Dirección de esta página: //medlineplus.gov/spanish/ency/article/007430.htm
Para usar las funciones de compartir de esta páginas, por favor, habilite JavaScript.
La diabetes gestacional es el nivel alto de azúcar (glucosa) en la sangre que empieza en el embarazo. Consumir una alimentación equilibrada y sana puede ayudarle a manejar este tipo de diabetes. Las recomendaciones en cuanto a la alimentación que se presentan a continuación son para las mujeres con diabetes gestacional que NO toman insulina.
Para una dieta equilibrada, usted necesita comer una variedad de alimentos saludables. Leer las etiquetas de los alimentos puede ayudarle a hacer elecciones sanas cuando va de compras.
Hable con su proveedor de atención médica si usted es vegetariana o tiene alguna dieta especial para garantizar que esté siguiendo una alimentación equilibrada.
En general, usted debe comer:
Usted debe comer tres comidas entre pequeñas y moderadas y uno o más refrigerios cada día. No se salte las comidas ni los refrigerios. Mantenga la cantidad y los tipos de alimento (carbohidratos, grasas y proteínas) casi iguales día a día. Esto puede ayudarle a mantener estable su azúcar en la sangre.
CARBOHIDRATOS
GRANOS, LEGUMBRES Y VERDURAS CON ALMIDÓN
Consuma 6 o más porciones al día; una porción equivale a:
Escoja alimentos con muchas vitaminas, minerales, fibra y carbohidratos saludables. Estos incluyen:
Use harinas de trigo integral u otras harinas integrales para cocinar y hornear. Consuma panes más bajos en grasa, como tortillas, panecillos ingleses y pan de pita.
VERDURAS (HORTALIZAS)
Consuma de 3 a 5 porciones al día. Una porción equivale a:
Las opciones de vegetales saludables incluyen:
FRUTAS
Consuma de 2 a 4 porciones al día. Una porción equivale a:
Las opciones de frutas saludables incluyen:
LECHE Y PRODUCTOS LÁCTEOS
Consuma 4 porciones de productos descremados o bajos en grasa al día. Una porción equivale a:
Las opciones de lácteos saludables incluyen:
PROTEÍNA (CARNE, PESCADO, FRIJOLES SECOS, HUEVOS Y NUECES)
Consuma de 2 a 3 porciones al día. Una porción equivale a:
Las opciones de proteínas saludables incluyen:
DULCES
GRASAS
En general, usted debe limitar su ingesta de alimentos grasos.
OTROS CAMBIOS EN EL ESTILO DE VIDA
Su proveedor de atención médica también le puede sugerir un plan de ejercicios seguro. Caminar suele ser el tipo de ejercicio más fácil, pero nadar u otros ejercicios de bajo impacto pueden funcionar igual de bien. El ejercicio es una forma importante de mantener el azúcar en la sangre bajo control.
SU EQUIPO DE ATENCIÓN MÉDICA ESTÁ ALLÍ PARA AYUDARLO
Al principio, la planificación de los tiempos de comida puede ser abrumadora. Pero será más fácil a medida que vaya conociendo más sobre los alimentos y sus efectos en su azúcar en sangre. Si tiene problemas para planificar su alimentación, hable con el equipo de atención médica. Están allí para ayudarlo.
Alimentación en caso de diabetes gestacional
ACOG Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49-e64. PMID: 29370047 pubmed.ncbi.nlm.nih.gov/29370047/.
American Diabetes Association. 14. Management of diabetes in pregnancy: standards of medical care in diabetes – 2021. Diabetes Care. 2021;44(Suppl1):S200-S210. PMID: 33298425 pubmed.ncbi. nlm.nih.gov/33298425/.
Blickstein I, Perlman S, Hazan Y, Shinwell ES. Pregnancy complicated by diabetes mellitus. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin’s Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 18.
Landon MB, Catalano PM, Gabbe SG. Diabetes mellitus complicating pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 45.
Versión en inglés revisada por: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Traducción y localización realizada por: DrTango, Inc.
