eating to control blood sugar + the gestational diabetes vegan diet

blood-glucose-monitoringSo I have gestational diabetes.

Last night, after dinner, after I checked my post-dinner blood sugar (I have to poke myself 4 times a day to do this), I cried. It was 147, & according to my guidelines, it needs to be under 140 post-meals. I miscalculated the carbohydrates in “refried” beans & had nearly a cup, rather than 2/3 cups I should have had, which is just a slight difference, but enough to put me over the edge.

It’s an overwhelming feeling to feel like your health is in your control, yet at the same time you feel a little out of control. It’s also a depressing thought to think about having a long term health issue that affects every aspect of your life.

Believe me, I realize gestational diabetes (which is temporary), is nothing like a lifelong type-1 diabetic, or some other much more all-encompassing long-term disease or health issue. But, it’s giving me a glimpse of that life, & I have a greater empathy, though still limited understanding, of what those individuals might be going through.

Fortunately, as I mentioned in Tuesday’s post (which thank you, by the way, for so many great comments!), I’m feeling so much better since I’ve made some tweeks in my diet.

 

Here are some truths I’ve always known about myself, some even from a young age:

1) Sugar, especially too much sugar, makes me wacky. I love sweet things, as you well know, but I absolutely have to keep my sugar consumption (even unrefined sugars) in check.

2) My body is sensitive to foods. And like the princess & the pea, I’m overly-aware of any & all feelings/discomforts/issues going on with my body. At times it’s annoying, but overall, I’m glad my body speaks to me, & I try to listen & act accordingly, as best I can.

 

Here are some things I’ve realized recently:

1) The importance of exercise for controlling blood sugar. 
I spent most of my 20′s (& all previous pregnancies) exercising a minimum of 1 hour a day, 4-6 days a week. During my last pregnancy, I continued to teach 12-15 fitness classes nearly up to the birth of Salem, which I’m convinced, enabled me to pass the glucose tolerance test for that particular pregnancy. Exercise helps regulate blood sugar (primarily by burning off excess sugars, helping to keep levels under control), among having many other positive benefits for diabetics.

I’m absolutely seeing exercise with new eyes, & resolve, after I have this baby, to recommit to structured exercise (particularly yoga & cross-training). My 30-45 minute walks a few times a week haven’t been without value, but it’s not the same as what I had been doing prior to this pregnancy.

2) How it’s not normal to feel sleepy or lethargic after eating.
I remember eating breakfast one day about a month ago & then getting sooo sleepy I had to lay down & take a nap while Salem sat next to me watching Cailou on the Nook. When I went to the gestational diabetes class, I learned that due to pregnancy hormone levels in the morning, the body is especially senstive to sugars, which is why for gestational diabetics, breakfast has half the carbohydrates of all other meals.

I was eating oatmeal & toast with fruit or a smoothie with lots of fruit & not enough fat & protein–no wonder I was so sleepy! I imagine had I tested my blood sugar then, it would have been through the roof. Now that I’ve changed my diet I feel awesome after eating–not only am I not tired, but I have more energy!

3) How I’ve always had blood sugar issues.
Though didn’t always put two & two together, & that, whether I like it or not, even after this pregnancy, I need to treat myself like a pre-diabetic & continue to control my blood sugar through diet & exercise.

 

How was it determined that I do, in fact, have gestational diabetes?

I took several tests. They included two, one-hour glucose tolerance tests (& I failed both), & one, three-hour glucose tolerance test (also failed).

Here are the results of my 3-hour test:

Fasting: 70 (should be under 90, so this was good, but I had been fasting for over 15 hours when they drew my blood)

Then I drank the glucose.

1 hour post drink: 209 (should be under 180)

2 hour post drink: 212, even higher than my one hour, clear proof my body couldn’t handle all the sugars properly (should have been under 155)

3 hour post drink: 144 (should have been under 140)

 

So, you may be wondering, what changes have I made to feel better & control my blood sugar?

Really, just two changes, which have made ALL the difference!

