No one better than your diabetologist to define specific guidelines of diabetes care, which will focus on the establishment of adequate food and the implementation of a program of intensive insulin therapy. Since throughout pregnancy insulin requirements vary, it is essential to responsible and active participation of diabetic pregnant women in adjusting insulin doses. Very important and complement is the practice of physical exercise, adapted to the specific conditions of each of the pregnant women taking into account weight, age and maternal health.
Special care with insulin during pregnancy
During pregnancy diabetes tablets should not be used as therapy of diabetes. The treatment will consist of employment subcutaneously (6 hour) fast-acting insulins or intermediate (12-16 hours duration), alone or mixed, in patterns of three to four daily pricks (multiple doses of insulin or DMI).
Alternatively, in some isolated cases, you’ve come to the use of the so-called pumps of continuous subcutaneous insulin infusion, which together with the ongoing management scheduled a daily dose basal (50% of the total dose) preprandial insulin dose delivered as needed to pregnant women.
This system of insulin, however, is not superior to the use of multiple insulin injections (DMI). The total daily dose of insulin, administered during pregnancy can sometimes decrease in the first quarter and is usually generally increase From the middle of it.
The daily adjustment of the insulin dose will be based on the home glucose testing for diabetic pregnant herself, through the use of test strips and reading of results with the corresponding reflectometer (self-monitoring blood glucose).
Feeding of diabetic women in pregnancy
The requirements are identical to the of any pregnant woman, who will have to be adapted to the peculiarities of the insulin treatment. Although not contraindicated, it is recommended not to abuse the intake of artificial sweeteners (saccharin, aspartame, acesulfame K). To be considered a modest increase in protein content of the diet.
The distribution of calories comprise 50% carbohydrate, 30% fat and 20% protein. The caloric intake is greater in 300 calories from the second quarter. It will also consider the diet provide an adequate amount of vitamins and minerals. Sometimes taking iron tablets or folic acid is necessary. The regularity in schedules and control of intakes is undoubtedly a standard which helps achieve the goals of glycemic control.
In general, the number of daily meals recommended is the three main (breakfast/lunch/dinner) and three additional (midmorning/afternoon/after dinner snack) and should not take more than 3-4 hours between daytime intakes, and more than 8-9 hours during the night, since prolonged fasting negatively affects the control of diabetes.
It should be remembered not whether to follow very restrictive diets on pregnant women with significant obesity, because it favor the emergence of ketone bodies that may be harmful to the psychomotor development of the child.