KEY NUTRTITIONAL CARE FOR WOMEN WITH GESTATIONAL DIABETES

Mrs.sheela Paul & Ms.Vimala

Pregnancy alone is a critical condition, how much more if the mother is going through another serious medical situation such as diabetes? Gestational diabetes is a type of diabetes that occurs only during pregnancy. Like other forms of diabetes, gestational diabetes affects the way your body uses sugar (glucose) — your body's main source of fuel. Gestational diabetes can cause high blood sugar levels that are unlikely to cause problems for you, but can threaten the health of your unborn baby. Any pregnancy complication is concerning, but there's good news.

You can manage gestational diabetes by eating healthy foods, exercising
regularly and, if necessary, taking medication. Taking good care of yourself can help ensure a healthy pregnancy for you and a healthy start for your baby. Fortunately, gestational diabetes is usually short-lived. Blood sugar levels typically return to normal

soon after delivery.

Gestational diabetes will affect about 4 percent of all pregnant women, potentially causing major consequences for both the mother and her child


Healthy Eating:

• No single diet is right for every woman. Your meal plan should be based on your blood sugar levels, height, weight, exercise habits and food preferences

• Eating the right kind and amount of food is one of the best ways to control your blood sugar level.

• Making healthy food choices also helps prevent excessive weight gain during pregnancy, which can put you at higher risk of complications

• A healthy diet often means including more fruits, vegetables and whole grains.

• Take a well balanced and nutritious food, calories in required amount, low in fat and complex carbohydrates.

• Choosing high fiber foods will help to control your blood sugar and have regular bowel movements. Include fiber foods such as fresh fruits, vegetables, green leafy vegetables, whole grain cereals, legumes, dhal, and nuts.

• No harm taking Non-Veg in prescribed amount. Avoid deep fried preparations

• Use combination of oil (groundnut oil+gingelly oil +sunflower /saffola oil.

• Include 3% fat milk and milk products in your every meal to strengthen your bones and promote healthy development of your baby’s bones.

• Artificial sweetener are NOT safe during pregnancy.

• Some people with gestational diabetes can control their blood sugar with diet alone. They do this by eating 3 meals and 1 to 3 snacks each day.

• You will need a snack at bedtime to prevent low blood sugar levels during overnight..

• Eat at the same times each day, whenever possible, and never skip meals or snacks. Spread your food out evenly over the day so that you eat about every 2 to 3 hours.

• Avoid foods and beverages with added sugar, sugar syrup, honey, or jams and jellies.

• Read the labels of packaged foods to find the nutritive value.
There are no guarantees when it comes to preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better. An expectant mother who is going through gestational diabetes must be closely monitored by a pediatrician to ensure her safety and of the child as well.

Get out of Diabetes burn out

Dr. Sripriya Shaji

Burnout arises when we're overworked, overtaxed emotionally, physically exhausted or unwell, and often unable to cope with everyday situations. Trying to achieve that perfect balance between family and work life is hard enough; throw in the demands of living with and managing a chronic medical condition,
And it’s not surprising that you get burnout, when your doctor points the numbers in the investigation profile and says you need work on diet and exercise.

When we become truly burned out, it's time to take stock and make changes.

Let’s take inventory of the situation.

Accept the fact that burnout is a time of self-evaluation and change. Just as you would treat a physical illness with rest and restriction of activities, cut back as much as you can on commitments and responsibilities for a time and allow yourself to "treat" this emotional and mental exhaustion. AADE recommends these 7 strategies as Self-care behaviors

* Healthy eating
* Being active
* Monitoring
* Taking medicines
* Problem solving
* Reducing risk and
* Healthy coping

Diabetes Diet – No doubt it is frustrating to count on every rice you eat. But why to count?
Diabetes diet just demands you to spare proper time and making nutritious choice. Plan your meal. Make yourself determined that you eat healthy food on time, without excuses.

Exercise – ADA recommends 150 minutes of walking / week. Just think can’t we spare 30 minutes a day? Can’t we keep our self active?
Monitoring – Right from the school days, we are worried about the term examination. Fails to understand, they improvise us for facing the final exams. same way the regular SMBG check up helps us to keep our blood sugar in control, which leads to better HbA1c control and over all glycaemic control.

