Treatment for gestational diabetes mellitus (diabetes of pregnancy)

Gestational diabetes mellitus (GDM) may affect the health of both mother and baby, why should begin treatment immediately to avoid complications. Pregnant women should be seen by a medical team composed of medical obstetrician, endocrinologist, a nutritionist, educators and others.

The treatment will consist of a special meal plan, a program of physical activity, insulin treatment and education regarding the disease.

Diet therapy:

All women with GDM should receive the attention of a nutritionist. It will recommend an individualized meal plan for weight, height and activity level of women.

Should include enough calories to meet the demands of pregnancy. For obese women with a BMI (greater than 30%, the amount of calories should be reduced although not optimal gestation time for a very restricted diet. It has been shown that a reduction of 30 to 33% of calories demonstrated a reduction of hyperglycemia and plasma triglycerides.

Also the restriction of carbohydrates in a 35 to 40% has been shown to decrease maternal glucose levels and a great improvement in both the health of the mother and baby.

The diet should be complete, ie providing sufficient amounts of carbohydrates, proteins and fats as well as minerals, especially iron and calcium (mineral increased requirement during pregnancy).
Following the guidelines of a balanced diet recommended foods can be done to control gestational diabetes.

Deliver the recommended daily intake in the three main meals, breakfast, lunch and dinner and three snacks, mid morning snack and bedtime.
The distribution of calories during the day must be:

* 15% breakfast
* 5% in the collation
* 30% at lunch
* 15% in the snack
* 5% at night snack or afternoon
* 30% at dinner

It is advised to eat slowly absorbed carbohydrates, called complex carbohydrates such as vegetables, bread, pasta, potatoes, rice, cereals, and avoid eating those quick absorption, called simple carbohydrates, such as products made with refined sugar, sugar, honey , jams, jellies and candies.

Examples of simple carbohydrates – Not recommended:

* Sugar
* Sweets,
* Candy,
* Chocolate
* Whipped cream,
* Custard,
* Dulce de leche,
* Candy quince or sweet potato
* Invoices
* Soft,
* Ice Cream,
* Chocolate milk,
* Mass,
* Jams,
* Honey
* Desserts with sugar.

The diet should include:

* An adequate intake of protein and fat as meat, fish, eggs, milk, cheese,
* Fresh vegetables and cooked
* The contribution necessary vitamins and minerals, especially folic acid, iron, iron and vitamin D

Should not drink alcohol or smoke during pregnancy because it increases the risk of complications in pregnancy and the baby.

Insulin treatment

This is when the meal plan has failed to control diabetes. Involves the application of subcutaneous insulin injections two or three times daily.

Sometimes insulin can occasionally in some patients the onset of hypoglycemia or fall in normal blood sugar levels below normal as a side effect of the injections. This is associated with decreased food intake, excess insulin to be administered, lack of complementarity between food intake and insulin administration or excessive physical activity.

It must regularly analyze glucose and glycosylated hemoglobin testing to determine the evolution of the DMG. Also the woman herself from her home may monitor your blood sugar through a special device and the presence of ketones in the urine.

Insulin administration does not in any way affect the fetus.

Exercise Plan

A program of moderate exercise has been shown to reduce glucose concentrations in the mother with GDM. You should never reach fatigue conditions.

Post-partum care

Most women with GDM, once the pregnancy return to normal before. Women who were treated with insulin is no longer needed it. But should not be excluded that there may be risk for type 2 diabetes.
It is always advised breastfeeding for the benefit of the baby.
It must make a blood sugar test at least 6 weeks after giving birth.

If glucose levels are normal postpartum, she should be a double check blood glucose every 3 years minimum. Those who show intolerance to glucose it must make each year and receive nutritional and medical treatment and have an individualized exercise program because of its high risk of developing diabetes.

All patients who have had GDM should change their lifestyle so as to decrease insulin resistance, which should include maintaining a normal weight and physical activity.

Vitamin supplements do not protect against lung cancer, and even in some cases, such as vitamin E, may increase the risk of developing

This is indicated by a study on a population of 77,000 regular users of vitamin supplements published in the March issue of American Journal of Respiratory and Critical Care Medicine, American Thoracic Society.

“Our study of vitamin supplements, vitamin C, vitamin E and folic acid showed no evidence of a reduction in the risk of lung cancer,” says the author of the paper, Christopher G. Slatore, University of Washington in Seattle (USA).

“Indeed, increasing intake of supplemental vitamin E (for food) was associated – statistically – with a slightly increased risk of lung cancer.”

