For many pregnant women, the term "morning sickness" is a misnomer because it lasts all day. Morning sickness generally occurs during weeks 6-14 weeks of pregnancy but some women experience symptoms beyond this time. While gestational diabetes is typically not diagnosed until later in pregnancy, it can still coincide with symptoms of nausea and vomiting.  It is that much more important to eat all of the complex carbohydrate foods you need to help keep your blood sugars in check while managing morning sickness.

Here are some quick tips that may help alleviate the symptoms:

• Eat a few crackers or a handful of dry cereal before you get out of bed
• Eat a small amount of food every 2-3 hours
• Drink fluids separately from eating and only take small sips
• Take your prenatal vitamin with food
• Avoid odors that make you nauseous
• Open a window or go outside to get fresh air
• Eat cold foods if the smell of food cooking bothers you
• Have someone else do the food preparation
• Avoid sudden movements, get out of bed slowly
• Try ginger or peppermint tea
• Eat foods high in protein before bedtime to keep your blood sugar stable all night

If you experience severe nausea, vomiting or weight loss consult your health care provider, you may have a serious condition called hyperemesis gravidarum which can require intravenous fluids or hospitalization. Do not take any medication that has not been approved or prescribed by your doctor.

Sample Meal Plan

Breakfast:

1 egg or 1/4 cup egg substitute
1 whole wheat english muffin with 1 teaspoon of butter or margarine
4-6 oz. cup light yogurt (such as Dannon Light & Fit or Stonyfield YoKids)
1 orange

Morning Snack:

1 cup unsweetened applesauce
1 mozzarella string cheese

Lunch:

2 slices whole wheat bread with 2 oz. lunchmeat*, 1 oz. cheese, 2 teaspoon mayonnaise, lettuce and tomato
1 apple
1 cup pretzels
1 cup raw carrots with 1 tablespoon lowfat ranch dressing

Afternoon Snack:

1/2 cup dry whole grain cereal mixed with 2 tablespoons raisins and 1/4 cup walnuts

Dinner:

4 oz. baked boneless, skinless, chicken breast
1 cup cooked whole wheat pasta with sautéed mushrooms, zucchini, bell peppers
2 cups green salad mix with 1 tablespoon salad dressing
1 cup skim milk

Bedtime Snack:

3 squares graham crackers with 1 tablespoon peanut butter
1/2 cup skim milk

Adapted from the American Dietetic Association meal planning guidelines

For additional meal plans see the 3 day Sample Menu at GestationalDiabetesMoms.org

*During pregnancy consuming deli meat can be a food safety risk due to unsafe handling practices. If you choose to include deli meat in your pregnancy diet, it is important to always heat it to steaming such as in the microwave prior to consuming.

You may have been given carbohydrate guidelines from your doctor or dietitian but are left wondering what this means? What does 30 grams of carbs look like in real food?!

Healthy snacking between meals can help to keep your blood sugar at a constant level throughout the day. In general, it is recommended to eat snacks during the day that contain around 15-20 grams and before going to bed have a 20-30 gram snack. At bedtime, be sure to eat something that includes both carbohydrate and protein to keep your blood sugar stable all night and prevent a hypoglycemic episode. If you find you need a larger snack between meals you can add in foods that naturally contain zero to little carbohydrate. These include a mozzarella string cheese stick, non-starchy vegetables (carrots, cucumbers, celery, bell peppers, etc.) with a low-fat dip, a quarter-cup portion of unsweetened nuts, or a piece of deli meat* rolled up with your favorite spread.

Here are some ideas for healthy daytime and bedtime snacks:

Daytime Snack Choices: (15-20 grams of carbohydrate)

• Small piece of fruit
• 1/2 cup unsweetened applesauce
• 3 cups popcorn
• 1 cup no-sugar-added pudding
• 6 ounces light yogurt
• Granola bar

Bedtime Snack Choices: (20-30 grams of carbohydrate plus protein)

• 3 graham cracker squares with peanut butter
• 1/2 sandwich on whole grain bread
• 1/2-1 cup unsweetened cereal with 1/2 cup lowfat milk
• 1/2 pita bread with 2 tablespoons hummus
• 1 medium piece of fruit with 1/2 cup cottage cheese
• 4-6 crackers with cheese

*During pregnancy consuming deli meat can be a food safety risk due to unsafe handling practices. If you choose to include deli meat in your pregnancy diet, it is important to always heat it to steaming such as in the microwave prior to consuming. See also: http://www.cdc.gov/ncbddd/pregnancy_gateway/infections-listeria.html

Remember the old food guide pyramid from health class?  Well, it has been updated and there is a special version for pregnancy that highlights the recommended serving sizes for each food group. The new guidelines include additional tips for whole grains, vegetables, discretionary calories and physical activity.  It can serve as a nice reminder and resource to ensure you eat the essentials for you and your growing baby.  The USDA's My Pyramid program can even customize a meal plan designed for your individual nutrition needs because it considers your pre-pregnancy weight, height, and activity level.

