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Dietary guide for patients with gestational diabetes mellitus (GDM)
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Basic data
| Standard ID | WS/T 601-2018 (WS/T601-2018) |
| Description (Translated English) | Dietary guide for patients with gestational diabetes mellitus (GDM) |
| Sector / Industry | Health Industry Standard (Recommended) |
| Classification of Chinese Standard | C55 |
| Word Count Estimation | 10,153 |
| Date of Issue | 2018-04-27 |
| Date of Implementation | 2018-11-01 |
| Regulation (derived from) | State-Health-Communication (2018) 6 |
| Issuing agency(ies) | National Health Commission |
WS/T 601-2018: Dietary guide for patients with gestational diabetes mellitus (GDM)
---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Dietary guide for patients with gestational diabetes mellitus (GDM)
ICS 11.020
C 55
WS
People's Republic of China Health Industry Standard
Dietary guidance for patients with gestational diabetes
2018 - 04 - 27 released
2018 - 11 - 01 Implementation
National Health and Wellness Committee of the People's Republic of China
Foreword
This standard was drafted in accordance with the rules given in GB/T 1.1-2009.
This standard was proposed by the National Health Standards Committee Nutrition Standards Committee.
This standard was drafted. Peking Union Medical College Hospital of China Academy of Medical Sciences, Beijing Maternity Hospital, Haidian Maternal and Child Health Hospital, PLA General Hospital.
The main drafters of this standard. Yu Kang, Li Rongrong, Fu Chenwei, Qin Wei, Zhao Weigang, Liu Youli, Teng Yue, Liu Yinghua.
Dietary guidance for patients with gestational diabetes
1 Scope
This standard specifies dietary guidelines, energy and recommended intake of nutrients for patients with gestational diabetes.
This standard applies to dietary guidance for patients with gestational diabetes.
2 Terms and definitions
The following terms and definitions apply to this document.
2.1
Gestational diabetes mellitus; GDM
Different degrees of impaired glucose tolerance during pregnancy, excluding diabetes that pre-pregnancy.
2.2
Medical nutrition therapy; nutritional nutrition therapy; MNT
Nutritional interventions and management measures for patients with specific diseases under clinical conditions, including individualized nutrition assessment and diagnosis of patients,
And the development, implementation and monitoring of nutritional treatment programmes.
2.3
Glycemic index glycemic index; GI
After eating food containing 50g of carbohydrates, the area under the blood glucose curve within 2h was increased by the increase in fasting time compared to the phase after eating 50g of glucose.
Should increase. It is generally defined that GI < 55 is a low GI food, 55 ≤ GI ≤ 70 is a medium GI food, and GI > 70 is a high GI food. Common food GI values are attached
Record A.
2.4
Blood sugar load glycemic load; GL
The product of the actual amount of carbohydrate available (in g) per unit weight of food and the glycemic index (GI). usually
Define GL ≤ 10 for low GL food, 10 < GL < 20 for medium GL food, and GL ≥ 20 for high GL food. See Appendix B for common food GL values.
2.5
Food exchange list
Divide common foods into different categories by source and nature. Proteins, fats and carbohydrates of the same type of food in a certain weight
The proportions are similar and the energy produced is similar. Food rooms are interchangeable to enrich the range of food choices.
3 Dietary guidance goals
Patients with GDM should be treated with medical nutrition, and by adjusting their eating behaviors, they should form reasonable dietary habits to meet the nutritional needs during pregnancy.
Maintain proper weight gain during pregnancy, achieve and maintain reasonable blood glucose levels, avoid ketosis, and improve clinical outcomes.
4 The main principles of medical nutrition therapy
4.1 Recommended intake of energy and nutrients
4.1.1 Energy
Ingestion of energy should meet the physiological and metabolic needs of pregnant women and fetuses, maintain appropriate weight gain during pregnancy, and achieve and maintain reasonable blood sugar
Level. According to the Body Mass Index (BMI), the average energy intake of GDM patients is shown in Table 1.
Table 1 Average energy intake of GDM patients
Pre-pregnancy weight
Pre-pregnancy BMI
Kg/m2
Energy coefficient
kJ/kg (kcal/kg)
Early pregnancy
kJ/d(kcal/d)
Mid-pregnancy
kJ/d(kcal/d)
Late pregnancy
kJ/d(kcal/d)
Underweight < 18.5 146167(3540) 8360(2000) 9614(2300) 10241(2450)
Normal weight 18.5 ≤ BMI < 24.0 125 146 (30 35) 7524 (1800) 8778 (2100) 9405 (2250)
Overweight/obesity ≥ 24.0 104125(2530) 6270(1500) 7524(1800) 8151(1950)
Normal and low-weight GDM patients (pre-pregnancy BMI < 24kg/m2) energy intake should be based on non-pregnancy daily energy intake, pregnancy
The early pregnancy remained unchanged, with an increase of 1254 kJ/d (300 kcal/d) in the second trimester and 1881 kJ/d (450 kcal/d) in the third trimester.
