The Pregnant Diabetic: Modification of Diet throughout Pregnancy
The modification of diet throughout pregnancy
Diet is of vital importance in the management of diabetes in pregnancy and the following principles will help you to plan diets for pregnant diabetics.
- When the diabetic control of a pregnant women and the adequate nutrition of her foetus are in conflict, the needs of the foetus must take precedence.
- When managing the diet of an insulin-dependent, pregnant diabetic the principles that apply to the non-pregnant diabetic and those that apply al pregnancy should be coordinated.
Important guidelines concern the specific content of diets.
A diet containing 30-35 kcal per day per kg body weight is recommended.
- The total weight gain allowed should be about 10-11 kg (22-24 Ib) but should not be less than 9 kg (20 lb).
- An increase of about 0.5 kg (1 lb) per month is recommended during the first half of gestation and the same per week during the second half.
- Calculated on the basis of her usual daily requirement of 30 kcal per kg ideal body weight, sedentary woman requires about 2,1080 kcal per day during the first trimester and 2,200 per day during the last trimester. An additional 600 kcal per day are required for physically active pregnant women.
- If the patient is in hospital, and relatively inactive, her diet may be reduced to 1,60K)-1,800 kcal per day.
Why should concentrated sweets not be used in the diet of a pregnant diabetic?
Concentrated sweets comprise a pure form of carbohydrate and directly raise the level of blood sugar, this can be dangerous in diabetics. Carbohydrates should provide about 45% of a pregnant diabetic's calories, with a minimum of 200 g per day.
- This takes into account the glucose lost to the foetus and moderate
- In patients with marked glycosuria, an additional 50 g or more carbohydrate per day may have to be given in order to make up urinary losses.
- Starchy foods should be eaten to provide carbohydrate. These are absorbed relatively slowly. particularly if they are rich in fibre, and are more suited a diabetic patient's insulin apparatus, which responds slowly.
- The protein intake should average 2 g per kg per day, or about 100-120 g.
- The remainder of the caloric allowance is made up with calories from fat. Eating regularly and taking snacks between meals are important to prevent insulin reactions.