Here is the basic outline of the food pyramid during pregnancy:

Now in the case of gestational diabetes, you also need to take into account the recommendations for the amount and frequency of carbohydrate foods given to you by your health care provider or registered dietitian. Eating more whole grains and fruits as your carbohydrate sources are much better choices than white bread and cookies, right?  Remember that these healthy choices will help to keep your blood sugar stable throughout the day!

In May of 2009 the Institute of Medicine released new guidelines for weight gain during pregnancy, this it the first time the guidelines have been updated since 1990. In that time the incidence of overweight and obesity has increased dramatically in this country and more research has been completed related to the effects of increased weight gain on both mom and baby. The guidelines are based on Body Mass Index indicators or BMI which compare your individual proportion of weight and height. If you are unsure of your pre-pregnancy BMI category there are simple calculators online which will calculate your BMI for you.

The primary update from the guidelines is a decrease in the recommended amount of weight gain for pregnant women who fall into the "obese" category.

Another important point is that women should not be losing weight during pregnancy, despite the BMI category. You may experience a slight decrease in weight from nausea and vomiting caused by morning sickness but this should be a temporary occurrence and if the weight loss persists you may need medical intervention.

Many women justify liberal eating habits because they are "eating for two," however this can increase the risk for chronic overweight or obesity after the baby is born. Most women need to increase their caloric intake by only 200-300 calories each day which may mean just adding in one extra healthy snack between meals, not loading up on dessert! It is the equivalent of:

• 1/2 cup low-fat vanilla frozen yogurt with 1 cup fresh or frozen blueberries
• Whole grain english muffin with 2 slices of cheese or 1-2 tablespoons peanut butter
• Medium piece of fruit with 1/4 cup walnuts
• 10-12 carrot sticks with 3 tablespoon lowfat ranch dressing
• Whole grain tortilla rolled up with 3 slices of deli meat (heated to steaming!), lettuce and tomato

Slow and steady weight gain is the best, typically 1-4 pounds total in the first trimester then 0.5-1 pound each week in the second and third trimesters. If your weight increases or decreases in a short amount of time be sure to check with your health care provider.

Many parts of the country are currently experiencing snowy conditions and you may find it difficult to stay active during the winter months. But when you're pregnant and especially if you have gestational diabetes it is very important to get at least 30 minutes of daily exercise*.  Be sure to look for activities and instructors that are specifically focused on prenatal exercise.

Here are some ideas for indoor exercise:

• Head to the Mall. Bring a friend but leave your purse at home! Many shopping malls are open before the stores are to allow walkers to get in a few laps. Or, go when the stores are open to window shop but remember to keep up the pace. 
• Take Prenatal Yoga Class. The breathing techniques and postures of yoga can help you relax and as an added bonus help prepare your body for the work of labor and delivery (article from Babaycenter.com). 
• Watch Workout DVDs. Check your local library for prenatal workout videos that you can try for free or check websites like Metacafe or YouTube. 
• Find TV Walking Programs. Get your workout in without leaving your house. Check to see if your cable provider has an exercise channel or OnDemand type program. 
• Take a Prenatal Water Aerobics Class. Swimming is one of the best exercises you can do while your pregnant (article from The Journal of Perinatal Education). If you already comfortable in the water, it can really help keep you toned while not putting added strain on your joints and muscles.

*Always consult your health care provider before beginning any new exercise routine.

It’s 6:30. You haven’t eaten since lunch. And you’re hungry. Thankfully, your husband said he’d pick up dinner on his way home. But when he walks in the door with a super-sized value meal from a nearby drive-through restaurant, how can you hope to stick with your diabetes-friendly diet?

Here are some tips to help you modify that meal:

• Take half the bun off your burger and eat it open-faced.
• If you like, dress up your burger with lettuce, tomato, and onion from your fridge.
• Round out your meal with fresh vegetables or fruit from your fridge, like carrot and celery sticks, a cut-up apple, or some grapes.
• Drink water instead of soda.
• If the restaurant put packets of mayo or dipping sauce in the bag, skip it. The sauces, dressings, and dips from fast food restaurants are usually very high in calories and fat.
• Don’t add any extra salt to your meal; it’s already salty enough.
• Watch your portion size. A typical fast food meal can contain as much as 1,000 calories (or even more). You don’t have to eat it all—and probably shouldn’t! Share a meal with someone, save half for later, or throw half in the trash.
• Eat slowly, chew your food well, and enjoy every bite. Mindful eating actually helps you eat less and feel more satisfied. Try it, and you’ll see.

