Fact sheetDiet specifications

Published on 1 Oct 2016 ; Partial revision Apr 2021


Diabetes diet - diabetes in pregnancy

This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.

Aim

To provide a nutritionally adequate diet that optimises blood glucose and gestational weight gain in pregnant women with diabetes.

Characteristics

The usual goals of treatment for diabetes in pregnancy include tighter blood glucose targets with less fluctuation than the goals for non-pregnant women.

Moderate energy, with 40-50% energy from carbohydrate and < 10% energy from saturated fat, total fat 30-35% energy. Includes one low glycaemic-index (GI) food (GI≤55) at each meal and snack. Ensures a set level of carbohydrate at each meal and mid-meal (30-45g per main meal and 30g per mid-meal). Added refined sugars are to be minimised to ensure nutrient density.

All foods need to comply with NSW Food Authority guidelines on food safety in pregnancy. Fish offered must comply with Food Standards Australia New Zealand guidelines on mercury in pregnancy

Indications

Pregnant women with Type 1, Type 2 and Gestational Diabetes Mellitus. This diet is for use where strict carbohydrate portion control is specified.

Nutritional adequacy

Nutritionally inadequate.

Precautions

It is appropriate to serve patients with diabetes from regular unrestricted menus, with consistent amounts of carbohydrate at meals and snacks. Special sugar-free foods are not required but artificially sweetened foods and beverages are allowable in modest amounts.

The energy level and carbohydrate distribution may be individually determined by the dietitian, but a typical meal plan would include the following number of 15g carbohydrate portions per meal.

Meal 15 portions per meal
Breakfast 2.5
Morning tea 2
Lunch 3
Afternoon tea 2
Dinner 3
Supper 2

Compared to other diets for diabetes, there is not a range of carbohydrate portions allowed. This is to avoid inconsistency day to day.

Default mid-meals should provide two carbohydrate portions (e.g. full sandwich or fruit and yoghurt) and be nutrient dense with particular reference to calcium.

Paediatrics

Generally not suitable for use in paediatrics. May be suitable for adolescents under dietetic supervision.

Specific menu planning guidelines

 Allowed Not allowed
Hot main dishes

Main dishes ≤15g fat, ≤5g saturated fat and ≤30g carbohydrate per serve

Lean meat, skinless chicken, fish, eggs (thoroughly cooked)

Soy products, e.g. tofu, textured vegetable protein (TVP)

Cooked legumes

Low-mercury fish, e.g. canned tuna and salmon

Dishes with added soft cheese (e.g. ricotta / fetta) are allowed if cooked

Main dishes >15g fat, >5g saturated fat and >30g

Carbohydrate per serve

Fatty meat (e.g. bacon, sausages, hamburger mince), offal

Deep-fried and shallow fried meals

Shark (flake), billfish (broadbill, swordfish, marlin), orange roughy (deep sea perch), catfish

Sauces, gravies

Gravies and sauces with <1.5g fat and <5g carbohydrate per serve

Cranberry and mint sauces in small amounts

Cream-based sauces

Gravies and sauces with >1.5g fat and >5g carbohydrate per serve

Starchy vegetables / pasta / rice

All dishes with <1.5g saturated fat per serve

Dishes prepared without added fat, or made with small amounts of mono or polyunsaturated oil (e.g. mashed and steamed potato, sweet potato)

Use low-GI rice (e.g. basmati or doongara) if possible (see GI website for full list)

Dishes with >1.5g saturated fat per serve

Fried or roasted vegetables with added saturated fat

Vegetables

All vegetables* <1.0g saturated fat per serve

Vegetables prepared without added fat (e.g. plain steamed or boiled), or made with small amounts of mono or polyunsaturated oil

Dishes with >1.0g saturated fat per serve
Soups Low-fat soups (≤5g fat and ≤1.5g saturated fat per serve) Soups with >5g fat and >1.5g saturated fat per serve
Sandwiches

≤15g fat and ≤5g saturated fat per serve

Made with monounsaturated or polyunsaturated margarine

Sandwiches using allowed fillings including pasteurised meats (i.e. sous vide or cooked in bag and sliced are acceptable with correct food hygiene practices)

Canned fish, hard cheese

Thoroughly cooked eggs

Butter

Cold processed meats (e.g. ham, salami, chicken) (unless pasteurised)

Smoked salmon

Soft and semi-soft cheese (e.g. brie, camembert, ricotta)

Pâté

Sprouted seeds (e.g. alfalfa)

Salads, dressings

All salads* ≤15g fat and ≤5g saturated fat per serve (including the dressing)