Medications – Regular medication is as important as diet and exercise.

Problem solving, Reducing risk and Healthy coping - Try to identify those things most responsible for your present state, and ask yourself which areas are most in need of drastic change. Don't forget to take inventory of your strengths, skills, and resources, both internal and external, as well. Do you have good friends willing to lend a listening ear, family members who'll babysit, or anyone who can help you through this time? Think, too, about the inner strengths you have to fall back upon. What have you done in the past to solve similar, or other, problems?

If you need to make critical decisions concerning job or personal life, you'll be much better prepared to make healthy, sound choices when you're rested and not deep in the throes of burnout.

Alternatively, if you find that an overcrowded schedule is one of the main factors causing your burnout, you may need to pass along or delegate some of your regular commitments on a permanent basis. Accept offers of help from friends and family, and don't forget to show your gratitude. If your financial situation allows, hire someone to do household tasks or errands - or equip yourself to better self care management - or whatever seems unbearable at the moment - to give you more time for yourself.

Be good to yourself. You need plenty of rest, good nutrition, exercise, and the support of friends and/or family. Do something for yourself that gives you joy or pleasure. Read a good book or take in a film you've wanted to see. Allow your loved ones to help too, although you may have to explicitly communicate to them exactly what kind of help you need. Give yourself permission to spend the necessary time and energy to take care of yourself.

Reactive Hypoglyceamia

Mrs.sheela Paul
Chief Dietitian

Reactive hypoglycemia is a medical condition occurring from low sugar in the blood. It is mainly associated with people who suffer from diabetes, but has been also know to occur in non-diabetics. Though there are some people who experience this state even if they are not fasting, and the blood sugar drops irrespective of there food intake--this condition is referred to as reactive hypoglycemia.

So how does the sugar in the blood drop?
The most common cause of this is when a person goes hungry for a long period of time or is in a state of fasting. Basically the body needs food to keep all its functions going correctly, so if a person is fasting the body does not have the necessary fuel and so the sugar levels drop.

There has been quite a bit of research done on this subject and many researchers and experts have come to believe that this condition is mainly caused by the lack of a hormone called Glucagon. This hormone is the one that is mainly responsible for keeping the balance levels of sugar in the blood.

The main symptoms of this condition can be confused with other diseases as they are quite similar.

Listed here are of the symptoms of hypoglycemia:
-Dizziness, sweating, hunger
-Inability to sleep
-Excessive sweating
-Trembling and being nervous all the time
-Fatigue and tiredness.

A simple healthy diet will greatly help in improving your condition, like eating more often, up to 6 times a day. You don’t need to eat a lot every time, just small meals every three hours. Skipping meals will cause your blood sugar to fall down, as well as not eating for longer periods of time can have the same effect.


Nutrition tips to manage hypoglycemia
• Eat a small meal or snack about every 2-3 hours. Skipping meals can make symptoms worse.
• Choose high fiber foods at each meal and snack.
Fiber helps stabilize blood sugar. Increase fluid intake when you increase fiber intake.
• Eat a source of protein and or a source of fat with carbohydrate at each meal or snack.
Protein and fat eaten with carbohydrates will help slow glucose release and absorption.
• Limit simple sugars. (candy, soda, fruit juice, sweets)
Simple sugar intake can make hypoglycemia symptoms worse. Moderate your intake.
• Limit alcohol and caffeine (coffee, tea, soda, chocolate).
• Eat a meal or snack 1-3 hours before exercise.
Extra carbohydrates may be needed before exercise to compensate for energy used.

Physical Activity: Although excessive physical activity can bring your blood sugar level low, a simple exercise is still beneficial. All you need to do is to time your activity after a meal to make sure that your insulin hormone will have the needed sugar to break down in your system. Make sure not to overdo your physical activities as this can lead to sudden drop in your blood sugar level. Don’t forget to consult your physician before engaging in extra physical activities, they can best advice on how much exercise you can handle.

Controlling this condition can be done through right diet, which is the only treatment available for now. Following a healthy eating lifestyle can help blood sugar levels steady, as well as provide you with the necessary nutrients you need for good health. If you believe you are suffering from Reactive Hypoglycemia, it is best to consult a physician and a dietician to help plan your treatment.