Obsah fóra poradna o diabetes (= cukrovka) poradna o diabetes (= cukrovka)
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Dieta v rámci GDM

 
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Ronnie83



Založen: 4.3.2014
Příspěvky: 1

PříspěvekZaslal: út březen 04, 2014 6:41 pm    Předmět: Dieta v rámci GDM Citovat

Dobrý den,
jsem momentálně ve 20tt a již od začátku jsem sledována pro GDM, jelikož mi tato byla zjištěna již v předchozím těhotenství ve 26tt (tehdy jsem sledována nebyla). Dcera se narodila ve 40tt s váhou 3260g. Nyní při vstupním vyšetření v diabetologické poradně mi byl zapůjčen glukometr na pravidlené měření, všeobecně vysvětlena dieta. Při první kontrole mi byly zjištěny chyby v dietě ze zanamenávaného jídelníčku (ke svačině odpoledne 1 dílek bábovky, neslazené cappuccino). Byla jsem proto vybavena inzulinovým perem s Actrapidem na dopichování.
Problém je, že doporučení lékařky a dietní sestry se rozcházejí. Zatímco sestra mi doporučila úplně vyloučit veškeré sladké včetně umělých sladidel a snížit na minimum příjem ovoce a některé zeleniny (rajčata, kedlubny), doktorka mě informovala, že rajčata a kedlubny můžu, ale nesmím papriky a zelí.
Při větším stresu mi glykémie výrazně stoupne, jenže na stres se prý vymlouvat nemohu.
Sladké nejím, ovoce skoro také ne (kromě pomela a jablek).
Dietu si přísně hlídám, přesto mi občas glykémie vyletí.
Co vlastně tedy mohu a nemohu jíst, aby mi glykémie vydržely v normě (nalačno 4-5,5mmol/l, 2 hodiny po jídle 4-6,6mol/l)??
Děkuji za radu.
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MUDr. Dagmar Málková



Založen: 26.11.2008
Příspěvky: 129

PříspěvekZaslal: pá březen 06, 2015 2:41 pm    Předmět: Citovat

Dobrý den.

Předně je důležité určit,zda máte opravdu diabetes.
GDM je vázán na těhotenství a matky bývají v budoucnu rizikové pro vznik DM2.
Standardně se doporučuje půl roku po porodu a pak každý další po rok po 40. roce věku provést oGTT a tím klasifikovat poruchu. Zda se jedná o poruchu glukosové tolerance nebo již opravdu o diabetes.
Doporučení diabetické diety jsou nyní daleko volnější něž dříve. V podstatě jsou to zásady racionální stravy s omezením či rozvržením sacharidů do malých dávek několikrát denně.
Já svým pacientům ovoce, mléčné výrobky rozhodně doporučuji. Na svačinu tedy kousek ovoce nebo mléčný výrobek, nahradit lze i malým kouskem bábovky,i když ta by se hodila spíše na snídani.
Pokud glykémie vyletí i přes přísný režim,je na místě přistoupit k trvalé léčbě dle typu diabetu.Pokud se jedná o DM2 ,vystačíte většinou pouze s léky.Pokud o DM1 ,bude nutná insulinoterapie.

S pozdravem D.Málková
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