Alimentación en embarazadas con diabetes gestacional
Para tratar la diabetes gestacional puede ser suficiente una dieta sana y equilibrada y la práctica de ejercicio físico. Conoce los alimentos más adecuados, y cuáles evitar o limitar, para controlar tus niveles de glucosa.
Compartido:
23
Actualizado: 28 de octubre de 2022
Determinados alimentos aumentan mucho el nivel glucémico y por este motivo, aunque la embarazada con diabetes gestacional no los tiene prohibidos (salvo las bebidas alcohólicas), debe limitar al máximo su consumo.
“Hay que evitarlos”, señala la doctora Mercedes Calvo. Eso quiere decir que hay que desterrar las pizzas y sus derivados, los alimentos rebozados congelados, los platos ya elaborados… Hay que tener en cuenta que suelen tener elevados porcentajes de sal y azúcares.
Hay que eliminar las golosinas, los caramelos, la bollería y los postres industriales (e incluso los caseros), dulces, pasteles, helados, miel, chocolate, turrón… En realidad, son alimentos que no deberían formar parte de la dieta de ninguna embarazada, tenga o no diabetes, ya que proporcionan muchas calorías, y pocos o ningún nutriente.
Las barritas o los cereales de desayuno elaborados con arroz o trigo inflado, con miel, azúcar, o chocolateados. También conviene no recurrir al pan de molde.
Evitar los refrescos, los zumos, las bebidas de cacao, las bebidas vegetales azucaradas, como la horchata, la leche de coco o de almendra.
En el embarazo no hay que tomar nada de alcohol, ya que traspasa la placenta ocasionando graves defectos en el bebé. Hay que rehuir incluso los licores “sin alcohol”.
Las frutas en almíbar, desecadas, y las mermeladas, contienen elevadas cantidades de azúcar. No se deben tomar tampoco zumos, aunque sean naturales, porque en el proceso se elimina la fibra que ayuda a controlar la glucemia.
Hay que eludir las salsas como la mayonesa, alioli, salsa barbacoa, kétchup…, sobre todo si son industriales porque suelen llevar azúcares agregados.
Las grasas elevan los niveles de glucosa, y por ello hay que elegir formas de cocinar que las reduzcan al máximo como la cocción, el papillote, el horneado…
Los que contienen toda la grasa, como la leche o los yogures enteros, y los cremosos (tipo griego), de sabores o azucarados. Tampoco deben tomar postres lácteos industriales, como el flan o las natillas, ni quesos grasos y muy curados.
Como la panceta, salchichas, morcilla, y los embutidos y charcutería ricos en grasa (chorizo, salchichón, salami, mortadela).
Patatas fritas tipo chips, en todas sus variedades, palomitas de maíz, y aperitivos salados elaborados con harinas o tubérculos (pajitas, gusanitos, nachos…).
Como las procedentes de la mantequilla y la margarina.
Alimentos a limitar en la embarazada con diabetes gestacional Cuántas comidas hacer si tienes diabetes gestacional y ejemplo de menú
Creado: 28 de diciembre de 2018
Etiquetas:
Diabetes
Cocina
Trastornos del embarazo
Páncreas
Diabetes gestacional
Vivir el embarazo
Nutrición y enfermedades
Lack of insulin (the pancreatic hormone that is responsible for glucose metabolism) in the body, when the pancreas produces a small amount of this hormone, is called diabetes mellitus. This disease can appear in a woman both before pregnancy (pregestational) and during it (gestational). If diabetes mellitus develops during pregnancy, then this occurs after 24-28 weeks. In this case, the disease does not affect the embryo at the initial stages of development and does not cause congenital pathologies. Gestational diabetes mellitus is diabetes that develops and is first diagnosed in the second half of pregnancy and ends with delivery.
Gestational diabetes is characterized by a slow onset without pronounced symptoms. There may be a slight thirst, severe fatigue, an increase in appetite, but at the same time weight loss, frequent urination. Most women do not pay attention to this, attributing everything to pregnancy. But any discomfort should be reported to the doctor who will prescribe the examination.
