Saber para fazer - protocolo de assistência nutricional para mulheres com diabetes mellitus gestacional

Abstract

During pregnancy, the development of Gestational Diabetes Mellitus (GDM), which is characterized by hyperglycemia, should be considered a priority in health care, since its consequences directly affect mothers and babies. Scientific evidence demonstrates that nutritional therapy, physical activity and monitoring of capillary blood glucose play an important role in the treatment of this disease, since, during the gestational period, nutritional needs become increased due to physiological adjustments in the maternal organism and fetal development. , with adequate availability of nutrients and a balanced diet being essential for this stage of life. Thus, the objective of this study, in the format of technical product development, was to structure a protocol for nutritional assistance to pregnant women with GDM, based on the current stages of the Nutrition Care Process (PCN) to guide nutritionists in providing care in high quality nutrition. This is a bibliographic study, searching for data to carry out the nutritional assistance protocol for pregnant women with GDM. To structure the protocol, the Brazilian Nutrition Care Systematization Guideline Manual of the Brazilian Nutrition Association and the PCN model were used according to the following steps: Information, nutrition assessment, nutrition diagnosis, nutrition intervention and nutritional monitoring. The study was carried out between May 2022 and April 2023 and to define the indicators/information at each stage of the PCN, data was searched in Ministry of Health documents: (1) High-risk prenatal manual; (2) Guide for the Organization of Food and Nutritional Surveillance in Primary Health Care; (3) Basic prenatal care booklet; (4) Guidelines for the Collection and Analysis of Anthropometric Data in Health Services; (5) Protocol for the Use of the Dietary Guide for the Brazilian Population in Dietary Guidance for Pregnant Women. The Guidelines of the Brazilian Diabetes Society (2020 and 2022) and the DRIs were also used. After the first data extraction, four cycles of group meetings were held with nutritionists and research professors, with the aim of selecting pertinent information and adapting it for the construction of this protocol. The protocol has 70 pages, including presentation, summary, general information from the medical record and the steps of nutritional care. At each stage, in addition to the PCN terms, key information on the topic was included to support the nutritionist and a summary table of recommendations to be used by the nutritionist during GDM care. Its validation will also be carried out with specialists, to check whether the formatting, messages and frames are compatible and suitable for handling during consultations. After that, the protocol will be available for publication and made available in ebook format. The protocol developed can be an innovative tool for nutritional assistance in GDM, as it systematized the steps of nutritional care. Thus, after its validation, it can fill an important gap with regard to nutritional assistance to women with GDM, in order to guide the nutritionist's clinical practice for nutritional monitoring of this population.