Kim, a 24-year-old female, is 28 weeks pregnant with her first baby. She is 5'7" tall and currently weighs 173 pounds. She walks 30 minutes per day, but it is getting harder. Thus, she walks quite slowly. She had a 3-hour oral glucose tolerance test in which she was diagnosed with gestational diabetes. She is in your office and informs you her blood sugars need to be less than 90 mg/dL fasting and less than 120 mg/dL 2 hours post meals. She is having a hard time keeping her blood sugars down 2 hours after a meal. She currently is consuming 3 meals a day, in which she consumes 60-75 grams of carbohydrates. She also has about 4-5 oz. of meat at these meals and a relatively low amount of fat (about 30 grams per day).
Based on the fact her blood sugars are higher than 120 mg/dL 2 hours post meals, what recommendations would you have? (Consider the amount of carbohydrates per each meal, protein, and fat, and if you would recommend snacks)
Since she is pregnant, what at least 2 micronutrients, include the RDAs, she needs to consume on a daily basis?
Would you recommend she continue with her exercise? If so, what alternatives can she do since she has trouble walking?
Kim is eating too much carbohydrates considering her condition and her size. The average woman needs approximately 45 to 60 grams per day. My recommendation for her would be to cut back on carbs. The amount of fat she is getting per day is fine, but she is getting too much protein if she is eating 4 ounces at EACH meal (if it's a total of 4 to 5 for the day, then it's fine and shouldn't be altered). My suggestion is to cut back on the carb intake and increase the amount of vegetables. Kim should also switch to 5 smaller meals a day instead of three ...
This solution of 343 words looks at the case study on a pregnant woman with diabetes and provides specific suggestions on her diet, exercise and vitamin intake. References used are included.