Factors that increase the risk of developing gestational diabetes
Presence of diabetes in parents or close relatives.
If the woman is obese.
History of gestational diabetes mellitus in previous pregnancies, premature pregnancies, large fetuses over 4 kg, stillborn babies, polyhydramnios, spontaneous abortions.
Arterial hypertension (increased blood pressure).
Pregnant women at risk for gestational diabetes are screened at their first visit to the doctor. Pregnant women without obvious risk factors at the 24-28th week of the term, the O’Sullivan test or the glucose tolerance test is performed. For this, 50 gr. oral glucose, regardless of the time of the last meal, and an hour later, the level of glucose in the venous blood is assessed. The concentration of glucose should not exceed 7.8 mmol/liter (140 mg %). In case of detection of deviations from the norm, a three-hour glucose tolerance test is performed with an oral load of 100 g. glucose to confirm or refute the diagnosis of gestational diabetes.
Persistent hyperglycemia (high blood sugar) causes a lack of energy for normal fetal development. In the second trimester, the fetus develops its own pancreas, which, in addition to utilizing glucose in the child’s body, is forced to normalize the glucose level in the mother’s body. This causes the production of a large amount of insulin, hyperinsulinemia develops, which threatens with hypoglycemic conditions in newborns (since the pancreas is used to working for two), respiratory disorders and the development of asphyxia.
Not only high blood sugar is dangerous for the fetus, but also low blood sugar. Frequent hypoglycemia causes malnutrition of the brain, which threatens to slow down the mental development of the child.
If the diagnosis is made on time, the woman’s treatment is correct, and the pregnant woman herself follows all the doctor’s instructions, then the probability of having a healthy baby is 98-99%. Hence the need to determine the concentration of glucose in the blood in the period of 24-28 weeks. During pregnancy, oral hypoglycemic drugs should not be used. If the glucose does not exceed the indicators listed below, then the patient is recommended diet and exercise. If the glucose level exceeds the following indicators, then insulin therapy is necessary.
Criteria for normoglycemia:
Fasting: 5.5 mmol/l (60-100 mg %)
One hour after eating: 5.5-7.8 mmol/l (100-140 mg %)
2 hours after eating: 4.44 – 6.7 mmol/l (80-120 mg %)
Night: 4.44 – 5.5 mmol/l (80-100 mg %)
The diet of pregnant women diagnosed with diabetes must be agreed with an endocrinologist. It contains less carbohydrates (200-250 gr.), fats (60-70 gr.) and a normal or even increased amount of proteins (1-2 gr. per 1 kg of body weight). It is very important to consume the same amount of carbohydrates every day. Nutrition of a pregnant woman suffering from diabetes should be fractional from 5 to 8 times a day.
To compensate for diabetes, the diet must necessarily include vegetable fiber, which gives a feeling of satiety with minimal calories. Among other things, fresh berries are also recommended. Especially gooseberries, cranberries and cherries, since the fructose contained in them prevents obesity and the development of diabetes. But do not overdo it with sweet, carbohydrate-rich fruits: melons – only one slice, grapes – only a brush, banana – no more than half, potatoes – no more than two tubers a day. Limit bread to three slices per day. Give preference to varieties of bread made from wholemeal flour.
Among the prohibited foods are all refined, that is, free from fiber. For example, white bread, sugar, sweets (jams, jams, syrups, sweet juices, ice cream, cakes, pastries, waffles, cookies, sweets, other confectionery and pastries), honey, dates.
Also try to eat as little salt as possible (no more than 4 grams per day), eggs, fish roe, animal fats (including butter), liver. Instead, sweet lovers are offered xylitol, fructose and sorbitol. Up to 30 g of sweetener per day is allowed.
Your diet should primarily include:
boiled beans
lean fish, lean beef and skinless chicken, preferably boiled or oven baked
cabbage in any form
hard low-fat cheeses
grapefruits, lemons, oranges, cranberries, gooseberries, cherries
tomato juice, tea
gray bread without coarse flour
low-fat milk and curd
buckwheat, oatmeal, pearl barley
It is important to remember that your individual menu must be agreed with your doctor. Consult with an endocrinologist or nutritionist, do not self-medicate.
