THE POSSIBILITIES OF DIET THERAPY FOR GESTATIONAL DIABETES MELLITUS

Аннотация

Gestational diabetes mellitus is currently defined as a disease characterized by hyperglycemia, first detected during pregnancy. Hyperglycemia is one of the most common conditions that women face during pregnancy. The diet must be based on the list of permitted foods. A well-chosen diet and sufficient physical activity help prevent the development of complications of gestational diabetes mellitus. Key words: gestational diabetes mellitus, obesity, diet therapy, food. Actuality. In a healthy pregnant woman, to overcome physiological insulin resistance and maintain blood glucose levels normal for pregnancy, a compensatory increase in insulin secretion by the pancreas occurs approximately three times (the mass of beta cells increases by 10-15%). However, in pregnant women, especially if there is a hereditary predisposition to diabetes mellitus, obesity (BMI more than 30 kg/m2), etc., the existing insulin secretion does not always allow one to overcome the physiological insulin resistance that develops in the second half of pregnancy. Recent data indicates that approximately 65% of the working-age population in the country is overweight, including varying degrees of obesity. In a healthy pregnant woman, to overcome physiological insulin resistance and maintain blood glucose levels normal for pregnancy, a compensatory increase in insulin secretion by the pancreas occurs approximately three times (the mass of beta cells increases by 10-15%). However, in pregnant women, especially if there is a hereditary predisposition to diabetes mellitus, obesity (BMI more than 30 kg/m2), etc., the existing insulin secretion does not always allow one to overcome the physiological insulin resistance that develops in the second half of pregnancy. This leads to increased blood glucose levels and the development of gestational diabetes mellitus. With the bloodstream, glucose is immediately and unhinderedly transferred through the placenta to the fetus, facilitating its production of its own insulin. Fetal insulin, having a “growth-like” 167 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference effect, leads to stimulation of the growth of its internal organs against the background of a slowdown in their functional development, and excess glucose coming from the mother through its insulin is deposited from the 28th week of pregnancy in the subcutaneous depot in the form of fat. As a result, chronic maternal hyperglycemia harms the development of the fetus and leads to the formation of the so-called “diabetic fetopathy.” These are fetal diseases that occur from the 12th week of intrauterine life until birth: large fetal weight; violation of body proportions - large belly, wide shoulder girdle and small limbs; advancement of intrauterine development - with ultrasound, an increase in the main dimensions of the fetus in comparison with gestational age; swelling of tissues and subcutaneous fat of the fetus; chronic fetal hypoxia (impaired blood flow in the placenta as a result of prolonged uncompensated hyperglycemia in a pregnant woman); delayed formation of lung tissue; injuries during childbirth; high risk of perinatal mortality. The diet must be based on the list of permitted foods. Diet No. 9 for gestational diabetes mellitus allows you to consume: raw and boiled vegetables (except starchy ones and carrots); berries and fruits (sour): strawberries, currants, blueberries, raspberries, apricots, peach; cereals (except semolina); cheese, cottage cheese; Rye bread; lean meat (chicken, turkey, beef), cooked with a minimum of fat; nuts; chicken eggs; mushrooms; greenery; legumes. The following are excluded from the diet menu for GDM: sausages, sugar, jams and preserves, honey, baked goods and pasta made from white flour, confectionery, baked goods, fruit juices, potatoes, semi-finished products, ice cream, sweet fruits (bananas, persimmons, figs, melon). Butter should be limited. Conclusion. A properly formulated diet and adequate physical activity help prevent gestational diabetes mellitus.