Diabetes mellitus during pregnancy is not uncommon. It can be present in a woman for a long time, or it can appear in an "interesting" position for the first time. In any case, the expectant mother will need a large share of self-discipline and will to comply with all medical recommendations that will allow her to deliver on time and give birth to a healthy child.
Proper nutrition comes to the fore in the clinical guidelines. What it should be for a future mother with diabetes, we will tell you in this material.
General principles
Nutrition for expectant mothers with diabetes mellitus or gestational diabetes differs from the usual diet during pregnancy by a large number of restrictions. The calorie content for a diabetic pregnant woman should be reduced to 1600-2000 Kcal per day (while a pregnant woman without problems with high blood glucose levels in the blood and urine can consume up to 2800 and even up to 3000 Kcal). For each specific woman, the allowed calorie intake for diabetes is calculated individually according to the formula: 35 Kcal per kilogram of weight.
Up to 45% of the total daily diet should be complex carbohydrates, up to 20% should be allocated to proteins and about 30% to fats. The total amount of carbohydrates should not exceed 200 grams per day. For a woman with diabetes, it is important to eat frequently and fractionally - at least 6-8 times a day.
It will be preferable if the intervals between meals do not exceed 2.5 hours.
Your doctor should initially help you plan your diet. Only a specialist will be able to assess the ratio of the weight and height of the expectant mother, take into account the period of her pregnancy (in the first trimester, nutrition should be more high-calorie than in the third), compare the level of excess glucose levels with the norms and calculate the required ratio of substances in the daily diet.
The basic nutritional guidelines for a pregnant woman with diabetes include:
- you cannot eat a large amount of food at a time, because this can lead to a sharp jump in blood sugar levels, therefore it is better to divide the product into several meals and eat a little at a time;
- when drawing up a diet, you should be extremely careful with foods containing starch and milk (both are sources of glucose);
- when choosing fruits, you should avoid fruits with a high content of natural saccharides, it is better to choose sour fruits;
- the main meal - breakfast, the glucose level at the very beginning of the day and throughout the day depends on how it is planned, and since cereals and cereals for breakfast will lead to a jump in sugar, it is better to stay on protein foods and small whole grain breads;
- fruit juices should be completely abandoned, sweets, desserts, sweets, cookies should be strictly limited;
- the diet of a pregnant woman should include only foods with a low and medium glycemic index.
For convenience, doctors have compiled therapeutic diets, which have a serial number after the word "table". For diabetics, a diet of the "Table No. 9" type is used, for pregnant diabetics there is a variation of this diet - "Table No. 9a".
Diet "Table number 9"
This diet is one of fifteen therapeutic nutritional complexes developed by experts from the world of medicine. Its uniqueness lies in the fact that compliance with the recommendations not only promotes treatment, but is also an effective prevention of exacerbation of manifestations of diabetes mellitus or gestational diabetes (GDM).
All carbohydrates, which are quickly absorbed by the body, should be completely eliminated from the diet of the expectant mother. Do the same with foods that contain high-density cholesterol. This does not mean that the expectant mother needs to say goodbye to sweets, because she can eat foods with sugar substitutes - sorbitol, sucrose, xylitol.
Salt should be eaten no more than 12 grams per day, and at least 2 liters of ordinary clean drinking water should be drunk. Products should be baked, boiled, stewed, steamed. Fried, smoked and fatty are contraindicated. But on vegetables rich in fiber, you should lean on without much hesitation.
Permitted products include:
- fruits (excluding bananas, pears, sweet peaches and grapes);
- cereals (except semolina, and rice is allowed to be eaten no more than 1 time a week);
- meat and poultry (except lamb, pork);
- beef liver, tongue (pork offal are contraindicated);
- bread (whole grain or with bran in a total amount of not more than 300 grams per day);
- vegetables (except for beets, carrots and potatoes);
- dairy and fermented milk products with a low fat content;
- fish (only low-fat marine and river varieties);
- eggs (no more than 1-2 per week);
- oil (vegetable or butter can be added in small quantities not during cooking, but in ready-made dishes);
- drinks (decoction of wild rose or fruit drink from cranberries without sugar, compotes from berries and fruits without sugar, vegetable juices, still mineral water are allowed).