Overweight and obese patients with GDM (pre-pregnancy BMI ≥ 24 kg/m2) can be based on weight gain, fetal development, blood glucose and ketone bodies
Individualized energy setting for level and exercise status, generally should not be lower than 6270kJ/d (1500kcal/d) in early pregnancy, mid-pregnancy and pregnancy
The late stage should generally not be lower than 7524kJ/d (1800kcal/d).
4.1.2 Weight gain
During pregnancy, reasonable weight gain should be maintained according to different individual conditions such as pre-pregnancy body mass index and actual gestational age. See Table 2.
Table 2 GDM pregnancy weight gain reference
Pre-pregnancy weight status
Pre-pregnancy body mass index (BMI)
Kg/m2
Total weight gain during pregnancy
Kg
Mean and range of weight gain rates in the second and third trimesters
Kg/week
Underweight < 18.5 12.518.0 0.51 (0.440.58)
Normal weight 18.5 ≤ BMI < 24.0 11.5 16.0 0.42 (0.35 0.50)
Overweight 24.0 ≤ BMI < 28.0 7.0 11.5 0.28 (0.23 0.33)
Obesity ≥ 28.0 5.0 9.0 0.22 (0.17 0.27)
Note. This table is taken from the "Guidelines for the Diagnosis and Treatment of Pregnancy with Diabetes" (Chinese Medical Association Perinatal Medicine Branch Pregnancy and Diabetes Cooperative Group,.2014).
4.1.3 Carbohydrates
Carbohydrates provide 45% to 55% of the total energy. Daily carbohydrates are not less than 130g. Preferential carbonization
Compounds (such as coarse grains) or low GI/GL type staple foods, try to avoid the intake of single disaccharides (such as glucose, sucrose, etc.). Encourage whole grain food
The object accounts for more than 1/3 of the total daily staple food.
The dietary fiber intake should be 25g ~ 30g.
4.1.4 Protein
The energy provided by the protein accounts for 15% to 20% of the total energy. Protein intake is based on a non-pregnancy intake of 1.0 g/(kg·d).
Ingestion during the first trimester of pregnancy increased by 15 g/d and 30 g/d in the second trimester and the third trimester, respectively. It is recommended that fish, poultry, eggs and beans account for the total protein intake per day.
Half or more of the amount.
4.1.5 Fat
The energy provided by fat accounts for 25% to 30% of the total energy. Saturated fatty acids account for no more than 7% of total energy, and monounsaturated fatty acids should account for fat.
More than 1/3 of the total. Trans fatty acids should be less than 1% of total energy. Dicosahexaenoic acid (DHA) should reach.200 mg/d.
4.1.6 Vitamins, minerals and water
The reference intake for pregnant women can be based on the “Chinese Dietary Nutrient Reference Intake (2013 Edition)”.
4.2 Food selection
Promote food diversification, daily intake of cereal potatoes, fruits and vegetables, livestock and poultry, milk beans and oils, can refer to food delivery
Change the copy (see Appendix C). The daily diet should be 12 or more, and 25 or more per week. Valley potato based on energy goals and
Carbohydrate energy supply is better than adjusting daily intake. The preferred low GI/GL complex carbohydrate food, in which the whole grain is not less than the total amount of potato.
1/3. Animals, poultry, fish, milk, eggs and beans can be individually adjusted according to the energy target and the protein reference recommended intake for the actual gestational age.
whole. Reduce the processing of meat and animal foods with high levels of saturated fatty acids. Vegetable intake should reach 500g/d and above, among which green leafy vegetables
The dishes account for 2/3 and above. Under conditions of stable blood sugar, low GI/GL fruit, generally 150g/d to.200g/d, can be used to eat between meals. Cooking
The oil does not exceed 25g/d per day, and the salt does not exceed 6g/d. Avoid drinking alcoholic beverages and eating sugar-added foods.
4.3 Meal arrangements
It is recommended to have 3 meals a day and 2 to 3 times a day to avoid hypoglycemia. Carbohydrates should be included in both daily meals and meals.
The number is relatively fixed. The energy of three meals in the morning, middle and evening accounts for 10%, 15%, 30%, 30% of the total energy, respectively.
5% 总 10% of the total energy. For insulin or hypoglycemic agents, medications that control blood sugar should be closely coordinated with dietary arrangements.