Of the 77,126 individuals under study, chosen from the population with risk factors for four years, 521 developed lung cancer, which corresponds with the predictions of the group.

But among those who developed this cancer, and combined with contrasting relationships such as family history, age or smoking, there was a slight but significant association with intake of vitamin E.

When the study was extrapolated in time, the risk was equivalent to an increase of 7 percent for the consumption of 100 milligrams daily. “The risk translates into a 28 percent increase to a dose of 400 milligrams a day for ten years,” said Dr. Slatore.

The increased risk was more evident among smokers.

Tim Byers, Faculty of Medicine of the University of Colorado, says the editorial in the journal that published the study “the idea that vitamin supplements are healthy or at least harmless, comes from the desire of many people mimic the benefits of a healthy diet with adequate pill. ”

The Foundation for Research on Cancer, about vitamins, recommends two intakes of fresh fruit each day, based on a previous study that found a 20 percent increase in cancer among people who eat the least fruit.

Dr. Slatore states that “the results (study) should encourage doctors to advise patients that vitamin supplements are unlikely to reduce the risk of cancer and may be harmful.”

The characteristic of these products is their low or no fat, with characteristics identical to those of traditional foods.

There are several sources for these products:
As derivatives of carbohydrates are:

* Polydextrose
* Sta slim
* Avicel
* Paselli

As derived from proteins:
# Simplesse

As derived from fats:# Olestra
# Caprenin
# TATC

The use of these products as a substitute for fat intake can reduce fat by 10 grams. (Must be clarified that these 10 grams of fat considered as a component, presumed weight excluding water containing food.)

In Argentina you can find:

# Simplesse: Derived from milk protein and / or egg white, add water, sugar, pectin and citric acid. Its caloric value is 1 to 2 kcal / gram and its texture is similar to that of fat.

# Polydextrose: carbohydrate produced from glucose, sorbitol and citric acid linked, where the latter provides volume. A substitute of sugar and fat. Fiber form and 75% is excreted in the feces. The caloric value element is DE1 Kcal / gram. White powder, soluble in water.

# Olestra, the fat replacer. Not a sweet taste and its texture is similar to fat. Supports heating at high temperatures (frying), is not absorbed in human intestine, reason why no caloric value.

Diabetes mellitus is the result of altered metabolism of carbohydrates, due to inadequate insulin production (absolute or relative), accompanied by alterations in lipid metabolism and occurs by genetic factors or family.
There are different types:

* Diabetes Primary: genetic, hereditary or essential
* Diabetes Secondary: due to pancreatic injury, endocrine and glucocorticosteroids.

Classification of Diabetes Mellitus

* Type I or Juvenile: characterized by being insulin dependent, has unstable blood glucose. The pancreas produces little or no insulin.
* Type II or adult: is insulin independent (acidosis do not take insulin). Glycemia are more stable. The pancreas produces insulin and only on glucose load shows an increase in insulinemia. Development is slow.
* Type III or secondary is due to pancreatic disease, endocrine or corticosteroid administration
* Diabetes Mellitus of the pregnant woman:

Factors that may precipitate the disease

* Obesity: The declining insulin response in fat cells
* Steroids: it increases hepatic gluconeogenesis
* Pregnancy: because the placenta destroys endogenous insulin (gestational diabetes)
* Infections due to increased metabolism and decreased insulin response
* Diet: if it is rich in carbohydrates and fats.

Signs and symptoms

* Glycosuria: appearance of glucose in urine
* Polyuria: osmotic effect of glucose which draws water
* Dehydration, secondary to polyuria
* Polydipsia: by stimulating the thirst center because of dehydration
* Polyphagia: intracellular glucose deficit at the level of satiety center
Weight loss: for glucose excretion in urine involves the loss of calories
* Fatigue: for poor glucose utilization at the cellular level
* Acidosis and coma, due to increased ketone bodies, which if prolonged can reach the coma.
* Drowsiness, dry mouth, irritability, paresthesia, impotence, loss of vision.

The treatment of the types of diabetes involves:

* Adequate diet by eliminating foods that contain high concentrations of simple sugars and saturated fats.
* It indicates the practice of physical activities
* Insulin treatment. To maintain blood glucose levels within acceptable limits, where necessary. There are two types of insulin:
* The short-term The long-term addition there are oral hipoglucemientes type II diabetes
* Type I diabetics must take care of your blood glucose when developing physical activity. Being able to exercise only when these values are between 100 and 200 mg / dl per day and if no ketosis. For them, it is suggested that food intake 30 min. year prior to applying lean combinations of cheeses, fruit, yogurt, bread, cookies and smoothies. This should always be supervised by a health professional.

