What is Gestational Diabetes?
During pregnancy, hormones to help your baby grow are produced by the placenta. These hormones can cause insulin resistance, making the need for insulin 2-3 times greater. For many women, the body cannot cope with this extra demand. As insulin is required to allow your body to use carbohydrate foods as energy, which is essential, this increased demand can cause blood sugar levels to be too high if not managed. This may lead to issues such as having a larger baby, which can cause complications for the baby and/or the birth.
Click on the link below to find out more about gestational diabetes
Understanding Gestational Diabetes
What we offer:
- Small group education sessions with a Diabetes Educator and Dietitian to help you learn how to manage your diabetes during your pregnancy.
- Individual appointments for follow-up and ongoing care and treatment.
Please call 1300 308 969 to arrange an appointment.
What to eat until you see a Dietitian
What should I eat now that I have Gestational Diabetes?
When you have gestational diabetes, the foods you eat are important in helping manage your blood glucose levels. Following a healthy eating plan is also important for a healthy pregnancy in general.
Here are some guidelines to follow until you speak to the Dietitians at the Illawarra Shoalhaven Diabetes Service.
Please call and book an appointment if you don't already have one. Phone: 1300 308 969.
Step 1: Eat 3 meals and 3 snacks that contain small amounts of carbohydrate.
- Carbohydrate foods are healthy for you and your baby, and you need to eat these at every meal as they provide our bodies with energy.
- Carbohydrates will raise your blood glucose level too high if you eat too many in one meal, so spread these foods out over the day.
The foods below are equal to 1 serve of carbohydrate.
You should aim to choose 2 carbohydrate serves to eat at every meal and every snack.
- 1 slice of wholegrain bread or low G.I. white bread
- 1/3 cup of cooked rice e.g. Doongara or Basmati
- 1/3 cup cooked pasta
- 3/4 cup cooked rolled oats
- 1/2 cup cereal e.g. Special K or All Bran
- 1 medium potato
- 1 small corn cob
- 1 piece of fruit e.g. apple, orange, banana
- 2 small pieces of fruit e.g. mandarin, kiwifruit
- 2-3 wholegrain crackers
- 2 plain biscuits e.g. oatmeal
- 1 glass of milk
- 1/2 cup flavoured yoghurt or custard
Step 2: Eat some protein at meals
Protein does not raise your blood glucose levels and helps fill you up. Examples are cooked red meat, chicken, fish, eggs or hard cheese.
A good serve size is the portion of your palm.
Step 3: Eat lots of vegetables and low carbohydrate fruits
Aim for at least 5 serves each day. Non starchy vegetables do not raise blood glucose levels - except for potato and corn, which you will need to count as carbohydrate food.
Fruit such as strawberries and passionfruit are low in carbohydrate and can be classified as low carbohydrate fruit.
Step 4: Add healthy fat
Healthy fats do not raise blood glucose levels. Examples are avocado, olive oil and unsalted nuts. Eat small amounts of these foods during the day.
Step 5: Limit highly processed foods
These foods have lots of calories, carbohydrate and are poor nutrition choices for pregnancy. Examples include chips, chocolate, takeaway foods, soft drinks and cordials, cakes, biscuits and lollies.
Step 6: Drink plenty of water
Aim to drink 2 litres of water each day. Water is the best drink to choose.
For more information and a sample meal plan, visit the Diabetes Australia website
Getting a blood glucose meter
Getting a blood glucose meter to monitor your glucose levels
To purchase test strips at a reduced cost, you'll need to register with the NDSS and have a valid Medicare card. Your GP or Diabetes Educator can help you register. If you are not eligible for Medicare, please speak with the Diabetes Educator for alternative options.
How to get a free blood glucose meter
You will need to be eligible to register with the NDSS. Blood glucose meters can take up to 1 week to arrive. You can purchase a meter immediately at your local pharmacy. The cost is around $40.
You will receive a "starter kit" which has everything you need to get started (a blood glucose meter, 10 pack of test strips, a lancing device and lancets). You will need to purchase additional items (testing strips and lancets) during your pregnancy.
Which blood glucose meter should you get?
