Gestational diabetes dietary therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Randomized controlled trials suggest that the risk of GDM may be reduced by diet, exercise, and lifestyle counseling. Specific treatment will be determined by the physician(s) based on:
- Age, overall health, and medical history
- Severity of the disease
- Tolerance to specific medications, procedures, or therapies
- Expectations for the course of the disease
Lifestyle Management
After diagnosis, treatment starts with medical nutrition therapy, physical activity, and weight management, depending on pregestational weight.[1]
Target glucose control in gestational diabetes are:
- Fasting <95 mg/dL (5.3 mmol/L)
- One-hour postprandial <140 mg/dL (7.8 mmol/L)
- Two-hour postprandial <120 mg/dL (6.7 mmol/L)
70-85% of patients have good glycemic control with life style modification.[2]
Moderate amount of non-weight bearing exercise is an important adjunct to dietary advice. It is recommended that pregnant women exercise for about 20-30 minutes everyday/most days of the week.
Dietary Therapy
- Many randomized controlled trials suggest that the risk of GDM may be reduced by diet, exercise, and lifestyle counseling.[3][4]
- All women diagnosed with GDM require nutritional counseling for the appropriate amount of weight gain during pregnancy. Women with a normal BMI (20-25kg/m2) can consume about 30kcal/kg/d, while those who are overweight or obese [BMI >25-34] should restrict their diet to 25 kcal/kg/d and those that have a BMI >34 should consume 20kcal/kg/d or less.
- These patients should restrict fat intake and substitute simple or refined sugars in their diet for more complex carbohydrates.
References
- ↑ Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, Hod M, Kitzmiller JL, Kjos SL, Oats JN, Pettitt DJ, Sacks DA, Zoupas C (2007). "Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus". Diabetes Care. 30 Suppl 2: S251–60. doi:10.2337/dc07-s225. PMID 17596481.
- ↑ Mayo K, Melamed N, Vandenberghe H, Berger H (2015). "The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes". Am. J. Obstet. Gynecol. 212 (2): 224.e1–9. doi:10.1016/j.ajog.2014.08.027. PMID 25173183.
- ↑ Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P (2015). "Diet and exercise interventions for preventing gestational diabetes mellitus". Cochrane Database Syst Rev (4): CD010443. doi:10.1002/14651858.CD010443.pub2. PMID 25864059.
- ↑ Koivusalo SB, Rönö K, Stach-Lempinen B, Eriksson JG (2016). "Response to Comment on Koivusalo et al. Gestational Diabetes Mellitus Can Be Prevented by Lifestyle Intervention: The Finnish Gestational Diabetes Prevention Study (RADIEL): A Randomized Controlled Trial. Diabetes Care 2016;39:24-30". Diabetes Care. 39 (8): e126–7. doi:10.2337/dci16-0014. PMID 27457642.