Healthy diet of gestational diabetes mellitus
1, two principles of diet therapy for gestational diabetes mellitus
Q: It is said that more than 80% patients with gestational diabetes can get good blood sugar control through diet therapy. I am 25 weeks pregnant. Go for diabetes screening. The doctor said that I have gestational diabetes. I suggest controlling my diet. Excuse me, Director Pan, what is the standard of diet control during pregnancy? What principles should be grasped in diet treatment of gestational diabetes mellitus?
A: The standard of diet control is to control blood sugar in an ideal range on the premise of ensuring the nutrition of pregnant women, so as to prevent both hyperglycemia and hypoglycemia. Two principles should be grasped in the diet treatment of gestational diabetes mellitus. One is to control the energy intake throughout the day, and everyone's energy needs are different. It is necessary to comprehensively consider personal size, weight growth rate, activity, diet history and other factors. It is suggested that the nutrition clinic of the hospital should formulate an individualized treatment plan and eat according to the weight of various foods formulated by nutrition doctors, which is one of the keys to nutrition treatment. The second is to choose food reasonably. Learn to choose foods with low glycemic index.
Two principles should be grasped in the diet treatment of gestational diabetes mellitus. One is to control the energy intake throughout the day, and everyone's energy needs are different. It is necessary to comprehensively consider personal size, weight growth rate, activity, diet history and other factors. It is suggested that the nutrition clinic of the hospital should formulate an individualized treatment plan and eat according to the weight of various foods formulated by nutrition doctors, which is one of the keys to nutrition treatment. The second is to choose food reasonably. Learn to choose foods with low glycemic index.
2. Treatment of gestational diabetes in different periods.
Q: Hello, Dr. Pan. The results of diabetes screening at 28 weeks of pregnancy were 9 and 4mmol/L, and the results of fasting OGTT test after one week of diet conditioning were 5 and 6 mmol/L. I drank two glasses of sugar water, one hour was 1 1 and 4mmol/L, two hours was **mmol/L, and three hours was 7 and 9 mmol/L. In what range does the blood sugar value need insulin treatment, and under what circumstances can you choose to control diet treatment? Does dietotherapy require hospitalization to control diet?
A: At present, oral glucose tolerance test * * * OGTT * * is commonly used to diagnose gestational diabetes, that is, drinking 75g glucose mixed sugar water and measuring blood sugar within a specified time. The diagnostic thresholds of ogtt are fasting, 1, 10, 0, 8 and 5 mmol/L, respectively. It is suggested that nutrition treatment should be carried out first, and that nutrition clinic should formulate and adjust nutrition treatment plan first. If the blood sugar control of outpatient treatment is not ideal, you can consult an obstetrician whether it is necessary to be hospitalized for further examination and treatment. If the blood sugar control is still not ideal after diet therapy, especially if the fetus is larger than gestational age, insulin therapy can be considered.
3. Diet therapy for gestational diabetes mellitus needs to be combined with exercise.
Q: Hello, doctor! I had a sugar screening at 24 weeks of pregnancy. The doctor said I had gestational diabetes, but it was not serious. Just control my diet. Do you need to combine exercise while controlling your diet? Do you need to monitor the changes of blood sugar every day?
A: It is best to combine proper exercise with diet control. You can take a walk, do exercises and other relaxation activities one hour after meals to avoid strenuous exercise. The duration of exercise should not be too long, generally about 20-30 minutes. Pay attention to whether there are contractions during exercise. If you feel tired and have contractions, you should rest immediately. People with threatened premature delivery or other serious complications should not exercise. Please follow the doctor's advice to monitor the frequency of blood sugar.
4. Dietary distribution of gestational diabetes mellitus diet
@ 中中中: Hello, doctor! My wife was diagnosed with gestational diabetes when she was screened for diabetes at the 25th week of pregnancy. According to the internet, it can be controlled through daily diet. I would like to ask, what is the principle of catering for gestational diabetes? How should the heat be distributed reasonably throughout the day?