After the birth of a child, most women’s blood sugar levels return to normal, even if she injected insulin during pregnancy. But diabetes during pregnancy still increases the risk of developing it in the future. This can be avoided by strictly monitoring your weight.
What is the danger of gestational diabetes.
Pregnancy puts an increased burden on the mother’s body, it is at this time that many chronic diseases become aggravated and new problems appear. Among metabolic disorders in women bearing a child, gestational diabetes mellitus (GDM) is the most common. This disease accompanies about 4% of pregnancies, 80% of them occur with complications for the mother, in 45% of cases it causes preeclampsia.
The number of complications in a woman and a child largely depends on the timely detection of diabetes, the correct treatment and the responsible attitude of the future mother to her condition.
Gestational diabetes – what is it?
During childbearing, the need for glucose increases, the body retains it in the blood to meet the energy needs of the fetus, so physiological insulin resistance occurs. If this process fails, gestational diabetes develops. Its start time is the second half of pregnancy, when the baby is already quite large, usually from 16th to 32nd week .
Unlike ordinary diabetes, gestational diabetes is often not accompanied by severe hyperglycemia. Pregnancy diabetes, as it is also called, can be expressed not only in an increase in sugar, but also in impaired glucose tolerance. This means that fasting blood sugar levels are exceeded, but not so much that this violation is considered diabetes.
Another difference in gestational diabetes is its temporary nature. All signs of violation disappear immediately after delivery. In the future, such women have a higher risk of similar disorders during subsequent pregnancies (more than 60%), and an increased likelihood of type 2 diabetes.
Causes of GDM
Starting from the middle of pregnancy, serious hormonal changes occur in the mother’s body: the production of progesterone, placental lactogen, estrogen, cortisol is activated. All of them are insulin antagonists, which means that their increase causes its weakening. Contribute to the increase in glucose and the usual changes in the life of a pregnant woman – an increase in the calorie content of food, a decrease in physical activity and mobility, weight gain.
Most often this occurs in the following cases:
Symptoms and signs of gestational diabetes
Symptoms of gestational diabetes include:
As you can see, all these symptoms are non-specific, they can all be provoked by other causes, including pregnancy itself. Gestational diabetes does not have obvious, noticeable symptoms for everyone, therefore, after registration, every woman undergoes a mandatory examination to detect disorders of glucose metabolism.
Diagnostic measures
At the first visit to the doctor, all pregnant women are prescribed a blood test for sugar. With increased glucose, a woman is referred to an endocrinologist, who conducts additional studies, determines the type and stage of the disease, and prescribes treatment. During pregnancy in women who, according to several signs, can be classified as an increased risk of diabetes, such blood tests are carried out again after a few weeks.
The optimal time to detect gestational diabetes is between 24 and 26 weeks of pregnancy . According to the clinical recommendations of the Ministry of Health, a glucose tolerance test is used for diagnosis. If a woman has an increased risk of diabetes, a large fetus, signs of fetopathy, the analysis may be carried out later. Deadline – 32 weeks , later the test can be dangerous due to a strong rise in blood sugar.
How to treat diabetes in pregnancy
Being diagnosed with diabetes during pregnancy is no reason to panic. If you start treatment on time, visit a doctor in a disciplined manner and follow all his appointments, you can eliminate the negative consequences for the child, avoid complications in the mother, and exclude diabetes in the future.
When gestational diabetes is diagnosed, it is recommended to follow certain dietary rules. They will help to normalize the level of glucose in the bloodstream without negative side effects for the body of the fetus and the woman carrying it. So, recommended:
Gymnastics and exercise in gestational diabetes
Regular muscle work helps to reduce insulin resistance and prevent excessive weight gain, so exercise in gestational diabetes should not be neglected. The training program is compiled for each woman individually, depending on the state of her health and physical capabilities.