Dieta para diabetes gestacional: qué comer y consejos

The incidence of gestational diabetes has increased significantly in recent decades. They are the conclusions of the Spanish Society of Gynecology and Obstetrics, which points out that some studies place its prevalence around 12%, depending on the diagnostic system used. This situation multiplies the risk of maternal, fetal and neonatal complications in the short and long term. The good news is that, generally, with a healthy diet and regular exercise, it can be controlled.

What is gestational diabetes and in what months of pregnancy does it usually appear?

Irene Roth, dietitian-nutritionist at the Spanish Academy of Nutrition and Dietetics, explains that “gestational diabetes appears when the The pregnant mother’s body is not able to produce enough insulin«.

As a consequence, the pregnant woman has higher blood sugar levels, which in turn is transmitted to the fetus. “It is detected from the second trimester of pregnancy (between weeks 24 and 28), about the sixth month of pregnancy.” It usually disappears after giving birth. Roth estimates that it could be detected earlier, but, «unfortunately, it is from the second trimester onwards that the health system has established performing the O’Sullivan test, which is the one that detects it.»

The advantage of an earlier diagnosis is that it would allow treatment to be given before that moment. This anticipation would improve the prognoses of the mother and fetus.

Why does blood sugar rise during pregnancy?

There are several reasons why the blood glucose during pregnancy. Among them are: a family history of gestational diabetes, the age of the pregnant woman, excessive body weight gain due to physical inactivity or an inadequate diet with an increase in the intake of simple sugars.

High sugar values ​​in pregnancy, from what point is it gestational diabetes?

To determine what the pregnant woman’s normal blood sugar values ​​will be, the dietitian-nutritionist points out that “during pregnancy, fasting blood glucose or before meals should not exceed 95 mg/dL. One hour after eating, it will be less than 140 mg/dL and two hours after eating, less than 120 mg/dL.”

Risk factors and which can be prevented with lifestyle

Not all risk factors are preventable by leading a healthy lifestyle. Therefore, the expert makes a clear distinction.

Those that can be prevented:

Those that do not depend on lifestyle:

• First-degree family history of diabetes
• Polycystic ovary syndrome (PCOS) in pregnant women
• Ethnicity (Hispanic, African American, Native American, and Asian)
• Advanced age of the pregnant woman (over 35 years)
• Having had gestational diabetes in previous pregnancies

Consequences for maternal and baby health

If not controlled, there can be consequences for the health of both the mother and the baby. These are some of the problems that could arise:

• Preeclampsiawhich can even cause the death of the baby as a result of not receiving oxygen.
• Macrosomia in the birth canal can greatly delay the birth of the baby or have a complicated delivery.
• neonatal hypoglycemiaconsequence of the mother’s hyperglycemia that causes the baby to produce more insulin.
• In the future that baby could suffer from obesity. “And there will also be a greater risk of developing type 2 diabetes.”

Gestational diabetes diet: what to eat and what not to eat

For Roth, one of the keys to a pregnant woman’s diet is because not all of them should be the same. Quite the contrary, we must keep in mind that «each mother has special needs depending on her energy expenditure and, finally, it should be personalized and adapted to her needs.»

That said, “the pregnant mother’s diet has to be balanced, and above all, based on the dietary pattern of the Mediterranean diet, limiting rapidly absorbed carbohydrates (sweets, refined white flour…) and those foods that have “a high glycemic (or glycemic) index.”

Likewise, the dietitian-nutritionist states that foods rich in simple sugars or refined foods should be avoided, since their glycemic index is higher. And he advises simple culinary techniques: oven, steam, iron, microwave; and avoid fried foods, battered foods and stews.

Prohibited or restricted foods

Although in popular language we usually talk about prohibited foods, dietitians-nutritionists prefer to refer to foods with limitations or restricted intake. They are the following:

• Refined cereals and their derivatives
• ripe fruits
• Pastries and pastries
• Sugary carbonated drinks and soft drinks
• juices
• Simple sugars, such as table sugar or honey.
• Fried foods
• dehydrated fruits

allowed foods

• Vegetables in general and green leafy vegetables (spinach, chard, lettuce, sprouts)
• legumes
• Whole grain or whole grain cereals
• tubers
• fresh fruit
• Nuts (not salted or sugary)
• Fish (small white or blue)
• Semi-skimmed dairy
• eggs
• Meat (lean, white meat)
• olive oil

Mediterranean diet and gestational diabetes

The Mediterranean diet “is the best diet that can be followed for any type of diet,” Roth firmly assures. «Now, we must keep in mind that to reduce the amount of sugar in the blood and, if you follow a diet for gestational diabetes, it would be advisable not to abuse those foods rich in rapidly absorbed carbohydrates or even in «All foods rich in carbohydrates, reduce portions.»

An easy trick to modulate the glycemic load of a meal, not of each of the foods themselves, is to accompany foods with a higher index with others with a lower glycemic index. A good example is to accompany fresh fruit with dairy products or nuts, instead of eating them alone.

And that is one of the great virtues of our Mediterranean diet: we can incorporate many foods of plant origin, rich in fiber, which help regulate the increase in blood glucose. Olive oil and nuts also help control the total glycemic load.

Food suggestions for the environment.

It is recommended that the pregnant woman not feel alone in her changes in diet or habits. That is why it is advisable to follow some guidelines as a family, including collaborating in modifying the pantry:

• Eat every 3-4 hours
• Intake of water with meals if tolerated well, and outside of them (although if there is reflux, heartburn or burning, it is preferable not to incorporate it into meals)

Example of weekly menu for gestational diabetes

The weekly menu for pregnant women is as broad as each woman’s tastes. An example could be like this:

Post Expert: Irene Roth

Irene Roth. He belongs to the Academic Body of the Spanish Academy of Nutrition and Dietetics. She has a diploma in Human Nutrition and Dietetics and a Bachelor’s degree in Food Science and Technology from the University of Vic, an official Master’s degree in Nutrition and Metabolism from the University of Barcelona and an Expert Master’s Degree in Teaching from the University of the Balearic Islands. For 9 years he has been part of various research teams within the Hospital Clínic of Barcelona (Department of Internal Medicine, where he completed his doctoral thesis on Chronic Inflammatory Diseases and Aging, for which he obtained the CCNIEC Doctoral Thesis D’excel.lència Related Awards. with the world of nutrition and food and reconèixer the highest scientific quality in the Department of Endocrinology with various scientific publications on nutrition and cardiovascular risk). Between 2018 and 2020 she was responsible for the Nutrition and Food area of ​​the Cas Serres Assisted Residence Hospital. Between 2021 and 2022 she was a Dietitian at the Fundació d’Atenció i Suport a la Dependència i de Promoció de l’Autonomia Personal de les Illes Balears. She is currently a professional training teacher in the Health Department of the International University of Catalonia (UIC), for the DECIDE Chair.

Content endorsed by the Spanish Academy of Nutrition and Dietetics