Accu-Chek Guide Me
You can get an Accu-Chek Guide Me meter for FREE if you call the Accu-Chek Helpline on 1800 251 816 or access online at https://www.accu-chek.com.au/ndss-meter-request
To access a video on how to use the Guide Me meter, go to https://www.accu-chek.com.au/meter-systems/guide-me/support
Accu-Chek Guide test strips
Test strips will cost approximately $15 with NDSS registration. They are subsidised further if you have a valid concession.
Accu-Chek Guide FastClix lancets
Your finger pricker cartridges are not subsidised by the NDSS program. They will cost around $24 for a box of 17 cartridges (102 lancets).
Contour Next
You can get a Contour Next meter for FREE if you call Ascensia Diabetes Care on 1800 289 312 or access online at https://www.diabetes.ascensia.com.au/request-free-meter/
To access a video on how to use the Contour Next meter, go to https://www.diabetes.ascensia.com.au/products/contour-next-connected/
Contour Next test strips
Test strips will cost approximately $15 with NDSS registration. They are subsidised further if you have a valid concession.
Microlet lancets
Your finger pricker lancets are not subsidised by the NDSS program. They will cost around $15 for a box of 100 lancets
DO NOT Buy the Accu-Chek Instant S meter as the test strips are not subsidised by the NDSS program
When to check your blood glucose levels
Checking your blood glucose levels (BGLs) will help you and your pregnancy care team manage your Gestational Diabetes
When do I check my glucose levels?
- Before breakfast (fasting)
- 1 hour after starting breakfast
- 1 hour after starting lunch
- 1 hour after starting dinner
How high should my blood glucose levels be?
- Before breakfast (fasting): 5.0 or less
- 1 hour after starting meals: 7.4 or less
When do I need to contact the Diabetes Service?
If you have more than 3 glucose levels in a week that are:
- Higher than 5.2 before breakfast (fasting), and/or
- Higher than 7.4 after meals
Who do I contact at the Diabetes Service?
Monday to Friday 9am - 4:30pm
If you are NOT taking medication for your gestational diabetes (Metformin / other tablet or insulin), contact the DIABETES DIETITIAN - Phone: 4231 1920 (Wollongong) or 4424 6300 (Nowra) or email ISLHD-DiabetesDietitian@health.nsw.gov.au
If you are taking medication for your gestational diabetes (Metformin / other tablet or insulin), contact the DIABETES EDUCATOR - Phone: 4231 1930 (Wollongong) or 4424 6300 (Nowra) or email ISLHD-NurseDS@health.nsw.gov.au
How to record your blood glucose levels
Blood glucose record diary
You will need to keep a record of your blood glucose levels and have this record available when you speak with your diabetes care team.
Click on this link for a record diary. You can download this to your computer, tablet or mobile phone, or you can print for a paper copy.
Gestational Diabetes appointment schedule
How many appointments will I need to manage my Gestational Diabetes (GDM)?
Initial appointment
- You will have an appointment at the Diabetes Service 1-2 weeks after you have been diagnosed with GDM.
- Most women attend a small group education session (in-person) and are seen by the Diabetes Educator and Dietitian at the Wollongong or Nowra Diabetes Service. Allow 2.5 hours for this appointment.
- For women who have had GDM in the previous 2 years, a phone consultation can be arranged as an alternative, if suitable.
- An individual appointment with the Diabetes Educator and Dietitian can be arranged if a group session is not suitable.
1 - 2 weeks after attending the initial education session
Make sure you have your glucose level records (paper diary or App) with you at each appointment. It’s a good idea to take this to all your diabetes and antenatal appointments so your diabetes and pregnancy care team can review them with you at each visit.
- You will have a 30-minute follow-up appointment with the Dietitian. This may be in-person or a phone appointment.
- Appointments can be made at any Diabetes Service location
28 weeks and 36 weeks pregnant
- You will have a 30-minute appointment with the Dietitian and Diabetes Educator. This may be in-person or a phone appointment.
- Appointments can be made at any Diabetes Service location.