A: A small amount of meals is helpful for blood sugar control. You can take out 2-3 side meals from three main meals to reduce the sugar load of each meal. Breakfast accounts for 15-20% of the total energy, lunch and dinner each account for 20%-30%, and complementary food each accounts for 5%- 10%. The specific calorie allocation needs to be adjusted according to eating habits, hunger, blood sugar in each time period and other indicators.
Four key points of scientific diet for gestational diabetes mellitus
1. Choose foods with low glycemic index.
Q: Hello, Director Pan! It is understood that different kinds of food have different GI*** glycemic index * *. My sister was diagnosed with gestational diabetes at the 24th week of pregnancy. In daily life, do you need to choose foods with low GI? What should a scientific diet match be like? Which foods have low GI? Which foods have high GI? Hope to get an expert's answer.
A: The glycemic index is also called glycemic index * * * English abbreviation: GI***. Understanding the glycemic index of food plays an important role in arranging diet reasonably and controlling blood sugar level. Eating the same amount of food, foods with low glycemic index are more helpful to control postprandial blood sugar. The table below shows which staple foods have high glycemic index and which staple foods have low glycemic index. It is suggested that at least 1-2 meals a day should be the staple food with low glycemic index, such as buckwheat noodles and macaroni for breakfast. Choose spaghetti, mixed rice or vegetable jiaozi for lunch or dinner.
2. Principles of food cooking.
Q: A friend said that different cooking methods of the same food will also affect GI*** blood sugar index * * *. For example, the GI of potato chips is lower than that of shredded potatoes. Is there any scientific basis for this statement? Why? How do expectant mothers with gestational diabetes cook better?
A: There are many factors that affect the glycemic index of food, including the hardness, consistency, particle size, gelatinization degree of starch, dietary fiber content and so on. The cooking style of food is one of the important factors affecting the glycemic index. For example, the glycemic index of mashed potatoes is higher than that of potato chips. In order to avoid the rise of food sugar index caused by cooking, we should pay attention to the following points: (1) Don't be too fine when processing; Eat some coarse grains properly; Cook as quickly as possible; Except for special needs, do not add too much water to cereal, and the heating time is too long. Because this will make the food highly gelatinized, and the blood sugar index will also increase.
3. Increase protein in staple food.
Q: Hello, Dr. Pan! I was diagnosed with diabetes after 26 weeks of pregnancy, so I was worried. My colleague said that protein, a staple food, could be added to my daily diet. Is this correct? What staple foods are more suitable for expectant mothers with gestational diabetes? I'm really worried that eating the wrong thing will lead to an increase in blood sugar and affect the baby.
A: This statement is well-founded. For example, the GI of ordinary wheat flour is 865,438+0, while that of pasta with high protein content is 37. Pregnant women with gestational diabetes can choose some staple foods with low glycemic index, such as buckwheat noodles, pasta, macaroni, jiaozi and so on, which are all suitable for eating. Rice can be cooked with buckwheat kernels or mung beans. For example, it can be cooked into two-in-one rice according to the ratio of 3: 1. Eat less staple foods with high glycemic index, such as glutinous rice, refined flour bread, steamed bread and rice porridge. Dinner is often accompanied by non-staple foods rich in dietary fiber, such as various vegetables, kelp, laver, mushrooms and other lavers. Staple food should be matched with some vegetables and animal foods as much as possible, which also helps to reduce the glycemic index.
4. Increasing acidity when cooking food can reduce the glycemic index of food.
Q: Well, I've been paying attention to my diet since I got pregnant. I don't know how to find out that I have diabetes at 25 weeks of pregnancy, and I am worried that it will affect my baby's development. My best friend who gave birth to a child said that adding vinegar to the daily diet can reduce the GI*** glycemic index of food and control gestational diabetes. Is there any basis for Director Pan's statement? May I add some vinegar to every meal?
A: Increasing acidity can reduce the glycemic index of food, and vinegar or lemon juice can be added when cooking. The key is to choose more foods with low glycemic index on the basis of controlling food intake.