Prohibited foods include:
- fatty fish (herring, mackerel);
- sausage, sausages;
- "Strong" rich meat broths;
- rich pastries;
- canned food and semi-finished products;
- pickled foods;
- fish caviar;
- fast food;
- honey, sugar, chocolate, factory sweets and pastries, sweets and cakes, pastries.
During pregnancy, the "Table No. 9a" diet contains all the same fundamental principles and prohibitions, but in addition, the woman is introduced to the menu with vitamin preparations, which the doctor deems necessary.
Based on the exact composition of the vitamin complex, the nutrition itself can be corrected - somewhere the content of vitamin C is reduced, somewhere magnesium is added.
A woman following such a therapeutic diet must be weighed every week, regularly donate blood and urine to determine glucose levels, and use a home glucometer. In no case should you allow prolonged fasting, as it can lead to an excessive drop in sugar levels and impaired insulin production. One hour after a meal, it is advisable to measure the blood sugar level.
Sample menu
When drawing up a menu for every day, a woman must be guided by the principle of balanced products. It is desirable that the main meals (and there should be at least three per day) contain all the necessary components of a healthy diet - proteins, fats, complex carbohydrates. And three or four auxiliary meals, which are popularly called "snacks", should be as light as possible.
Based on this principle of rationality and balance, let's try together to compose an optimal menu for several days:
- the first breakfast (7.00) - oatmeal in water with a slice of butter, a soft-boiled egg, tea with low-fat milk and sorbitol, a green apple;
- second breakfast (9.30) - homemade cranberry juice with sorbitol, apricot;
- lunch (12.00) - salad of fresh cucumbers and tomatoes, cabbage soup with chicken breast broth with a small amount of low-fat sour cream, stewed zucchini, tomato juice;
- afternoon snack (14.30) - rosehip broth, whole grain bread, apple;
- dinner (17.00) - stewed or baked fish, cauliflower, tea with sugar substitute, avocado;
- the second dinner (19.30) - biokefir (about 200 grams);
- third dinner (an hour before bedtime) - a green apple or homemade berry juice without sugar.
Here is another option for a useful and correct menu for a future mom with diabetes:
- breakfast (7.00) - protein omelet, bran bread, a slice of unsalted and low-fat cheese, green tea with a sugar substitute, an apple;
- second breakfast (9.30) - low-fat cottage cheese with blueberries;
- lunch (12.00) - fresh cabbage salad with vegetable oil, soup soup without pasta and with a minimum amount of potatoes, steamed minced chicken cutlets, stewed pumpkin puree, fruit drink;
- Afternoon snack (14.30) - homemade applesauce (or sugar-free puree for young children);
- dinner (17.00) - steamed fish cutlets, stewed cabbage, zucchini and broccoli stew, fresh vegetable salad, tea;
- second dinner (19.30) - bioyogurt;
- the third supper (an hour before going to bed) - rosehip broth with sugar substitute, apple.
Useful Tips
Remember the following:
- When combining permitted foods, remember that most of the diet should consist of vegetables and fruits. During pregnancy, meat and poultry are needed every day, especially with a diabetic pregnancy, so there is no place for separate mono-diets and vegetarianism.
- Try not to skip meals. Create several food containers and place portions in them for all receptions for the next day. It will be easier this way, especially if the woman is working or studying. Even at work or in between lectures, you should find time to eat the proper portion.
- Use easy-to-prepare recipes when cooking... This will save time and provide the expectant mother and her baby with everything they need. Such simple dishes include buckwheat porridge in water, boiled pollock, stewed pieces of beef. Avoid exotic foods (fruits and fish) and spices. Of all the spices for a pregnant woman with diabetes or gestational diabetes, only a small amount of dill (in soup or salad) or parsley is acceptable.
- A woman should completely abandon mayonnaise, mustard, vinegar, ready-made sauces, ketchup. Natural coffee and cocoa are also completely banned. If you want to spice up the dish with something, use low-fat sour cream and your own ingenuity. It can be mixed with finely chopped dill or grated sour apple.
Very soon, you will be sure that homemade sauces are not only healthy, but also very tasty.
In the next video, see a sample menu for the week and recipes for dietary dishes for the "table number 9" diet.