The consumption of dietary products for diabetics should always be controlled, accessed and recommended by a specialist.

Diet and cardiovascular disease.

Since the beginning of this century, the dietary habits of modern societies, have changed considerably. Some of these changes are directly related to increased cardiovascular disease.

Fat consumption has increased dramatically. Currently the consumption of fat is 42% of the calories normally consumed, that, compared to those consumed in 1910 represents an increase of 31% of the total intake.

Has reduced the consumption of starches, or complex carbohydrates found in cereals, bread, dried peas and beans and vegetables. Starch is only 21% of the calories found in food habits and consumption current is reduced by 93%.

Furthermore, sugar consumption has increased. Refined sugar, corn syrup and other sweeteners represent 18% of total calories, which shows an increase of 50% compared to 1910.

These changes relate very closely with major changes in human health. These new eating habits, coupled with a sedentary lifestyle that requires less physical effort, has contributed to increased cases of diabetes, cardiovascular disease, stroke and some forms of cancer.

Does it affect the diet on blood cholesterol?

High cholesterol is associated with an increased risk of atherosclerosis and other cardiovascular diseases. In general, the greater the amount of fat and cholesterol from the type of food, the higher the levels of blood cholesterol and increased frequency of cardiovascular disease.

Although few studies have found no close relationship between fat intake from food and cholesterol, evidence from well designed studies supports the theory that there is a relationship between diet and heart. Fat from the diet, cholesterol levels are associated in the blood. But not all fats are equal, some raise blood cholesterol and not others.

Saturated fat, cholesterol and cardiovascular disease

The two fats from the diet that are associated with an increased risk of heart disease are saturated fats and cholesterol.
A system composed mainly of red meat, whole milk and other fatty dairy products and foods fried or sautéed in butter or margarine, raise cholesterol levels in the blood.

The way how are you cholesterol-raising saturated fat, has not been elucidated. Saturated fats may increase the absorption of dietary cholesterol or increase the production of cholesterol in the liver. The excess of these fats may alter other blood factors such as prostaglandins and platelets that have great influence on the onset and progression of atherosclerosis.

Since both saturated fats and cholesterol found in foods of animal origin could be a combination of the two that are associated with higher cholesterol in the blood and increased risk of cardiovascular disease.
However, the cholesterol from the diet regardless of saturated fat, raises blood cholesterol and therefore increases the risk of disease.

Olive oil and cardiovascular disease
In Mediterranean countries where they consume lots of olive oil, cardiovascular disease presents with a low incidence. The primary fat in olive oil is an unsaturated fat called oleic acid. It seems that this fat does not raise cholesterol levels in the blood and may reduce them. (See note on oils and fatty acids Omega 6)

Vegetable oils and cardiovascular disease

In general, when the highest proportion of fat in the diet comes from vegetable oils, the risk of cardiovascular disease is low. Vegetable oils may increase intestinal excretion of cholesterol and bile acids. This reduced absorption help reduce cholesterol levels in the blood.

Making changes in dietary habits of a lifetime can be difficult. Failure to adjust the diet before atherosclerosis and cardiovascular disease will probably revise it later.

The main purposes of feeding can be various, but generally they can be summarized according to four main objectives:

Energy intake, the plastic, the controller and the contribution of reserves.

Energy intake: This is the principal for any human being and for any activity carried out. The contributions of carbohydrates, proteins and fats (substrates) must be given in quantity, quality and proper proportion. Through this, what you get is the proper functioning of the metabolic system.

Plastic contribution: To fulfill this purpose should be considered adequate incorporation of protein and certain minerals. Proteins are a basic part of the structure of every living cell, and exercise the critical role of tissue building.

Within the minerals to be taken into account, we should mention the calcium, who as a plastic element plays a fundamental role in muscle contraction and transmission of nerve impulses. Finally, the fats are also involved in plastic function to the nervous system.

The supply regulator is usually given by the incorporation into the body of vitamins and minerals. In the case of vitamins, function as catalysts for biochemical reactions allowing the release of energy.

The reserve contribution: Considering that carbohydrates and fats are the main sources of energy assumes the storage of these substrates in the body to assist in energy metabolism at the time an effort. The fat is easily accumulated and therefore have no storage problems or availability.