5 Monitoring
Record the type and amount of food ingested daily, measure body weight weekly, and monitor fetal growth and development. After dietary adjustment for 3d to 5d,
Blood glucose and urine ketone bodies were monitored on an empty stomach and 2 hours after meal. Within two weeks of controlled diet, fasting or pre-prandial blood glucose ≥ 5.3 mmol/L and/or 2 h after meals
For ≥6.7mmol/L, insulin therapy should be considered. For those who are urinary ketone positive for energy intake, consider increasing carbohydrate intake.
AA
Appendix A
(informative appendix)
Common food GI value
The common food GI values are shown in Table A.1.
Table A.1 Common food GI values
Food Name GI Food Name GI Food Name GI Food Name GI
Maltose 105.0 Raisin 64.0 White Bread 87.9 Yam 51.0
Glucose 100.0 Mango 55.0 Brown Rice 87.0 Bread 50.0
Cotton white 83.8 banana 53.0 glutinous rice 87.0 taro 47.7
Honey 73.0 Kiwi 52.0 Rice 83.2 Macaroni 45.0
Sucrose 65.0 Banana 52.0 Pancake 79.6 Black Rice Porridge 42.3
Chocolate 49.0 Grapes 43.0 Fritters 74.9 Wheat 41.0
Fructose 23.0 Mandarin 43.0 Potato Puree 73.0 Noodles 37.0
Pumpkin 75.0 Apple 36.0 Comb Cookies 72.0 藕 Powder 32.6
Carrot 71.0 pear 36.0 rice porridge 69.4 barley 25.0
Lentils 38.0 Peach 28.0 Corn Noodles 68.0 Rice Bran 19.0
Chickpeas 33.0 Pomelo 25.0 Potato 62.0 Snow Magic 芋 17.0
Tofu 31.9 Plum 24.0 Millet Porridge 61.5
Mung Bean 27.2 Cherry 22.0 Hamburger 61.0
Green Beans 27.0 Ice Cream 61.0 Buckwheat Noodles 59.3
Tofu 23.7 Yogurt 48.0 Corn 55.0
Soy 18.0 Sour Cheese 33.0 Oat Bran 55.0
Broad Bean 16.9 Skim Milk 32.0 Popcorn 55.0
Peanut 14.0 Milk 27.6 Buckwheat 54.0
Watermelon 72.0 Whole Milk 27.0 Sweet Potato 54.0
Pineapple 66.0 Taro 88.1 Cornmeal Congee 51.8
BB
Appendix B
(informative appendix)
Common food GL
Common food GL is shown in Table B.1.
Table B.1 Common Foods GL
Food Name GL (per 100g) Food Name GL (per 100g) Food Name GL (per 100g)
Glutinous rice 17.8 Instant noodles 7.2 Watermelon 9.9
Buckwheat Bread 16.4 苕 7.1 Banana (cooked) 8.1
Rice 16.2 藕 powder 6.9 pineapple 6.3
Pancake 14.7 Pumpkin 5.9 Kiwi 6.2
Soda Crackers 13.7 Carrots 5.5 Soy Milk 4.9
White hoe head 13.3 mung bean noodles 5.0 apple 4.4
Millet (boiled) 13.3 Lotus Seed 5.0 Orange 4.4
Whole wheat bread 12.1 taro (steamed) 5.0 grapes 4.3
Wheat noodles 11.8 Yam 4.4 Strawberry 4.3
Ice Cream 11.1 Mung Bean 3.8 Mango 3.9
Potato (boiled) 11.0 Green Bean 3.3 Pear 3.7
Burger Bread 10.7 Meter Line 3.2 Peaches 3.1
Chestnut 10.7 Potato Flour 2.7 Skim Milk 2.6
Soy noodles 9.8 broad beans (six incense) 2.5 grapefruit 2.3
Sushi 9.6 Tofu 1.3 Yogurt (original) 2.3
Fritters 9.4 onions 1.2 cherries 2.2
Cornmeal porridge 9.4 tofu (frozen) 0.8 plum 1.9
Buckwheat (yellow) 9.0 peanuts 0.4 whole milk 1.5
Corn (boiled) 7.5 cashew 0.4
CC
Appendix C
(informative appendix)
Food exchange
The food exchange is shown in Table C.1.
Table C.1 Food exchange
Group category
Per weight
energy
kJ(kcal)
protein
fat
Carbohydrate
Main nutrients
Valley potato group potato potato 25 376 (90) 2.0 - 20.0 carbohydrate, dietary fiber
Fruit group
Vegetables 500 376 (90) 5.0 - 17.0
Inorganic salts, vitamins, dietary fiber
Fruits.200 376(90) 1.0 - 21.0
Meat group
Soybean 25 376 (90) 9.0 4.0 4.0
Protein, fat dairy products 160 376(90) 5.0 5.0 6.0
Meat and eggs 50 376 (90) 9.0 6.0 -
Grease group
Nuts 15 376(90) 4.0 7.0 2.0
Fat, protein
Grease class 10 376(90) - 10.0 -
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