Next time hubby wants to get take-out on his way home from work, take a few minutes to check the nutritional information at your favorite restaurant’s website. There, you’ll find all the information you need to make the best choice for yourself—and your baby!

If you eat out frequently, it might be worth investing about $10 to purchase the American Diabetes Association’s paperback “Guide to Healthy Fast Food Eating.”

Approximately 15% of women with gestational diabetes mellitus (GDM) need to take insulin to manage their blood sugar. If you’re nervous about giving yourself insulin injections, you are not alone! Most women with GDM are very apprehensive about the prospect of self-administering insulin. Listen to what some moms-to-be like you had to say about the day they found out they’d have to go on insulin:

“I cried in the doctor’s office because I was so scared about giving myself injections.”

“I imagined that the needle would be huge and the injection would be painful.”

“I let myself get very worked up before I had all the facts. Turns out, the insulin pen is practically pain-free and is very easy to use.”

Whether your doctor prescribes an insulin pen, syringe insulin injections, or an insulin pump, you CAN do this! Here are some tips to help you overcome or cope with your fears.

• Ask your doctor to give you a saline injection with an insulin pen so that you can see (and feel!) for yourself what to expect.
• If you end up using insulin pens, you’ll be pleasantly surprised to learn that they’re tiny and don’t look like needles at all.
• Know that, because of your fears, the first few times you give yourself an injection will be the worst. Rest assured, each injection gets easier. Most likely, you’ll soon be a “pro” and wonder why you ever were so nervous about giving yourself insulin shots.
• Ask your husband or partner to give you your injections.
• If you just can’t overcome your fear of needles, ask your doctor about an insulin pump. Pumps are typically more expensive, but there are no needles to worry about. Read more about insulin pumps—advantages and disadvantages, as well as how to get started with an insulin pump—at the American Diabetes Association website.

Here are some additional resources for learning how to self-administer your insulin:

• Read these detailed instructions on how to give yourself insulin with a syringe.
• Watch a step-by-step video demonstration of how to use an insulin pen.

Artificial sweeteners are also known as non-nutritive sweeteners because while they taste very sweet like sugar, they do not contain significant amounts of calories and carbohydrates. They can be found in many foods or drinks labeled as "diet," "light," or "sugar-free." They can even be found in foods not typically labeled this way such as in different cereal, granola bars or yogurt. The good news is that consuming artificial sweeteners will not affect your blood sugar but you may be wondering, are they safe?

Here is what to look for on food and drink product labels:

The Food and Drug Administration (FDA) has approved use of these sweeteners in the general public including pregnant women. Women who have a condition called Phenylketonuria (PKU) should not consume products containing Aspartame. Many women choose to avoid or reduce the intake of saccharin during pregnancy.  While there is inconclusive evidence that it causes direct harm to the unborn baby, it does pass the placental barrier and early studies showed a potential risk for bladder cancers in animals.

You should also keep in mind that you if you are consuming a lot of these products in your daily diet, you may not be getting the nutrition that you and your growing baby need. For example, instead of snacking on sugar-free candy or drinking diet pop, it would be much healthier to choose carrot sticks or an apple.

GestationalDiabetesMoms.org is providing a free 4-pack of Glucerna Bars to first 50 new moms who join our message forum. We are working hard to be the best social network for women diagnosed with Gestational Diabetes. Our message forum is a key part of the community and we need your help in making it a valuable resource to all new moms! Our signup process is very simple with no cost involved. In return, we will mail you a FREE 4-pack of Glucerna Bars, a great snack alternative to help maintain your Gestational Diabetes diet.  Glucerna Bars come in one of 3 delicious flavors; Blueberry, Caramel Nut Chewy, or Chocolate Carmel Chewy.

By joining our community and participating in our message forum, you are helping to educate and comfort moms just like yourself that have been diagnosed with Gestational Diabetes. This rare form of diabetes only occurs in about 5% of all pregnancies and there are not many firsthand accounts of how to treat and cope with this diagnosis. By sharing your story and questions with others, you will be a part of the first web community solely dedicated to Gestational Diabetes. Be assured that if you have questions about Gestational Diabetes or healthy steps you can take to prevent it, your questions will find answers in our message forum. You will see relevant answers not only from other women, but also from our own in house team of professionals, including both registered nurses and dieticians.

We know that adding complications like Diabetes to pregnancy is an additional stress in a time already filled with many new challenges and experiences. If you have been diagnosed with Gestational Diabetes one of the best things you can do to help yourself is improve your diet. In an effort to get you started, we are providing you with a nutritional bar specifically for pregnant women with Gestational Diabetes. The Glucerna Bar is a wonderful way to get the right nutrients and calories needed by pregnant women with diabetes. It is our way of saying thanks for joining and we look forward to hearing from you in our message forum!