Additional appointments
- Women who are prescribed medication to manage their gestational diabetes (tablets or insulin) will be reviewed by the Diabetes Educator every 4 weeks. This may be in-person or a phone appointment.
- If blood glucose levels are not meeting the target levels, additional appointments will be planned while your treatment is adjusted.
Who to contact if your blood glucose levels are above the target level
If your glucose levels are outside target ranges (3 times in a week), please contact the Diabetes Dietitian or Diabetes Educator in between your scheduled appointments
- If you are NOT taking medication for your gestational diabetes (Metformin / other tablet or insulin), contact the DIABETES DIETITIAN - Phone: 4231 1920 (Wollongong) or 4424 6300 (Nowra) or email ISLHD-DiabetesDietitian@health.nsw.gov.au
- If you are taking medication for your gestational diabetes (Metformin / other tablet or insulin), contact the DIABETES EDUCATOR - Phone: 4231 1930 (Wollongong) or 4424 6300 (Nowra) or email ISLHD-NurseDS@health.nsw.gov.au
After 36 weeks
Antenatal expressing of colostrum information.
Contact Wollongong Hospital antenatal clinic to book an online education class (offered Monday 1-2pm). Phone 4253 4256
More information can be found on the Division of Maternity and Women's Health website https://www.islhd.health.nsw.gov.au/services-clinics/welcome-division-maternity-and-womens-health/pregnancy-and-diabetes-gestational
Life after Gestational Diabetes
After your baby arrives, you will no longer need to test your blood glucose levels.
It is recommended that 6 to 12 weeks after delivery, you have a repeat Glucose Tolerance Test to check that your blood glucose levels have returned to normal. Your GP can give you a pathology request form for this test.
If you choose to breastfeed, your food requirements for grains, vegetables and fluids are higher than when you are not breastfeeding.
After pregnancy you no longer need to count carbohydrates, but following a healthy diet is still important. Having gestational diabetes means that you may be at risk of developing type 2 diabetes or cardiovascular disease later in life. The best way to prevent this is by following a healthy lifestyle. Make sure you get tested for diabetes every 2 to 3 years.
If you would like any further dietary or lifestyle advice, you are welcome to see the Diabetes Dietitian for a follow-up appointment. Please call 1300 308 969 to book your appointment.
Useful websites for information and support after Gestational Diabetes
NDSS - Life after Gestational Diabetes
NDSS - Caring for yourself and baby
Starting solids - The how, why, what and when
Starting Family Foods online session (run by ISLHD Child and Family Health)
Starting your baby on family food is exciting and a little daunting, working out when to start, how much, how often, what foods, where do milk feeds and water fit in? And what's the latest on allergies? This session will provide you with current information, tips, resources and opportunities to ask questions so that you feel confident to support your baby's family food journey.
Other helpful information
National Diabetes Services Scheme (NDSS)
The NDSS is an initiative of the Australian Government and is administered by Diabetes Australia. NDSS provides support to people living with diabetes by:
- providing resources to help people understand how to manage diabetes
- providing access to services, support and subsidised diabetes products.
The Diabetes Service or your doctor can assist you to register with NDSS.
For more information, visit the NDSS website at https://www.ndss.com.au/
Illawarra Shoalhaven Division of Maternity and Women's Health
Information for hand expressing of breastmilk (colostrum) from 36 weeks can be found here https://www.islhd.health.nsw.gov.au/services-clinics/welcome-division-m…
Baby Steps
Baby steps supports women who have had gestational diabetes during pregnancy to make healthy choices. It is designed to empower women to implement lifestyle changes and to reduce the risk of type 2 diabetes. You do not need to be registered with the NDSS to join Baby Steps. Click here for more information https://www.ndss.com.au/services/support-programs/baby-steps/
After the birth of your baby
"Your health after Gestational Diabetes" provides a range of information to help you to stay healthy after pregnancy. Click here for more information https://www.ndss.com.au/about-diabetes/gestational-diabetes/after/
What to do with unused insulin
You should return any unused insulin to your pharmacy. Please ensure you remove all needles from insulin pens.
You may also be able to send your unused insulin to 'Insulin for Life'. Click here for more information https://insulinforlife.org.au/