfeeding, as well as eating rich sources of vitamin D in your diet – such as oily fish.
Staying active in pregnancy
Exercise during pregnancy has many benefits for you and your baby so you should continue to stay active while you are pregnant.
As you have diabetes, exercise will have an extra effect on your blood glucose levels. When you work your muscles, they use up more of the glucose in your blood – and will lower your blood glucose levels. So if you treat your diabetes with insulin, you need to make sure you take the necessary precautions to avoid having a hypo:
- Discuss your plans for exercise with your healthcare team.
- Monitor your blood levels before and after exercise until you become familiar with how exercise affects your blood glucose levels.
- Take particular care to eat regularly, and carry snacks or glucose with you in case your blood sugar drops.
- Keep exercise moderate, with rest periods so that you do not become too hot or exhausted.
- You may need to have extra snacks before you exercise if you take insulin – ask your team for advice.
- Stay hydrated.
- If you are finding it hard to reduce your blood glucose levels, look at your activity levels to find ways to introduce more exercise into your daily routine.
Your healthcare team will be able to advise you on what to do, how often and for how long. If you don’t usually exercise, start with 10-15 minutes of continuous exercise three times a week. Over time, you can build this up to 30 minutes of exercise four times a week or more.
'I was advised to continue running because my body was used to it – I managed to run up until I was four months pregnant. When I felt unable to run anymore I did pilates and swimming, which I found hugely beneficial.' Laura, mum of one
Managing your weight in pregnancy with type 1 or 2 diabetes
Most diabetes pregnancy services weigh women with diabetes at every visit. This is because there is a strong link between high weight gain in the mother and macrosomia (extra weight gain) in the baby.
If your team feel that your weight could be an issue, they will support you to manage your blood glucose levels and keep yourself and your baby healthy through the right diet and exercise.
Keeping to a healthy weight is another important way of staying healthy. If you went to a pre-conception clinic, you may already have lost weight before you conceived. There is no specific UK guidance about how much weight you should put on during pregnancy but there are general guidelines to how much weight to put on in pregnancy here. Dieting is not advised as it may involve cutting out food groups.