Diabetes and pregnancy: Inpatient menu guidance

Aim: to provide catering information for inpatients with diabetes in pregnancy

Introduction: carbohydrates and meal delivery

As you have already experienced it is the carbohydrate foods in your diet that affect your blood glucose (sugar) levels the most (for example bread, rice, pasta, potatoes, cereal, fruit, yoghurt, milk). By being careful with the type and quantity of carbohydrate that you eat, you can help to keep your blood glucose levels within the target range for pregnancy. Whilst in hospital you may be less active than normal, you may have increased stress levels and you may be offered foods that you wouldn’t choose to eat at home. All of which are likely to affect your glucose levels. It is important to continue to avoid refined forms of carbohydrate and choose higher fibre options, in the quantities that the dietitian has advised, as much as you are able. Other information leaflets are available which give more detail about diet and lifestyle choices; if you have not already received one of these they are obtainable from your diabetes specialist midwife or ward dietitian.

The information in this leaflet will help you to make the best food choices from the menu on the ward. Please be aware that whilst the menus are designed to meet the needs of as many patients as possible it is likely that there will be days where there will be limited choice for you if you are following a gestational diabetes diet.

Whilst you are an inpatient on the ward, if you have any questions at all please ask to be referred to the ward dietitian.

Typical breakfast options served 08:00 to 09:00

• Natural yoghurt with a piece of fruit.
• Muller Light yoghurt with a piece of fruit.
• Alpro soya dairy free yoghurt (this will need to be ordered from the Special Diet Menu 24 hours in advance) with a piece of fruit.
• The ‘all day breakfast with bacon’ is available as a missed meal and will need to be ordered ahead of time, please discuss this with the ward housekeeper. To enable this meal to help keep your post meal blood glucose reading in target it is beneficial to have one slice of wholemeal bread or toast rather than the sauté potatoes included in the dish and it is helpful to avoid as much of the bean sauce as possible because it contains a lot of sugar.
• Wholemeal toast with a cold protein topping (some will be available in the dining room fridge or might need to be ordered from the Special Diet Menu) such as a boiled egg, cheese portion, cold meat or fish.

Snacks and drinks

Additional drinks and snacks are available 24 hours a day from the ward kitchen or your dining area on the ward. Available snacks include fresh fruit, wholemeal bread and toast, yoghurts, cheese, oat crackers and digestive biscuits. Please make sensible choices when snacking; think about the type, portion and timing of carbohydrate as advised by your diabetes team. If suitable snacks are not available please let the staff know who are caring for you to highlight any missing items that need to be ordered.

Lunch is served 12:00 to 13:00 and supper is served 17:00 to 18:00

The hospital runs predominantly on a two-week menu cycle and a picture menu in A4 format will be provided before each meal to show you the choices available for you at your next meal. You can ask your housekeeper to see tomorrow’s menu in advance to help with menu planning. If you are unable to find anything that is suitable from that days or the next day’s menu please ask for a copy of the Special Diet Menu. However, where possible please choose from the main menus available, thank you.

Main meal options at lunch and supper

• When choosing your lunch or evening meal from the A4 picture menu please consider if your main course contains carbohydrate such as a pie with a mash potato topping and please avoid choosing a second carbohydrate option such as rice or boiled potatoes. Please consider adding vegetables or salad instead to help balance your meal choice.
• If your choice for your main course does not contain any carbohydrate such as a cold meat option then please consider adding one choice of carbohydrate, for example the pasta and vegetable salad.
• When considering your one choice of carbohydrate at each meal it is helpful to consider portions as you would at home and think about your plate in thirds:

1. 1/3 single choice of carbohydrate
2. 1/3 vegetables / salad
3. 1/3 protein choices (meat, fish, eggs or vegetarian alternatives)

• Some examples of carbohydrate portions that work well at lunch and supper:
• 2 slices of wholemeal bread
• 4 cooked tablespoons of rice/ pasta/ mashed potato
• 4 egg-sized boiled potatoes
• 1 small fist-sized jacket potato

Below are some examples of the better carbohydrate choices available at lunch and supper:

Here are some examples of the less suitable carbohydrate choices available at lunch and supper:

• At each lunch you will find vegetables and/or salad options available to help balance your meal.
• The supper options are more limited but there will be at least one wholemeal bread sandwich option available each day.
• When choosing your one carbohydrate from the menu we have found that the diced, chipped, roast potatoes or sauté potatoes have not worked as well as suitable portions of the rice, pasta, potato salad or mashed potato.
• In addition the pastries, dumplings and breaded foods are likely to be less successful at achieving in-target blood glucose readings after your meal and are therefore best avoided. For some women this might mean removing those parts, for example removing the dumplings or peeling off the breadcrumbs. For others there might be another option from the menu for you to enjoy that day.
• If you have an above target blood glucose reading following a meal please consider making a note of what you ate so that you are aware of that choice not working so well for you and please consider discussing this with the diabetes team.

Pudding ideas

• At each lunch and supper puddings are offered however most are unfortunately unsuitable.
• The best options would be fruit in juice (with the juice drained off) with the option of single cream to taste. However, this might result in an above target blood glucose reading post meal if eaten straight after your main meal and therefore can be saved to have an hour or two later.
• Alternative puddings available that you can request include a piece of fruit, a Muller Light yoghurt, a natural yoghurt or sugar-free jelly. The sugar-free jelly is an option to have closer to your meal if you desire a sweet treat sooner.
• To help keep your one hour post-meal blood glucose reading in-target it would be helpful to hold off having your dessert until after your reading and potentially as a snack at two hours after the meal to help spread the load of carbohydrate for your body to use.

Special Diet Menu

If you find that you are unable to find anything from the main menus please request a Special Diet Menu from the ward housekeeper and ask to be referred to the ward dietitian for additional support. To order from this menu you will need to have a copy of the next day’s menu to add your request to the back page at the bottom. These requests tend to take 24 hours.

Alternative menus

The hospital aims to cater for patients who need a certain diet because of religious beliefs or lifestyle choices. We offer separate a la carte Halal, Kosher and Vegan menus. Please ask a member of staff if you require one of these menus.