1) I eat smaller, frequent meals–3 smaller meals (by smaller, I mean fewer calories, fewer carbs than I was used to) + 2-3 small snacks (which I never did before)
This has been the hardest part for me! For several years now I’ve only eaten 2 or 3 times a day. Though I don’t think meal timing or meal frequency is necessarily a cut & dried thing for everyone, I think it’s clear if you have blood sugar issues (especially if you’re diabetic), frequent smaller meals is the way to go for most folks.

2) I eat more protein, fewer carbohydrates, & more healthy fat than I’m used to.
Also hard for me. I’m still trying to overcome my fat phobia, since eating a very low fat vegan diet for years.

I really do find a small handful of raw almonds or adding pumpkin seeds or nut butters to my smoothies help me feel more satiated. And I feel that eating a bit more deliberate protein & fat is helping me to feel better, feel more grounded & keep my blood sugar in check.

Here are a few higher plant-based proteins:
whole soy foods, including organic tofu, tempeh, & plain unsweetened soy milk
legumes (but they also count as a carbohydrate too–1/2 c. beans= 1 protein & 1 carbohydrate)
seeds, such as pumpkin, sunflower, sesame, hemp & chia

Some examples of healthy fats:
avocado, unsweetened coconut (milk or shredded/dried/flakes), nuts & nut butter, organic cold-pressed flax seed or olive oils, coconut oil

 

Here are my parameters as a gestational diabetic:

First, a note on this. This is far fewer carbs than most people should get in a day (which is in the 175-300 g range, depending on height/weight/gender/activity levels). I am in no way recommending that everyone eat in this prescribed way, only to show what the parameters are for someone with gestational diabetes & what I’m doing to eat within those guidelines, as a vegan. Though, I think everyone would benefit from eating a good balance of protein, carbs, & fat with each meal & snack. Also, I’m pregnant, & not trying to lose weight, so my overall diet is higher in calories than someone who isn’t pregnant & may or may not be needing to lose weight. 

Get 175 g carbohydrate a day (or 12 carb “exchanges”)–the minimum for pregnancy
(for non-pregnant individuals, the minimum is 135 g)

Breakfast: 15-30 g carbs
am snack: 15-30 g carbs
Lunch: 45-60 g carbs
pm snack: 15-30 g carbs
Dinner: 45-60 g carbs
post-dinner snack: 15-30 g carbs

To give you an idea of what this might look like, this is what I eaten the past two days. Again, this is no prescription for anyone else, only to show you, for informational purposes, how I’ve been eating, which has absolutely, 100% helped me feel soo much better.

eating-for-gestational-diabetes

A few notes: 

Though things like peanut butter, nuts, seeds, & non-starchy vegetables have a small amount of carbohydrates, I don’t have to count them, they are considered “free foods” unless I eat more than 3 servings in one sitting (which I often do with non-starchy veggies), at which point 3 servings of these free foods = 1 carb exchange (or 15 g carbs). 

Also, you may notice I use soy milk. Plain, unsweetened soy milk only has 4 carbs per cup & 8 grams of protein. I use unsweetened almond milk in many cases too, as it has only 2 carbs per cup, but has no protein. So, it’s a balance–I use either one depending on what I’ve eaten (or will eat that day). 

 

Day 1

 

Breakfast: (2 carb exchanges)
1 small avocado spread over two plain rice cakes
smoothie–
1 c. plain unsweetened soy milk
1 c. water + 1 c. ice
3 c. chopped kale
1/3 frozen banana
1 TBS. unsweetened dark cocoa powder*
2 packets stevia

am snack:  (2 carb exchanges)
2/3 c. chia seed pudding**–I love this stuff! So filling & similar texture to tapioca pudding (which incidentally, I don’t actually like!) & very easy to make
1/2 banana (15 g carbs) spread w/ 1 TBS. natural peanut butter

lunch: (3 carb exchanges)
1 1/2 c. collard greens & diced tomato soup
chickpeas & salad–
2 c. shredded kale + 4 c. chopped spring mix greens
1 c. chickpeas
2 TBS. raw pumpkin seeds
basalmic vinegrette