Two dietary taboos of gestational diabetes mellitus
1. Can I eat sweets?
Q: I am a little overweight myself. I went to the hospital for examination last week and found it was gestational diabetes. I wonder if gestational diabetes is related to eating sugar? Because I prefer sweets, I have eaten a lot of sweets and desserts before? I worked hard during pregnancy, so I can't eat my favorite dessert in the future? Can I eat it occasionally?
A: Gestational diabetes is related to many factors, such as genetic factors, exercise and diet. Gestational diabetes is not directly related to eating sugar, but related to excess energy. Whether it is staple food, fruit or snacks, eating too much may lead to excess energy. Gestational diabetes generally does not advocate eating sweets, preserved fruits, sweet drinks, sweet biscuits, cakes, ice cream and so on. Add sucrose, glucose and maltose.
2. How should I eat fruit?
Q: Can you still eat fruit in gestational diabetes? Because I used to eat a fruit every day, but recently my mother-in-law won't let me eat fruit, saying that I can't eat too much sugary things because of diabetes. I think we should give priority to balanced nutrition and eat some fruit during pregnancy. Ask the doctor for help. What kind of fruit can I eat in this situation? How to arrange the time to eat fruit is more appropriate?
A: When the blood sugar control is stable, you can make appropriate choices under the guidance of a doctor, provided that the energy intake throughout the day is controlled within the scope of diet control. Pay attention to choose fruits with low sugar content and low glycemic index, and eat them between meals or before going to bed. Eating fruit should reduce the staple food accordingly.
Common misunderstandings in dietary treatment of gestational diabetes mellitus
1. The less staple food you eat, the better disease control?
Q: Hello, Dr. Pan! I am a pregnant mother with gestational diabetes. I heard that you can't eat more rice and pasta. Is it true?/You don't say. I'm from the south. I'm hungry if I don't eat rice, but what else is in the staple food besides rice and pasta? Or can we use those foods instead of rice and pasta, which will help us control blood sugar?
A: For expectant mothers with gestational diabetes, the less rice and flour they eat, the better. Eating too little will lead to insufficient nutrition and affect the growth and development of the fetus. Therefore, it is recommended to eat according to the amount ordered by the nutrition doctor and not to go on an excessive diet. There are many staple foods, so we should choose staple foods with low glycemic index, such as buckwheat noodles, pasta, macaroni and jiaozi. If you eat rice, you can add rice and coarse grains such as buckwheat kernels and oat kernels to make bibimbap. Low GI food stays in the gastrointestinal tract for a long time, absorbs slowly, releases glucose slowly, and the peak blood sugar after meals is relatively low and flat.
2. Do you need to control your diet after insulin treatment?
Q: Hello, Dr. Pan! I've been injecting insulin to control my blood sugar, so can I not over-control my diet? I'm pregnant now, and I'm worried that diet control will affect my baby's development. My mother-in-law often makes a lot of supplements for me to eat. Can I eat? What foods do pregnant mothers with gestational diabetes suggest to eat?
A: Insulin injection should be combined with nutritional therapy to control blood sugar, otherwise the therapeutic effect will be greatly reduced. The supplement should be selected according to the individual's physical condition. Besides, be careful not to eat too much. For example, after eating the meat in the soup, it will be reduced in other non-staple foods.
Pregnant mothers should ensure comprehensive and balanced nutrition in their bodies, and their daily food should include several categories: cereals, fish, eggs and poultry, fruits and vegetables, dairy beans and oils. Except sugary sweets and foods with high glycemic index, most foods can be selected, and staple foods, meat and other foods can be freely selected within the specified amount.
3. Diabetes does not need to control the amount of sugar-free food?
Q: I have gestational diabetes, and I have been controlling my diet since I found it. My husband bought some sugar-free special food for diabetes. Excuse me, doctor, can pregnant mothers with gestational diabetes eat these foods? Don't you have to worry about rising blood sugar after eating these sugar-free foods?
A: No matter how many sugar-free foods you eat, many sugar-free foods on the market just do not contain monosaccharides or disaccharides, and some sugar-free foods have high carbohydrate content or high energy content, which is not conducive to blood sugar control. Therefore, the choice of this kind of food should be based on the composition of the food and the blood sugar index. Dietary taboos of gestational diabetes mellitus