Question

Elizabeth’s Story: Gestational Diabetes Elizabeth is a 36 year old who entered pregnancy with a BMI of 23.5 kg/m. She began receiving prenatal care at 32 weeks gestation and was screened for gestational diabetes the next day. Results of her oral glucose tolerance test revealed the following blood glucose levels: Fasting: 90mg/dl 1 hour: 195 mg/dl 2 hour: 163 mg/dl Elizabeth’s health care provided advised her to consume a no-sugar, low carbohydrate diet and to keep her weight gain low throughout the rest of the pregnancy. She delivered a large infant (4750 grams) at 39 weeks gestation.

Questions (answers must be at least 2-3 sentences):

1. Was Elizabeth insulin resistant?

2. What was wrong with the dietary advice Elizabeth was given?

3. List three components of appropriate dietary advice for women with gestational diabetes.

Answer 1

1. The above scenario describes that Elizabeth was not insulin resistant. Insulin resistance occurs when insulin levels are sufficiently high over a prolonged period of time causing the body's own sensitivity to the hormone to be reduced.

2. The wrong health education given to Elizabeth was reduce carbohydrates diet after 32 weeks of gestation. This is the period when most of the final development of fetus taking place and wight improving. So she need carbohydrate rich foods.

3.The main components of dietary advice for women with gestational diabetes are;

* Eat a variety of foods, distributing calories and carbohydrates evenly throughout the day. Make sure both your meals and your snacks are balanced.

* Include high-fiber foods, such as fresh fruits and vegetables, whole grain breads and cereals, and dried peas, beans, and other legumes. These foods are broken down and absorbed more slowly than simple carbohydrates, which may help keep blood sugar levels from going too high after meals.

* Limit intake of foods and beverages that contain simple sugars such as soda, fruit juice, flavored teas and flavored waters, and most desserts – or avoid them altogether. These foods can quickly elevate blood sugar.

* Milk is high in lactose, a simple sugar, so may need to limit the amount drink and find an alternative source of calcium.

* include more fibre in diet.