pm snack: (1 carb exchange)
peanut butter smoothie–
2 TBS. natural peanut butter
1/2 c. plain unsweetened soy milk
1/2 c. water + 1 c. ice
2 TBS. raw pumpkin seeds
1/2 banana

dinner: (3 carb exchanges)
2/3 c. Asian rice
1 1/2 c. cooked collard greens
lettuce wraps–1/2 c. diced tofu w/ lettuce
1 orange

post-dinner snack: (0 carbs)
hot cocoa–
1/2 c. plain unsweetened almond milk
1/2 c. hot water
1 TBS. unsweetened cocoa powder
2 packets stevia

* I use a brand from Costco that is higher in iron than typical brands (15% of your DV per tablespoon)
**I modified Gena’s recipe a bit–I only use 2/3 c. chia seeds, 2 1/2 c. unsweetened plain almond milk (almond breeze–only 30 calories & 2 g carbs per cup)

 

Overall look at the day:
I had 4 servings fruit, 10 servings of vegetables, & somewhere around 90 grams of protein, all while managing my blood sugar levels & staying within prescribed carb intake.

 

Day 2

 

breakfast: (1 1/2 carb exchange)
2 TBS. natural peanut butter
1 scoop PlantFusion vanilla bean protein powder (vegan, soy-free, & gluten-free)
1 c. plain, unsweetened almond milk
1 c. water + 1 1/2 c. ice
3 c. raw kale
1/2 c. wild blueberries
1 TBS. unsweetened cocoa powder
2 packets stevia

am snack: (2 carb exchanges)
1/3 c. hummus
1 cucumber, sliced into spears
1 fresh pineapple spear

lunch:  (3 carb exchanges)
1/2 c. chickpeas
1/3 c. Asian rice
Asian salad–
4 c. shredded kale & spring mix greens
1/2 cucumber, diced
1 c. chopped purple cabbage
2 tsp. sesame seeds
dash of seasoned rice vinegar + 1 tsp. sesame oil
2/3 c. chia seed pudding

pm snack: (2 carb exchanges)
apple, cut into slices

dinner: (4 carb exchanges)
nachos–
9 tortilla chips
nearly 1 c. non-fat refried beans (should have been 2/3 c., which is why my blood sugar was higher than it should have been)
1/2 c. diced green bell pepper
diced tomatoes
shredded lettuce
salsa

post dinner snack: (0 carbs)
1/4 c. raw almonds
hot cocoa (see previous day’s post dinner snack for ingredients)

 

Overall look at the day:
I had 4 servings of fruit, 10 servings of vegetables, plus, somewhere around 90 grams of protein–again, definitely met my requirements! Though, as I said in the beginning of the post, I should have eaten less beans for dinner, which the added 1/3 c. did cause me to have higher blood sugar than I should have had.

 

Further Reading: 
American Diabetics Association: Gestational Diabetes

I’m sure I’ll have more to share in the coming weeks & months, as I have time to experiment with foods & recipes. The foods I’m eating now are not entirely unlike how I ate before, it’s just more spread out, deliberate, & there’s certainly no eating 5 corn tortillas or cookies in one sitting!

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Comments


  1. lfwfv
    on December 27, 2013 at 10:33 am said:

    Thanks for sharing Janae! Your detailed food diary seems so tedious and stressful to me, but I know it’s for the best, and i am so glad it is starting to feel like a new habit to you. I typically only eat one or two large meals per day (spread over a few hours), and though they’re made up entirely of veggies, whole starches, legumes, and fruit, i know it would be better in some ways to spread it out more. I love eating just once or twice per day and then not thinking about food the rest of the day. I sleep well and am very energized all day eating this way. I feel i am so much more productive because i don’t have to stop to eat during the day, and I only “waste time” eating at the end of the day, when i’m tired and want to relax anyways. I have tried a couple of times to really increase my meal frequency and spread my food out, and it always leads to me feeling anxious, overwhelmed, and unsatisfied. Oh well, i guess it’s working for now, but i know it’s pretty “abnormal” and sometimes i wish i followed a more “normal” pattern.

