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?
