Diabetic diet in pregnancy
Q: Please advise me some points regarding NIIDM gestational diabities - diets & facts for Gestational Diabetes detected when an IUFD occured in my first pregnancy 4 months ago & now I am NIDDM and maintaining it by proper diet. I will be highly benifitted if you send me a diet chart mentioning protien, fat and carbohydrates. Docted advised me to take 1600 KCal 3 months ago. Now as I am far away from my home & here unavailability of doctors & dietician, I am confused about what foods to take. I will consult my docotor by november when I will be back in India. Till then, please give me diet chart for now upto pregnancy & also after pregnancy is confirmed. I am 26 year old female, around 55 kg. weight (during 3 months), height - 5feet, normal blood sugar level (81) before pregnancy, during delivery blood sugar level was 525. Human mixtard insulin was injected for one month. Now, blood sugar level (fasting: 81; normal 70-110; PP /postprandial: 962).
Please mention separately if banana, kathal, onion can be taken raw because I am avoiding it as fruit. As iron is so necessary for me because I do not take any iron tablets during pregnancy, due to constipation. Now we are planning for a baby so, what will be the special diet for me to take to prepare me for my coming pregnancy which we are assuming within one month. Should I change my diet, if so in what quantity? If our next baby can be effected by my NIDDM? It is observed that the sugar level decreases every month (from pp: 162 to present 96). Please advise if it may be a sign of hypoglycemia. Eagerly waiting for your valued response.
A:First of all I am giving you the diet chart that you should follow and then I shall answer your questions.
Diet plays an important role in the treatment of diabetes. The diet may be used alone or in combination with insulin injections or oral hypoglycaemic drugs. The diet plan of an individual is based on height, weight, age, sex, physical activity and nature of diabetes. More of carbohydrate must be given as complex starches rather than simple sugars as they breakdown more slowly to release glucose in blood. The presence of fibre in complex carbohydrate like grains, vegetables and other starches slows the glucose absorption. One should emphasise more on the high fibre foods instead of high fibre supplements available in the market. This diet plan is provided to you assuming that you are a non insulin dependent diabetic.
Early Morning: Tea (preferably without sugar)
Breakfast: Dalia (salted) / Paneer on toast / Sprouts salad / Cereal with milk / 1 Chapati stuffed with vegetables such as carrot, spinach, radish, methi (any one of these), Tea without sugar, Apple or any other fruit ( Avoid banana, cheeku, grapes and mango)
Lunch: 2 chapatis, Channa curry / or any other whole dal, Beans sabzi / or any other sabzi (avoid potatoes), Curds / ghia raita, Salad (must take plenty of salad)
Evening tea: Tea
Dinner: Vegetable soup / tomato soup / chicken soup, 2 chapatis / missi roti (combining wheat flour with channa flour and soya flour), Palak paneer, sabzi / paneer bhurji, Curds and Salad
It will be wise to avoid fruits like banana, cheeku, grapes and mangoes. You can have all other fruits freely. To meet your iron requirement concentrate more on green leafy vegetables along with citrus fruits. You also get some amount of iron from wheat flour and other grains. Include enough milk and milk products as well.
In the strict medical definition, hypoglycaemia mainly refers to a drop in fasting blood sugar below 50 mg% (normal range 70-90 mg%). This drop can be associated with differing symptoms depending on the rate at which the blood sugar falls. It will be good if you discuss this with your doctor incase you feel any symptoms of hypoglycaemia like weakness, trembling, paleness, perspiration, rapid heartbeat, hunger, irritability, fatigue, blurred vision or agitation.