I am now in my 19th week of pregnancy and have gotten a few requests from people asking what I eat and how I maintain tight blood sugar control as a pregnant woman with Type 1 diabetes. It’s pretty simple really; I eat almost the same exact thing every day. My High Risk OB/GYN explained it to me it mathematical terms, which I can appreciate, being and engineer: trying to control blood sugars in pregnancy is based on several variables:
- Insulin dosing
- Other hormones floating around in our bodies
- Stress Level
- Activity level (am I sitting at my desk all day or did I just run 3 miles?
As anyone with Type 1 diabetes knows, trying to juggle those 4 variables and maintain tight blood sugar control, feels impossible at times. And diabetes has no days off, remember that. It is 24/7 every day of your life.
Pregnancy introduces another factor:
5. Growing a human & a placenta and all the hormones that go with that process (lots of hormones!)
I said to my high risk OB, “Ok so 5 variables, I get it.” He then said he needed me to eat the same amount of carbohydrates at every meal and stop using my bolus wizard.
**(For my non-diabetes readers a bolus wizard is a feature on the insulin pump that makes it easy for a person with diabetes to calculate how much insulin to give for any food amount. All you have to do is type in the amount of carbohydrates in your food and it gives you the amount to take using preprogrammed insulin to carbohydrate ratios. For example, one unit of insulin to every 15 grams of carbohydrate. If I ate 60 grams of carbohydrate the bolus wizard would calculate 3 units)**
“Why?” I really value my freedom to eat however little or many carbs I want.
“By keeping your insulin dosing and food this same we reduce your variables….exponentially”
He explained that eating whatever I wanted would make my tight sugar control exponentially harder to get and maintain. So I conceded.
So what do I eat now?
-30 carbs for breakfast
-40 carbs for lunch
-40 carbs for dinner
- interspersed with 15-20g of carbohydrate snacks in the evening and afternoon
For breakfast I eat 2 Eggo Nutrigrain blueberry waffles with peanut butter. I usually smash them together and eat them like a sandwich. Very tasty. On the weekends I have 2 pieces of French Toast made from Oroweat Honey Oat bread with sugarfree syrup. If I am going for a morning run I’ll have 3 pieces but do the same bolus as I would with 2 pieces do to the exercise factor.
For lunch I have a big salad. I mix spinach, cheddar cheese, croutons, chick peas, and fat free italian dressing. It’s very filling and also delicious. I love cheese. Sometimes I will have soup or cous cous too.
For dinner, our go-to meal is cous cous and breakfast sausages. I put a dollop of Greek yogurt on my cous cous because I love Greek yogurt and it’s delicious. We don’t get bored of this meal because there are so many kinds of cous cous at our store. We love them all but particularly enjoy the Mediterranean curry. If you make the whole box, it is 3 servings of 40 g of carbohydrate. I eat one serving, my husband eats one and the third is either leftovers or my husband’s midnight snack 😉
We have also started grilling a lot as it gets nicer. I have been craving cheeseburgers, and if I eat 2 I am super full. The hamburger buns I get are 18 g of carb a piece, so that works out well.
If I am still hungry after dinner I will make myself a scrambled egg or eat a pickle or a spoonful of peanut butter. But I am rarely hungry. Eating low carb makes you feel so full and satiated all the time.
For snacks I eat a lot of string cheese or cottage cheese. Cottage cheese is so low carb. You can eat an entire cup of cottage cheese for 10g of carb. Have you ever eaten an entire cup of cottage cheese? It is a lot. As far as real carbs go, I eat a lot of apples and clementines for snacks.
I try to stick to this plan 90% of the time, but I am only human. Sometimes on the weekends we will get Thai food (the only takeout I have somehow managed to master my blood sugars on) and I will get Basil Fried Rice. I know it is about 85 carbs which is close to double my dinner carb intake, so I double my dose and end up 2 hours later at 130, which isn’t terrible.
This sounds simple but it’s takes a lot of willpower to stick to a regimented food plan, especially while pregnant. And you have to remember, despite all the food efforts, it is STILL a variable. If I follow the food and insulin dosing plans perfectly, one day I may do great at my blood sugars, the next may be a total failure. It’s tough to take that when you give your best efforts every day. You also have to keep in mind, in pregnancy your body is constantly changing, so insulin needs change every 2-3 days. I sometimes talk to my High Risk OB/Gyn team three times a week.
I try to give myself a break as much as possible. I won’t survive this pregnancy if I feel guilty every time my blood sugar is too high or too low, because that is almost daily. I need to keep pivoting dosing but keep my eating regiment the same. AND I need to remember, I’m doing great. An A1C of 6.5 or less is recommended for Type 1 women in pregnancy and I just got mine back last week. It is 5.7. So I’d say my broken down pancreas wins the battle sometimes, but I’m the one winning the war.