Breakfast cereal AKA 'GD kryptonite'!
The majority of dietitians and hospital dietary info. will suggest a suitable diabetic breakfast being breakfast cereal such as Weetabix, Bran flakes, All Bran, Shreddies, Shredded Wheat, Granola, No added sugar Muesli, or porridge oats.
High fibre and low in fat, covered with a helping of lactose (milk) and sometimes they like to advise to add a helping of fructose (fruit) on top too.... so a high carb cereal covered in carbs and more carbs.
We have learnt through experience that it is very rare for ladies to be able to tolerate these cereals throughout a pregnancy when diagnosed with gestational diabetes.
Many will be able to tolerate them earlier in pregnancy, when insulin resistance has not yet peaked. Then as the pregnancy progresses and insulin resistance increases, overnight, a cereal which was once tolerated often raises levels very high (spikes), usually into double figures, hence we named breakfast cereal GD kryptonite!
Sometimes ladies are able to move onto things like porridge oats which are low GI, but for many all cereals become an intolerable food which has to be forgotten until baby is born. For this reason, cereal becomes a craving food for many ladies with gestational diabetes.
We see many ladies being told that they should be able to tolerate cereal and that they should continue to try and ultimately this results in them being medicated, or doses of medication or insulin being increased in order to control the sugar hit from the cereals.
If it's not broken then you don't need to fix it!
If breakfast cereal works for you then that's great. Don't stop eating it if it is not causing you any problems, but eat it in the knowledge that tolerance to it can change (literally overnight) and please be careful if advising others with gestational diabetes that it is a 'tolerable food' as for many it is very tricky to tolerate.
Beware of potentially misleading products
Recently we have seen many new breakfast cereals come to the market which are boasting to be lower in sugar or higher in protein.
We have tried and tested many of these cereals and still have not found one that more than a handful of ladies have continual success with unfortunately.
I promise I will tell you if we find a cereal that works!
If we come across a cereal that a good majority can tolerate well, then I promise I will shout it from the rooftops as I know how hard it is for those that can't tolerate cereal and desperately crave it.
Breakfast cereal is a great quick and easy breakfast and people in the UK LOVE it! It is a great source of fibre and iron for many who are used to eating it, aiding the digestive system. Many ladies that are suffering from sickness find it a good thing to be able to eat. So I honestly do understand all the reasons behind wanting to eat cereal.
Some members believe Gestational Diabetes UK's Facebook admin team are anti-cereal, or are against it...
The only reason for being 'against' cereal is the impact we see it has on our own blood sugar levels and on hundreds of members. Some ladies will be able to tolerate it, just like some will be able to tolerate fruit, whilst another lady will struggle. With breakfast cereal there is a high majority who struggle with it and when it becomes a struggle, levels can hit the teens. For this reason we try to advocate breakfast options which we believe are much more safer, tolerable and better for lowering and stabilising blood sugar levels.
Missing the spike?
The other big concern with breakfast cereals is that they spike blood sugar levels very quickly and so those that only test pre-meal levels or 2 hours after eating will miss the big rise in blood sugar levels.
Following a big spike in levels, you can also get crashes in blood sugars. This may make those only testing at 2 hours or pre-meals believe that things are tolerable.
For further information on testing blood sugar levels and our thoughts around testing to check for spikes, please see this page.
What to do about breakfast cereal?
Our advice is if you want to try breakfast cereal, to try a sensible option, (i.e. not sugar puffs or crunchy nut cornflakes, but something like Shredded wheat, Weetabix, Lizi's Low GI granola e.t.c.), add things like nuts and seeds to increase protein and natural fats, but if you don't tolerate it, give porridge a try.
You can tweak porridge to make it more suitable by adding nuts, seeds or cream to help increase the protein and natural fats. If you are unsure on how well you tolerate lactose, then a milk test is a good idea (explained on here) and depending on the result you may get better results from a milk alternative or try making porridge with water instead.
The porridge from most shops are rolled oats, but there is a better form of porridge which gives lower blood sugar levels called pinhead porridge which is steel cut rather than 'rolled' and is the wholegrain with the outer husk removed. These links show Hamlyns Pinhead Oatmeal and Goodness Pinhead Oats which can be bought online.
