The Adjustments
The treatment of the diabetes during the gestation aims at a good glicmico control. When it occurs imperfection in the attainment of good glicmico control with diet, associate or it physical exercises are not indicated the insulinoterapia (Bertini, 2005 and Langer, 2006). The number of gestantes that use insulina depends on the population and the used glicmicos parameters as objective, being able to arrive 60% of these more than. (LANGER, 2002). For the beginning of the insulinoterapia with security, the education of the administration technique must be made, of the adjustments of the diet and recognition, treatment and prevention of hipoglicemia crises. The dose insulina initial, as the number of daily administrations, has frequent that to be increased with the progress of the pregnancy, which had to the increase of the insulinorresistncia folloies that it. Another factor that helps in the therapeutical one of diabetes is the adequate food ingestion for the gestante, therefore the therapeutical nutricional is the rock of touch of this treatment and has as objective main to keep the glicmico peak after-prandial inside of normal values.
The limitation of the carboidratos in the meals is basic, since these are the factor most determinative for glicmico peak after-prandial. The nutricional program must contemplate 6-7 daily meals, being 3 main meals, 2 3 intermdias and 1 when lying down. The diet must provide to calories and enough nutrients, as much for the necessities of the pregnancy, as for the attainment of the established glicmicos objectives. In the composition of the diet the carbohydrates will have to contribute with 50 55% of the energy necessities, the proteins with 15 20% and the lipdeos with 30% (10% of saturated fats, 10% of monoinsaturadas and 10% of I polished-insaturadas). Therefore, the accompaniment with a nutritionist is essential during the gestation, independent if the gestation will be of risk or not. The necessary gestante to know that its nutricionais necessities are fulfilled of adequate form.