Dietary control and monitoring of gestational diabetes mellitus (GDM)

  Gestational diabetes mellitus (GDM) is mostly caused by insufficient insulin secretion, which has adverse effects on the mother and fetus. 85% of patients can control their blood glucose through dietary modification, i.e., eating fewer and more meals, while 15% of patients need to add insulin for treatment, and observe the blood glucose control through the small profile test (also known as five times blood glucose), and adjust the insulin dosage accordingly.  Pregnant women who are diagnosed with gestational diabetes need to adjust their diet for at least one week, i.e. meal sharing or eating less and more meals, before they can do the small profile test (monitoring the change of blood glucose throughout the day) to decide whether they need insulin treatment. Other considerations are as follows: 1. Meal system: breakfast: the usual breakfast amount can be seven or three points, eat a meal at eight in the morning about seven or eight points full, and then add a meal at ten, so as to reduce a meal full of insulin is not enough, resulting in increased blood sugar. Chinese food: you can eat completely full without meals, 3-4 p.m. can be a little additional meals, such as snacks, fruit, etc. Dinner: basically eat full, to about 10 pm a little extra meal, can be half a bowl of noodles, dumplings, snacks, fruit, etc., to reduce the morning hunger, thus reducing the amount of breakfast eating.  2. Monitor blood sugar: Bring breakfast to measure fasting blood sugar, then start eating breakfast, start timing from the first bite, finish eating within 15 minutes, timing two hours, measure blood sugar two hours after breakfast, and so measure blood sugar two hours after Chinese meal and dinner. The last blood glucose is measured before bedtime, at least after 10 o’clock, and you can go home to rest after the measurement.  Note: If you feel hungry obviously, you can eat a little after measuring blood glucose two hours after meal, do not eat within two hours to avoid affecting the blood glucose results. Another test day must be restored from the previous multiple meals a day to three meals a day, each meal should be full, do not eat less in order to pass the blood glucose and affect the judgment. When doing the 75g OGTT test, venous blood must be drawn for the test, while for the small profile test, only finger blood is tied, i.e., peripheral blood is used for the test, so there is no need to be afraid of drawing blood!  The diabetic diet is: scientific, reasonable eating, provide a reasonable total calorie, to ensure that a variety of nutrients, and a reasonable proportion, in line with physiological needs. Coarse and fine, meat and vegetables, diabetic patients in addition to direct sweets do not eat, in fact, anything can eat, the key is the quality and quantity, as well as the timing of meals. That is, what to eat, how much to eat, what time to eat, for some points in time poor blood sugar control, under the premise of the total calories remain unchanged can be divided into meals, conducive to blood sugar control.  The purpose of dietary adjustment is: the intake of nutrients to meet the needs of fetal growth and development, but also try not to overload the mother’s pancreatic function (insulin) … When fasting blood glucose is greater than 5.3 mmol/L, 2 h after meal blood glucose is greater than 6.7 mmol/L, generally need to add insulin treatment.  One of the misconceptions is that diabetic diet therapy is starvation therapy. Blind long-term starvation will definitely weaken people’s resistance, and serious ketoacidosis will occur. Excessive interference with the use of sugar or converted into sugar, but also easy to promote atherosclerosis .  Myth No. 3 is that diabetic dietary treatment is to eat more vegetables and no or less meat, because the resistance of diabetics is low, and if they do not eat protein-containing foods, their resistance will be even lower.