The main treatment for gestational diabetes is diet control + exercise.
Many friends will struggle with how to control the diet?
Some pregnant women even tell the whole pregnancy afraid to eat fruit, all day with cucumbers, tomatoes. So much so that when you see cucumbers and tomatoes, you have to throw up. I think it is necessary to talk about the dietary control of gestational diabetes here.
In 60-80% of cases of gestational diabetes, blood sugar can be controlled by strict dietary control and exercise therapy, so dietary control is the foundation of gestational diabetes treatment and is the top priority. Cultivate good eating habits, no partial diet, and a variety of food. Timing, rationing, meal and quality, not to be hungry or too full are the principles of diet control.
I recommend that pregnant women have two types of scales at home: a weight scale and a kitchen scale. The weight scale monitors your weight, while the kitchen scale quantifies your diet.
(a) First, calculate your pre-pregnancy weight and calculate your body mass index.
Body mass index (BMI) = weight (kg) ÷ height2 (m2)
Chinese adult body mass index standards.
Underweight: BMI < 18.5
Healthy weight: 18.5≤BMI<24
Overweight: 24≤BMI<28
Obese: BMI≥28
The most ideal body mass index is 22.
(ii) Calculate your required calories.
(Early pregnancy) Pre-pregnancy ideal weight: 30kcal/kg/d
Low weight pregnant women: 40kcal/kg/d
Obese pregnant women: 24kcal/kg/d
In other words, the fatter the pregnant woman is, the more calories she needs to limit.
（Pre-pregnancy ideal weight: 30kcal/kg/d+200Kcal/d
Low weight pregnant women: 40kcal/kg/d+200Kcal/d
Obese pregnant women: 24kcal/kg/d +200Kcal /d
From 4th to 9th month of pregnancy, increase 300kcal/kg/d, the purpose of increasing caloric energy is to increase blood volume and maintain fetal growth
(iii) How much weight can be gained during pregnancy? The following are the standards for weight gain.
The ideal weight before pregnancy can be increased: 11.5~16Kg
Low weight pregnant women can gain: 12.4～18Kg
Obese pregnant women can gain: 7～11.5Kg
Weight growth standards refer to the United States, Chinese people are thin, it is best to follow the lower line of standards.
Calculate the range of your weight gain?
Example: Female, 29 weeks gestation, single live birth, first delivery, age 30, Ht:167cm, pre-pregnancy weight 60kg, current weight 70kg, OGTT: 4.6-10.5-9.8. diagnosis: GDM, no complications.
Pre-pregnancy weight: 60kg; BMI=21.4kg/m2; normal weight
Calories required = 60kg x 30kcal/kg + 200kcal = 2000kcal
So how to choose food?
The nutritional needs of pregnant women with gestational diabetes are the same as those of normal pregnant women, except that more attention must be paid to the intake of calories, the distribution ratio of nutrients and the distribution of meals. In addition, you should avoid sweets and foods high in oil, and increase dietary fiber. Usually, you need more than 20 kinds of food in a day. However, these 20 kinds of food cannot all be the same kind of food, but should be diversified. The four major food groups, namely grains, vegetables and fruits, meat, eggs, milk, beans and fats, should be eaten every day, and the total number of food items should not be less than 20, in order to be beneficial to health. However, the total amount of energy should not exceed your body’s needs. (Total daily calories calculated)
1. First of all, protein: Calorie ratio: 1g=4kcal
Protein sources include: high quality protein from fish, poultry, meat, eggs, milk, etc. and general protein from soybeans and cereals. We recommend choosing high quality protein: animal protein accounts for at least 40% to 50%. However, excessive intake of red meat increases the risk of GDM. If you eat 100g of protein today, then the calorie intake is 400Kal.
2, fat: calorie ratio: 1g = 9kcal, including animal fat, nuts and vegetable oil.
3, carbohydrates: calorie ratio: 1g = 4kcal.
When it comes to carbohydrates, I must first introduce GI. what is GI?
GI is a physiologically significant indicator of the glycemic response to food intake.
Foods with high GI (>70) are quickly digested and highly absorbed after entering the stomach and intestines, with rapid glucose release and a high peak of glucose entering the bloodstream.
Low GI (<55) food, long residence time in the stomach and intestines, low absorption rate, slow release of glucose, and low peak value after entering the blood.
Low GI food: energy slow release system, try to choose more.
4, dietary fiber: dietary fiber can effectively control blood sugar, coarse grains such as oatmeal, leafy greens, etc. are a good choice.
Knowing these basic common sense, we can arrange our recipes. Kitchen scales play a role here, first of all, we are talking about the weight are raw weight, not cooked after the weight. It’s a little hard at first, but once you’re familiar with it, you can estimate the weight.
Principle 1: Pay attention to calorie requirements
No special increase in calories is needed in the early stages of pregnancy, and in the middle and later stages, the calorie requirement must be increased by 300 calories/day according to the pre-pregnancy requirement. Since weight loss may increase the ketone bodies in the mother’s body, which may have an adverse effect on the fetus, it is not advisable to lose weight during pregnancy.
Principle 2: Pay attention to meal distribution
To maintain a stable blood glucose level and avoid the occurrence of ketosis, meal distribution is very important. Because eating a large amount of food at one time will cause a rapid rise in blood glucose, and ketone bodies are easily produced when the mother is fasting for too long, it is recommended to eat small amounts of meals and divide the daily food intake into five to six meals. In particular, it is important to avoid too long a gap between dinner and breakfast the next day, so it is important to supplement snacks before bedtime.
Principle 3: Consume the right sugars
The intake of sugar is to provide calories, maintain normal metabolism, and avoid ketone body production. It should not be mistaken that not eating starch can control blood sugar or weight and not eating at all; instead, you should try to avoid sugary drinks and sweet foods with sucrose, sugar, fructose, glucose, icing sugar, honey, and maltose, which can avoid rapid increase of blood sugar after meals.
It is recommended that you try to choose unrefined staple foods with high fiber content to better control blood sugar, such as brown rice or grains instead of white rice, whole grain bread or buns, etc.
Principle 4: Focus on protein intake
If you have taken enough nutrients before pregnancy, you don’t need to increase protein intake in the first trimester. In the middle and second trimesters, you need to increase the amount of protein by 6 grams and 12 grams each day, half of which should come from high physiological value proteins, such as eggs, milk, dark red meat, fish and soy milk, tofu and other soy products. It is best to drink at least two glasses of milk every day to get enough calcium, but never drink milk as water to avoid high blood sugar.
Principle 5: Be careful with fats and oils
Use vegetable oil as the main cooking oil, reduce deep-fried, fried and crispy food, as well as animal skin and fatty meat.
Principle 6: Consume more fiber
Within the range of intake, take more high-fiber foods, such as brown rice or grain rice instead of white rice, increase the intake of vegetables, and eat fresh fruit instead of juice, etc. This can delay the rise of blood sugar, help control blood sugar, and make you feel fuller. However, you should not eat unlimited amounts of fruit.
How to choose fruits? This is also often asked.
Types: Choose more fruits with low glycemic index and low sugar content
Choose more: peach, lemon, plum, pear, apple, grapefruit, orange, orange
Choose less: coconut, pineapple, banana, watermelon
Avoid: dates, sugar cane, lychee, longan, grapes, durian