    • on December 27, 2013 at 4:56 pm said:

      “Your detailed food diary seems so tedious and stressful to me”
      Ha! I agree!

      “I typically only eat one or two large meals per day (spread over a few hours)”
      That was how I used to eat too, though mine was more like big breakfast OR lunch (usually not both), then dinner with family later on. I also liked just getting eating out of the way, & not having to think about eating for long stretches…but with gestational diabetes in combination with having a tighter space (ie. a smushed stomach due to baby), eating frequently is absolutely what I have to do. Also, there’s no way I could get the amount of nutrition I need (especially carbs) in just two meals with diabetes. I’m learning what foods are awesome for blood sugar (greens, anything green!) & what foods I have to be careful with & measure/limit at each sitting (mashed beans, sweet potatoes).

      I say, if it ain’t broke don’t fix it! In other words, if it’s working for you & you feel great, no need to change things up just because it’s not “normal.” Over the years this is something I’ve realized–there’s no one “right” way for meal timing. Some people do really well with a pattern as you’ve described, while others do much better with more frequent meals. So much depends on your weight, gender, physical activity, health history, etc. I think more importantly, is *what* your eating, not so much when you’re eating, though with a health condition like mine, meal timing plays a huge role (I know this is purely anecdotal–but I feel so much better since I’ve made these changes). I’d think that a normal (non-pregnant) diabetic would also benefit from more frequent meals & I know it does help some people from binge/over-eating. But, again, I still am convinced there’s more than one healthy way to eat, including meal timing & frequency.

      I’m still having a hard time eating more frequently, but knowing it’s for my health & the health of my baby helps. Having to monitor my blood sugar 4 times a day, & seeing how those numbers go up & down based on what I eat is also extremely enlightening. It’s a good practice for when I’m no longer pregnant because as someone with a history of blood sugar issues & diabetes does run in the family, I think smaller, more frequent meals is something I just need to learn to get good at. It’s not rocket science, just takes some practice & like any habit, takes some time to develop & get used to.

      P.S. Hope you had a great Christmas!!

  2. on December 19, 2013 at 11:39 pm said:

    Wow, this is the best post I have read in a very long time. Thank you for being so thorough and so honest and while I am not pregnant nor do I have diabetes, I do have issues with sugar and not eating enough protein … this was enlightening for me and much needed right now.

    • on December 20, 2013 at 5:46 am said:

      Thank you Stacy!

      “I do have issues with sugar.”
      I think everyone does, to some extent. Believe me, I’m a huge proponent of treats (they have their time & place), but eating too many &/or too frequently, well, it’s just a disaster & can affect our moods & energy much more than we realize!

      I think for busy women (aren’t we all?!), particularly moms of young kids, we get wrapped up in taking care of them, feeding them, that we don’t give ourselves due diligence. I know that was my reasoning for several years–I preferred eating just twice, maybe 3 times a day because then I could focus on other things & not have to worry: “now what am I going to eat for my little snack?” But I’m finding it’s not as hard as I thought. What’s hard is breaking an ingrained habit, & beginning a new, better one. But what is it they say–do something 13 times & it will be a habit? It does get easier once it becomes habitual.

  3. on December 19, 2013 at 1:23 pm said:

    Thank you for this—so helpful! I am 20 weeks pregnant right now and or some reason am nervous that this time around that I will have gestational diabetes. Any tips on how to prevent it? Is it even preventable? I have the same sweet tooth as you do!

    • on December 19, 2013 at 2:50 pm said:

      Congrats on your pregnancy! (Do you know what you’re having?)

      “Is it even preventable?”
      Not sure it can be prevented (from what I’ve read it’s not entirely clear why some women get it, though there are risk factors that make you a more likely candidate for gestational diabetes), though there are things you can do now to help control your blood sugar. Things I should have been doing :)–eat smaller frequent meals (3 smaller meals + 2-3 snacks–enables you to spread out your carb intake so you get what you need, but not all in one or two sittings), eat a good balance of protein/fat/carbohydrates paying close attention to amount of carbohydrates you’re consuming (I was for SURE eating too many carbohydrates in one meal), avoid/limit/restrict refined (& even unrefined) sugars & exercise daily. I have been exercising–just walking & when our pool was open, swimming, but I could have been more consistent & done it for a longer period of time each session.