Low-joule dressings, or dressings made with mono or polyunsaturated oils are preferred

All salads >15g fat and >5g saturated fat per serves (including the dressing)

Sprouted seeds (e.g. alfalfa)

Breads, cereals

Wholegrain / wholemeal breads (preferably grainy low-GI breads)

White bread may also be available

Breakfast cereals containing <23g carbohydrate per serve

Higher-fibre breakfast cereals only (>3g/serve, e.g. rolled oats, muesli, bran cereals, Guardian®)

At least two low-GI cereal choices per breakfast (see GI website for full list)

Sweet breads and pastries e.g. croissants

Highly sugared breakfast cereals (>30% sugar, unless primarily from added fruit)

Breakfast cereals containing >23g carbohydrate per serve and <3g fibre per serve

Spreads

Yeast spread, peanut butter

Monounsaturated and polyunsaturated margarines

Jam, honey and sweet spreads

Saturated fats (e.g. butter, cooking margarine,)

Pâté

Hot breakfast choices

Any item containing <20g carbohydrate and <3g saturated fat per serve

Hard boiled or hard poached egg

Scrambled egg

Mushrooms, baked beans, tomatoes

Any item containing more than 20g carbohydrate and 3g saturated fat per serve

Fried egg, bacon, sausages

Hash browns

Pancakes, hotcakes and waffles

Canned spaghetti

Fruit

Unsweetened fresh*, frozen or canned fruit in natural juice

Dried fruit if <15g carbohydrate per serve

Canned fruit in syrup

Fruits that cannot be readily sanitised to reduce pathogen load e.g. strawberries and rockmelon

Yoghurt Yoghurts with <5g saturated fat and <30g carbohydrate per serve Yoghurts with >5g saturated fat and >30g carbohydrate per serve
Desserts Desserts with ≤2g saturated fat and ≤30g carbohydrate per serve

Full-fat ice-cream

High-fat and sugar pastries and pies

Soft serve ice cream

Desserts containing >2g saturated fat and >30g carbohydrate per serve

Milk and cheese

All unsweetened milks and calcium-fortified milk alternatives (e.g. soy or nut beverages)

Hard cheese <5g fat per serve

Pasteurised cottage cheese

Grain derived milk alternatives (e.g. rice or oat beverages)

Flavoured milk drinks

Cheese spreads, soft and semi-soft cheese (e.g. ricotta, brie, camembert)

Unpasteurised dairy products

Beverages

Water, tea, coffee, low-joule soft drinks or cordial, plain mineral water

All unsweetened milks and calcium-fortified milk alternatives (e.g. soy or nut beverages)

Fruit juice with no added sugar (1 serve per day)

Regular soft drinks and cordial, flavoured mineral water, alcoholic drinks

Flavoured milk drinks

Grain derived milk alternatives (e.g. rice or oat beverages)

Biscuits

Plain low-fat biscuits and crackers with ≤2g saturated fat per serve (e.g. Granita™, Shredded Wheatmeal™, Milk Coffee™, Milk Arrowroot™)

Muesli bars (less than 2g sat fat and 30g carbohydrate per serve)

Biscuits and crackers with >2g sat fat per serve e.g. Cream or chocolate biscuits
Miscellaneous

Herbs and spices if cooked or appropriately sanitised

Nuts Artificial sweeteners, pepper, salt

Cream, sugar

Potato crisps, chocolate

Milo™ and malted milk powders

Celebratory Foods/
Special Occasions

20g chocolate easter eggs on Easter Sunday

References

  1. American Diabetes Association Guide to Nutrition Therapy for Diabetes; Second edition, 2012
  2. American Diabetes Association. Planning meals. [accessed 26 August 2015].
  3. Glycemic Index Foundation, University of Sydney. The GI Index and GI database. [accessed 26 August 2015].
  4. Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
  5. Dietitians Association of Australia. Evidence based practice guidelines for the nutritional management of type 2 diabetes mellitus for adults. Canberra: DAA; 2006.
  6. NSW Food Authority. Pregnancy and food safety. [accessed 26 August 2015].

Change log

Change date Section updatedChange
April 2021 Title of Specification Title changed from Diabetic diet - diabetes in pregnancy to Diabetes diets - diabetes in pregnancy
September 2022 Specific menu planning guidelines Created a new food group row under Miscellaneous, titled Celebratory Foods / Special Occasions
September 2022 Specific menu planning guidelines -
Celebratory Foods / Special Occasions
In Allowed, added 20g chocolate easter eggs on Easter Sunday
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