All people have a considerable percentage of fat compared to its weight, about 11% by weight of a person in good physical condition to develop a daily activity. (7 kilograms for a 70 kg weight) carbohydrates are accumulated as glycogen in the liver and muscles, but not exceed 0.5% of the total weight of the individual (500 grams in a 70 kg weight.)

This glycogen is metabolized to glucose and thus converting it into energy. For this cause muscle fatigue appears after overspending glycogen after exercise.

It looked into the four main objectives, we can define the daily needs of the different substrates.

Credit to: Marco Licata

A person who leads a normal or full power, never with lack or excess of vitamins. The daily requirement of vitamins the body needs has been scientifically established after years of research.

The quantities required are different depending on sex and age of the person, and in the case of women also changes during pregnancy and lactation.

Their values are expressed in different units, usually micrograms (mcg) or milligrams (mg) as the vitamin of the talk, but can also be found listed in international units (IU).

Daily requirement: Men and Women

Vitamin A 900 mcg 700 mcg
Vitamin D 5 g
Vitamin E 15 mgVitamin K 120 mg 90 mg
Vitamin B1 1.2 mg 1.1 mg
Vitamin B2 1.3 mg 1.1 mg
Vitamin B3 16 mg 14 mg
Vitamin B6 1.3 mg
Vitamin B12 2.4 mg 2.4 mg
Vitamin C 90 mg 75 mg

There are a number of everyday activities that interfere with the proper nutrition and vitamins, to which they should be considered as contrary to vitamins, and are covered primarily by the consumption of snuff, alcohol, excessive coffee and tea, certain medications and methods of cooking food that affect conservation.

Some people have vitamin deficiencies systematic, and are candidates to be prone to problems due to lack of attention to nutritional deficiencies. In this risk group may be regarded often as victims of such problems.

The medical dietary prescription will aim to promote the enrichment of food, according to individual needs and no calories or imbalances promote inappropriately.

The summer holidays need not be reason to abandon our activities throughout the year, to earn extra kilos, although one is stretched and relaxed, you need to adjust our favorite sports or we keep moving .

Therefore we recommend for those who choose an attractive holiday destination to travel around places, and walk at least 30 minutes every day, as this will help to maintain tone in the legs, maintaining or improving aerobic capacity, and care for the weight, plus the walks are of little use to combat stress and depression.

You can also take advantage of the beaches or pools that are offered in hotels for swimming, as well as walking you must do at least 30 minutes, then you will not neglect any of his muscles, and upon returning from vacation, will not meet the reluctance of having to resume their daily physical activities.

The beach is a nice place to run or jog, as well as being outdoors and oxygenate your lungs, is also a great way to keep the activity that has made throughout the year in a gym, jogging and running remember to keep healthy the heart.

Another option is the bicycle, why not load the bike and take it to go as a family, all those places we choose to vacation.

All of these pre-planned activities can be an excellent choice when it comes to stay active and not taking a vacation quite sedentary.

Sometimes, due to a wound by an accidental bite or scratch, are formed in the skin of the face plates around annoying and painful. They are due to poor oral hygiene. To avoid this, keep in mind the following tips.

• Do not eat the nails, because in this part of the body are too many bugs and infections.

• Do not share food items (spoons, forks, knives, etc.). Salivation because each person is different and the exchange can affect an injury occurs in the mouth.

• Change your toothbrush every three months.

• Do not take things in their mouths, so avoid unexpected injury or wound infections present.

• When you brush, do not forget to gently clean the gums and tongue. Keep in mind that to achieve good hygiene, the approximate oral brushing is three minutes.

• When you finish using it, wash well the toothbrush so there are no food residue from the bristles.

Knowing that food can be divided according to their content of substrates, shows that we can classify them according to the function that contribute to the body. Functions or objectives of food is the energy intake, plastic controller and backup. Therefore, the food division of function can be shown as follows:

Energy: Carbohydrates and Fats
Protein Plastics
Regulators: Minerals and Vitamins

Physically to perform any processing or energy-consuming movement therefore requires energy and a reserve. To the person is indispensable training and muscle structure, so that’s the plastic. And as the body must be ordered and regulated displayed metabolic regulators and organic.

While we assumed that the proteins provide energy to qualify as organic, the energy supplied is minimal therefore not identified as the main source of energy.

Likewise, the three substrates can expose them, much synthesized by and involved in the metabolic process:

Carbohydrates Carbon Dioxide Water Heat Energy
Fats Energy Carbon Dioxide Water Heat
Heat Energy Protein Nitrogen Carbon Dioxide Products

If seeking more detail on this table, see the Millennium Food.