      • on December 19, 2013 at 2:55 pm said:

        Thanks! We find out tomorrow—can’t wait!

        Thanks for the tips! Got to get past this Christmas season—I love making sweets way too much :) And carbs—too yummy :) Somehow as a vegan I feel like I then have license to eat all kinds of other goodies! Hey, it’s vegan :)

        • on December 19, 2013 at 2:59 pm said:

          “Somehow as a vegan I feel like I then have license to eat all kinds of other goodies! Hey, it’s vegan :)”
          Believe me, I KNOW the mentality! And I too LOVE sweets, love carbs. I find that filling up on lots of green leafies & green veggies helps A LOT. When I’m full of the good stuff, it’s hard to find much room for the other stuff.

          • on December 19, 2013 at 3:01 pm said:

            Yep, exactly! I’ve been getting back to my green smoothie routine in the mornings and am finding a huge difference in my energy levels in the afternoon!

  4. on December 19, 2013 at 1:23 pm said:

    I have always had issues with my blood sugar levels too, so thank you for showing what works for you. When I started eating more fat and protein through foods like peanut butter, hemp seeds, tempeh etc. I found it calmed down a LOT.

    Do you (or anyone else) find that stress, anxiety or your mood affect your blood sugar levels? This is obviously something that can be hard to pin down, but when I was recovering from anorexia, my hypoglycaemia was worse than it ever was before or during my eating disorder, despite the fact that I was eating enough fat, protein and carbohydrates (which certainly wasn’t true before that). I have heard that the hormones released by stress (and caffeine, too) affect the levels of glucose in your blood, so the anxiety I had around food may have been part of that.

    Now that I am so much more relaxed and happy about food, my blood sugar levels are a lot more stable. Although like I said, there are a multitude of things that play into this complex issue, and it can be difficult to work out what works why.

    • on December 19, 2013 at 2:41 pm said:

      “Do you (or anyone else) find that stress, anxiety or your mood affect your blood sugar levels? This is obviously something that can be hard to pin down, but when I was recovering from anorexia, my hypoglycaemia was worse than it ever was before or during my eating disorder, despite the fact that I was eating enough fat, protein and carbohydrates (which certainly wasn’t true before that). I have heard that the hormones released by stress (and caffeine, too) affect the levels of glucose in your blood, so the anxiety I had around food may have been part of that.”
      I’ve read the same, & believe it to be true based on personal experience. I know hormones play a huge role in controlling blood sugar (for example your blood sugar naturally rises early in the morning due to an increase in certain hormones to help you get up out of bed…). When you’re stressed, or anxious, hormone levels are affected, thus, it would seem rational that blood sugar would also be affected. But, I’m no expert, & it’s certainly worth looking more into. Though, I think we could all benefit from chilling out & doing some yoga, or anything else that helps us keep a check on anxiety/stress :)

  5. Joya
    on December 19, 2013 at 1:15 pm said:

    I know you’re thanking God this is only temporary! But it is nice to know that you can control it. I have always had blood sugar issues too. I have to be careful about the amount of sugar I am getting, and also making sure I get enough protein. When the rest of my family has pancakes or something fun for breakfast, I have gf toast with almond butter or tempeh. I simply cannot handle the sugar, especially at breakfast. I know the “wacky” and it’s not fun!!

    • on December 19, 2013 at 2:37 pm said:

      “I know the “wacky” and it’s not fun!!”
      Amen to that! Sometimes I’m jealous of people who seem to be able to eat whatever they want (ie. my husband), but then I realize, hey, it could be sooo much worse. And, because I am so sensitive, it’s causing me to live in such a way that hopefully I can bypass a lot of the discomforts/health issues that seem to creep up around 40 or 50, when the consequences of a lifetime of poor eating habits tend to start making their appearances.

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