If you still get high readings from porridge then it is advisable to keep breakfast cereals locked in the cupboard and step away from them. Add them to the list of post GD treats to have once your baby has been born.
You are not unusual if you cannot tolerate breakfast cereal
This is from a survey held in our Gestational Diabetes UK Mums and Life After GD UK Facebook support groups Autumn 2016.
916 women answered:
- 73% (666) could NOT tolerate ANY breakfast cereals, including porridge
- 12% (107) could tolerate only porridge or porridge oats, but no other breakfast cereals
- 6% (61) could NOT tolerate cereal after around 32 weeks gestation (between 32 - 36 weeks insulin resistance worsens)
- 9% (82) could tolerate some breakfast cereals throughout their pregnancy
Which shows a staggering 91% of women with gestational diabetes in this survey could not tolerate breakfast cereals suggested by their dietitian such as bran flakes, Weetabix or porridge.
Breakfast - the worst meal of the day to control
Due to natural raises in blood sugar levels at dawn (the dawn phenomenon), we are more insulin resistant at the start of the day. This means that out of all the meals we eat, breakfast is the hardest meal to try to keep within our targets. Because of this it is also extremely important to always eat breakfast to help stabilise your blood sugar levels for the rest of the day.
This occurs when the body releases hormones in the early hours of the morning (hence the 'dawn') in all people, diabetic and non-diabetic. These hormones (including cortisol, glucagon, epinephrine and growth hormone) cause blood sugar levels to rise, giving the body a boost and wake up call to start the day. This can happen anywhere between 3am and 8am.
In diabetics not enough insulin is produced, or insulin is not able to be used effectively in order to process this boost in glucose, resulting in high fasting levels. For more information on high fasting levels please read here.
It is extremely important to try to eat breakfast as soon as you can after waking. This helps to stabilise levels for the rest of the day.
The key to a good GD breakfast - protein, fat and planning!
The best tolerated breakfasts are high in protein. As many ladies struggle with increased insulin resistance in the mornings, breakfast has to be adapted so that it contains only small amounts of complex starchy unrefined carbs, or the breakfast has to be split in two i.e. one piece of toast is eaten, wait for an hour and test levels and then a second piece of toast can be eaten (paired with protein and good natural fats of course). This makes the carbs easier for the body to process, eating little and often and not requiring as much insulin to process the sugars. In some cases the starchy carbs have to be removed from breakfast completely.
The more protein and natural fat added into breakfast is extremely beneficial, albeit inconvenient for some. Planning breakfasts and preparing them the day or night before may be necessary if you do not have time to cook breakfasts in the morning.
Boring breakfasts... "how do you like your eggs in the morning?"
Unfortunately, due to the increased insulin resistance, ladies often find a 'safe' breakfast that they get good numbers from. When trying different things they may struggle to tolerate them and therefore they may end up eating the same breakfast repeatedly for many weeks or months.
Keep your eyes on the prize and remember this is not forever. You may feel like you are going to turn into a chicken if you eat another egg, but it will be worth it when you're holding your baby in your arms!
Information on eggs. Dippy or runny eggs? Look for the Lion stamp...
There is varied information given regarding eating eggs during pregnancy. Eggs (as long as you have no allergies) will become your best friend whilst having gestational diabetes! They have many vitamins, minerals and heart healthy fats. Most importantly they are high in protein and therefore become a food that will be tolerable for your blood sugars and will actually help keep levels lowered and stabilised. The majority of good GD breakfasts include eggs in one form or another and they are a good tool for food pairing.
Egg safety in pregnancy
At the time of the salmonella and eggs scare in 1988, the Department of Health recommended that recipes for uncooked dishes involving raw eggs should be avoided, and that lightly cooked eggs should not be served to vulnerable groups – i.e. infants, pregnant women, elderly and debilitated people.
This advice, however, pre-dated the introduction of the British Lion scheme in 1998. Since the British Lion scheme was introduced in 1998, however, these risks have been effectively eliminated from Lion-marked eggs and a report published by Government food safety advisors, presented on 29 January 2016, concluded that British Lion eggs can safely be eaten runny, even by pregnant women, babies and elderly people. Read more here.
GD friendly low carb cereal with no added sugars
There are also the following pages which may be helpful:
Our Instagram account has lots of additional ideas too