Breakfast with gestational diabetes (GDM)
Have you been diagnosed with gestational diabetes (GDM) and are struggling to keep your blood glucose (sugar) levels under the target at breakfast time? You are not alone!
For women with GDM, what to eat at breakfast and varying blood glucose levels can be very confusing. You might have noticed that you have high levels after eating a certain meal at breakfast, but if you eat that exact same meal at lunch or dinner, then your levels are normal. How does that work?!
Let us look at why this happens and what you can do to manage it.
Why are my blood glucose levels higher after breakfast?
Morning hormonal fluctuations: Hormonal changes that occur during the early hours of the day can make it harder to control blood glucose levels. Our cortisol hormones tend to naturally peak in the morning, which can lead to increased insulin resistance. Insulin resistance means that the hormone insulin is not moving glucose out of your blood as well as it should, so you have higher blood glucose levels when you test.
Limited time for meal preparation: Busy mornings may lead to rushed meal choices and convenient but less nutritious food options. If you are feeling stressed in the morning while you try to get out the door on time, this could also be increasing your blood glucose levels.
Higher fasting blood glucose levels: If your fasting blood glucose levels (the test you take when you first wake up) are above the target range, then you are already starting the day a bit higher, which will push up your levels after breakfast. Although you don’t have a lot of control over your fasting blood glucose levels, speak to us about some tips and tricks that can make a difference for some women.
A whole lot of other random factors: Sometimes you get a high reading and there really is no explanation for it! This is normal as there are many other factors that can impact your blood glucose levels on any given day. Remember, the odd high reading can be normal and is not going to make or break your GDM management.
OK so now we know why they might be higher, but what can you do about it?
Top tips for managing high blood glucose levels after breakfast:
Balancing Carbohydrates: Carbohydrates directly influence blood glucose levels. Choose high fibre carbohydrates like multigrain bread (the denser with nuts and seeds, the better), quinoa or wholegrain oats. Some women have to eat their fruit separate to breakfast and keep it for snack times, as fruit also contains carbohydrates. Play around with this and see what works for you. Or you could use berries which are lower in carbohydrates. If using frozen berries, make sure you heat them first for food safety in pregnancy.
Incorporate protein. Protein helps stabilise blood glucose levels and keeps you feeling full for longer. Include high protein foods such as eggs, Greek yogurt, cottage cheese, peanut butter, nuts, seeds, tinned fish, tofu or legumes in your breakfast. Legumes also contain some carbohydrate, so you may need a smaller portion than usual if eating these nutritious beans with another carbohydrate food.
Healthy Fats: Healthy fats are great for overall health and can lower blood glucose levels. Avocados, nuts, seeds, extra virgin olive oil and oily fish like salmon (make sure it’s cooked for food safety in pregnancy) are excellent sources of healthy fats that can be incorporated into your breakfast.
You might need to ditch the cereal: Even when you choose a high fibre cereal like Weetbix or low sugar muesli and add a high protein food, your blood glucose may still go higher than the target. This is because the carbohydrate from these cereals tend to be released more quickly than other foods. Swapping cereal for some other breakfast options may help. See below for some other breakfast ideas.
Take a walk: A 10-15 minute walk after breakfast can make a big difference. That is because exercise helps glucose move out of your blood and into your muscle. Perhaps you could park your car that little bit further away from work in the morning. If you can’t fit a walk in, try to stay on your feet after eating as any type of movement will have some effect.
Give yourself time: If you are rushing and feeling stressed in the morning, getting up that little bit earlier might help with slowing down and not being as rushed. You could also try prepping your breakfast the night before.
Split your breakfast: If your blood glucose levels are still high after all the above, then you could try a ‘split breakfast’. This is where you have a smaller breakfast, for example 1 piece of toast, and then have a second small breakfast 1-2 hours later. Your second breakfast could be another piece of toast, or something else like a piece of fruit and yoghurt. This helps get around the tricky mornings, but you shouldn’t have to do this at other mealtimes.
Sometimes no matter what you try, your blood glucose levels are still above the target, and that is OK! It is not your fault when this happens. It is completely normal that some women cannot get their blood glucose levels to the target range with diet and exercise alone and might need medication to help them.
Should I just skip breakfast?
It is understandable that you might get frustrated with breakfast and consider skipping it all together. Or maybe you didn’t used to eat breakfast before you found out you had GDM, so why should you start now? When you are in the later stages of pregnancy, your body and your baby needs extra nutrition, and so you need to eat a bit more food than before you were pregnant.
Breakfast is a great opportunity to get extra protein, high fibre carbohydrate, healthy fats and vitamins and minerals that are essential for a healthy pregnancy. Skipping breakfast makes it harder to make up that extra nutrition later in the day, especially when you still have to be mindful of portions at other mealtimes. When we skip meals and get very hungry, we are more likely to overeat at other times in the day, which could lead to high blood glucose levels.
There is a fine balance between controlling your blood glucose levels and restricting your diet too much. Your diet needs to provide nourishment for you and your baby, and you don’t want to be feeling hungry for the rest of your pregnancy - that would not be fun! We can help you to balance controlling your blood glucose levels and making sure that you and your baby are getting enough nutrition. Our aim is always that you are still able to enjoy your diet.
Breakfast Ideas for Gestational Diabetes:
Here are a few breakfast ideas to get you started.
1. 2 pieces of multigrain toast with a topping such as nut butter, cream cheese, eggs and avocado. Add your favourite vegetables. You can’t go wrong with this quick and easy breakfast.
2. Chia Seed Pudding: Combine chia seeds with your choice of milk and let it sit overnight to thicken. In the morning, top it with a handful of sliced fruits, such as berries or a kiwi, a sprinkle of oats and a sprinkle of nuts for added texture and flavour.
3. Vegetable Omelette: Whip up an omelette with loads of colourful veggies like spinach, bell peppers, tomatoes, and mushrooms. Pair it with 1-2 slices of multigrain toast or a handful of roast potatoes (keep the skin on) or put it into a multigrain wrap.
4. Smoothie: Blend together 1 cup of your choice of milk , 1/2 cup of frozen fruit, a tablespoon of Greek yoghurt, and a tablespoon of nut butter or avocado for a creamy texture. You could also try adding some spinach leaves. Smoothies are a convenient option for busy mornings and can be customised to suit your taste preferences.
5. Quinoa Breakfast Bowl: Cook quinoa in your choice of milk with ½ small sliced banana. Add a dollop of nut butter, and a drizzle of sugar-free maple syrup. Aim for ½ - ¾ cup of cooked quinoa. Quinoa is a nutrient-dense whole grain that provides fibre and protein to keep you satisfied.
6. Greek Yoghurt Parfait: Layer Greek yoghurt with berries and a sprinkle of nuts or seeds and oats for crunch. Greek yoghurt is high in protein and low in sugar. Depending on your portion size, this could be a small breakfast so you should have something else to eat 1-2 hours later.
Hopefully this article has helped you to understand why blood glucose levels at breakfast can be hard to control, and what you can do about it.
We know that in different regions of New Zealand, when you are diagnosed with gestational diabetes, there is limited access to a publicly funded dietitian. Sometimes you may not get to see one at all!
At Nutrition for Women, we are highly experienced in helping women manage gestational diabetes with diet.
We offer a Gestational diabetes/Diabetes in pregnancy appointment bundle to support you through your pregnancy and after you have your baby. Visit our ‘Book an appointment’ page to learn more.