Diabetes and Pregnancy: Diabetes and Pakistani diet

Introduction

What are carbohydrates and how do they affect my diabetes?

Carbohydrates are a nutrient and an important source of energy in the diet. All carbohydrates are broken down into glucose (sugar), which is used by the body as fuel. In people with diabetes the blood glucose levels become raised as the insulin produced by the pancreas doesn’t meet the demands of pregnancy due to insulin resistance.

Why are carbohydrates important?

Since all carbohydrates are broken down into glucose, some people with diabetes may wonder if it would be better if they avoid eating carbohydrate completely. This is not recommended due to reasons listed below:

play an important role in the gut health

Which foods contain carbohydrate?

1. Foods containing starchy carbohydrate
2. Foods containing natural sugar
3. Foods containing added sugar

This booklet will provide you with a list of foods and the amount of carbohydrates that is culturally appropriate for the Bangladeshi community in the United Kingdom.

High fibre, unrefined and unprocessed carbohydrates work best to keep blood glucose levels in target after meals.

The list will be categorised as:

a) Breads

b) Rice, grains and pasta

c) Flours

d) Pulses

e) Starchy carbohydrates and tubers

f) Fruits

g) Dairy products

h) Desserts and sweets

i) Snacks

j) Drinks

What is carbohydrate awareness and carbohydrate counting?

Carbohydrate awareness and carbohydrate counting is having the knowledge to identify carbohydrates in the diet and quantify them. This will help you to know the amount of carbohydrates to include daily during pregnancy.

Example meal plan

It is beneficial to only have one type of carbohydrate at a time.

Split breakfast (it is helpful to leave 2 hours (120 minutes) between carbohydrates)

7-8am have small pot yogurt with cup berries sprinkled with mixed seeds

9-10am have 1 x small wholemeal chapati with meat or vegetable curry

Mid-day meal

1 x medium or 2 x small wholemeal chapati with meat or vegetable curry

Or soup and wholemeal roll

1.5 - 2 hours (90-120 minutes) later have fruit or yogurt

Evening meal

4 x egg sized potatoes or 4 x tablespoon cooked rice, pasta or grains. Generous portion of protein and plenty of vegetables or salad.

1.5 - 2 hours (90-120 minutes) later have fruit or yogurt

Snacks

Carbohydrate free snacks can be eaten at any time. It is best to have one carbohydrate containing snack between meals.

We would recommend not to consume any carbohydrates after 19h30.

If hungry choose a carbohydrate free snack.

Breads

Choose high fibre breads: Whole-wheat, granary, multi-grain and oat enriched. Chapattis with wholemeal flour. Freezing bread can help lower the glucose response.

Rice, grains and pasta

It is best to choose basmati rice but brown rice and whole-wheat pasta will also give benefit. Cooling rice and pasta after cooking and then eating cold or re-heating fully can lower the glucose response.

Flours

Choose whole meal flour where possible.

*Maida flour and potato starch would not be recommended as can lead to high blood glucose levels.

Starchy carbohydrates and tubers

Home cooked potato is best. Cooling potato after cooking and then eating cold or re-heating fully can lower the glucose response.

Fruits

It is best to avoid over ripe fruit as they can have a greater impact on blood glucose levels.

*These fruits would not be recommended as can lead to high blood glucose

Dairy products

Hard pasteurised cheese can be eaten as a snack. It will have no impact on blood glucose levels as carbohydrate free.

Desserts and sweets

These foods will all cause a rapid rise in blood glucose levels. We suggest you limit these to celebrations rather than enjoy daily.

To enjoy something sweet you can choose a piece of fruit, sugar free jelly or 2-3 squares of dark chocolate 70% or above.

Snacks

Processed snacks made with white flour will have a greater impact on blood glucose levels and make it harder to achieve glucose targets. Aim for 5-15g carbohydrate in snacks.

Carbohydrate free snacks

These have little or no impact on blood glucose and can be enjoyed at any time of day.

• Antipasti – sun blushed tomatoes, roasted vegetables (such as peppers and courgettes)
• Avacado
• Cheese cubes (ensure pasteurised and avoid mould-ripened soft cheese
• Cocktail sausages
• Cold meats (avoid all pâte, deli meats and ensure well cooked)
• Cooked fish such as sliced salmon, mackerel, prawns and seafood sticks
• Eggs (avoid undercooked or raw eggs without the Lion Code)
• Grilled asparagus wrapped in cooked ham
• Grilled mushrooms with cheese (or other spreads or dips inside)
• Lettuce roll-ups with cooked meat, bacon, egg, tuna, cream cheese or another filling
• Lettuce roll-ups with cooked meat, bacon, egg, tuna, cream cheese or another filling
• Vegetable sticks – carrots, celery, cucumber, peppers. Can be served alone or with a dip
• Olives
• Pickled onions or gherkins
• Quorn slices
• Salad (thoroughly washed)
• Seeds
• Small corn on the cob
• Sugar free jelly
• Sugar free lollies (homemade or bought)
• Tofu (without the sugar rich marinates such as Hoisin)
• Tomatoes (cherry, plum or salad tomatoes)
• Tuna and sweetcorn with shop-bought mayonnaise (limit tuna to 4 medium-sized cans per week)
• Dip ideas - cream cheese, salsa, cottage cheese, guacamole, hummus, nut butters (no sugar added), shop bought mayonnaise, sour cream

Carbohydrate-containing snacks

These are best eaten 1.5-2 hours after breakfast and 1.5-2 hours after lunch

• A cup of berries with or without a spoon of Crème Fraiche (when made with frozen fruit can be an enjoyable substitute for ice cream)
• 1 small apple
• 1 small banana (fun size/kid size)
• 1-2 clementines
• 10-12 grapes
• 1 peach
• 1 nectarine
• 1 pear
• 1 orange
• 1 kiwi
• 70% dark chocolate 1 larger square or 3 smaller squares
• 3 - 4 plums
• 2 oat cakes
• 2 whole-wheat crackers
• 1 slice of wholemeal bread
• 1-2 plain digestive biscuits
• 1-2 plain hobnobs
• No added sugar Angel Delight®
• 1 small glass of pasteurised milk
• 1 small glass of oat milk
• 1 yoghurt (14g of less total carbohydrate)
• Small bag of crisps (Kettle or Walker best as cut from the potatoes)

Drinks

It is best to avoid drinks that contain sugar and instead enjoy water, sugar-free or diet options. Ideally fruit juice should be limited to hypoglycaemia treatment.

It is important to limit caffeinated drinks such as tea and coffee to 1-2 cups per day.

Scan the QR code to access a Urdu-language video on gestational diabetes.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device. More information is available on the MyChart section on our website.

Contacts/further Information

• Dr Sadia Nasir

References/sources of evidence

Correia, A., Bangladeshi carbohydrate reference list: A practical way to count carbohydrates. Newham Challenge Project.