What to eat with gestational diabetes

Written by Chen Xie
Endocrinology
Updated on December 09, 2024
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The dietary control for gestational diabetes adheres to the same overall principles as non-pregnant diabetes management, mainly focusing on controlling total caloric intake and eating smaller, more frequent meals. This approach helps manage blood sugar levels and reduces the occurrence of hypoglycemia. Additionally, it is important to consider the nutrients required for fetal growth and development. Generally, carbohydrate intake should make up 50%-60% of the diet, proteins 15%-20%, and fats should not exceed 30%. Foods that quickly increase blood sugar levels and are high in fat should be consumed minimally. Instead, it is beneficial to consume a lot of vegetables, at least 500 grams daily, to ensure adequate intake of vitamins and fiber.

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Written by Chen Xie
Endocrinology
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Do you need insulin for gestational diabetes?

Gestational diabetes refers to the elevated blood glucose levels found during pregnancy. For patients diagnosed with gestational diabetes, we first need to control diet and exercise to manage blood sugar levels, maintaining fasting blood glucose between 4.0-5.3 mmol/L and postprandial (two hours after meals) blood glucose between 4.4-6.7 mmol/L. If blood sugar control can be achieved through diet and exercise, insulin treatment is not required. However, if blood sugar levels still do not meet the standards through diet and exercise, exceeding the figures mentioned earlier, insulin treatment is necessary. For patients receiving insulin treatment, it poses no harm to either the fetus or the mother. In fact, when blood sugar is well-controlled, it can actually reduce the risks associated with gestational diabetes.

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Written by Liang Yin
Endocrinology
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How is gestational diabetes treated?

The treatment of gestational diabetes includes dietary therapy, exercise therapy, and insulin therapy. For dietary therapy, we mainly control the total calorie intake and supplement with elements such as calcium, iron, folic acid, and various vitamins; in exercise therapy, we aim to control the speed of weight gain, improve the peripheral tissues' utilization of glucose, and improve the lipid profile. For patients whose blood glucose levels do not meet the standards after two weeks of diet and exercise therapy, we initiate insulin therapy. The goal of insulin therapy is to control fasting blood glucose below 5.3 and postprandial blood glucose below 6.7. The methods of insulin therapy include twice daily injections, multiple daily injections, or the use of an insulin pump.

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Written by Chen Xie
Endocrinology
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Gestational diabetes blood sugar standards

The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.

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Written by Chen Xie
Endocrinology
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The dangers of gestational diabetes

The harms of gestational diabetes mainly include two aspects: the effects on the child and the effects on the pregnant woman herself. For the fetus, the early impacts mainly manifest as spontaneous miscarriage, fetal abnormalities, abnormal fetal development, macrosomia, and delayed maturation of fetal lungs. At birth, this may lead to complications such as premature birth and hypoglycemia. Newborns face a higher risk of respiratory distress syndrome compared to healthy infants. The long-term effects on the child mainly include a significantly increased incidence of glucose intolerance and diabetes, increased risk of obesity, and notable rise in cardiovascular abnormalities and neuromotor developmental disorders. For the mother, the impacts mainly manifest as concurrent miscarriage, gestational hypertension and pre-eclampsia, an increased likelihood of diabetic ketoacidosis. A macrosomic fetus can lead to difficult labor, trauma to the birth canal, prolonged surgical labor, postpartum hemorrhage, and an increased risk of gestational diabetes in subsequent pregnancies, extended hospital stays, and a significantly increased incidence of Type 2 diabetes postpartum.

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Written by Zhao Dan
Orthopedics
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What is gestational diabetes?

The group of people who were diagnosed with diabetes before pregnancy is called gestational concurrent diabetes. Those who were not diagnosed with diabetes before pregnancy, but were diagnosed after becoming pregnant, are referred to as having gestational diabetes. Eighty percent of women are diagnosed with gestational diabetes, while twenty percent have gestational concurrent diabetes.