Gestational diabetes dietary therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gestational diabetes}} | {{Gestational diabetes}} | ||
{{CMG}} | {{CMG}};{{AE}}{{MehdiP}} | ||
==Overview== | ==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<br> | |||
==Lifestyle Management== | |||
After diagnosis, treatment starts with medical nutrition therapy, physical activity, and weight management, depending on pregestational weight.<ref name="pmid17596481">{{cite journal |vauthors=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 |title=Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus |journal=Diabetes Care |volume=30 Suppl 2 |issue= |pages=S251–60 |year=2007 |pmid=17596481 |doi=10.2337/dc07-s225 |url=}}</ref><br> | |||
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.<ref name="pmid25173183">{{cite journal |vauthors=Mayo K, Melamed N, Vandenberghe H, Berger H |title=The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes |journal=Am. J. Obstet. Gynecol. |volume=212 |issue=2 |pages=224.e1–9 |year=2015 |pmid=25173183 |doi=10.1016/j.ajog.2014.08.027 |url=}}</ref> | |||
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== | ==Dietary Therapy== | ||
All women diagnosed with GDM require nutritional counseling for the appropriate amount of weight gain during pregnancy | *Many randomized controlled trials suggest that the risk of GDM may be reduced by diet, exercise, and lifestyle counseling.<ref name="pmid25864059">{{cite journal |vauthors=Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P |title=Diet and exercise interventions for preventing gestational diabetes mellitus |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD010443 |year=2015 |pmid=25864059 |doi=10.1002/14651858.CD010443.pub2 |url=}}</ref><ref name="pmid27457642">{{cite journal |vauthors=Koivusalo SB, Rönö K, Stach-Lempinen B, Eriksson JG |title=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 |journal=Diabetes Care |volume=39 |issue=8 |pages=e126–7 |year=2016 |pmid=27457642 |doi=10.2337/dci16-0014 |url=}}</ref> | ||
*All women diagnosed with GDM require nutritional counseling for the appropriate amount of weight gain during pregnancy. Women with a normal BMI (20-25kg/m<sup>2</sup>) 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== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Obstetrics]] | [[Category:Obstetrics]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Diabetes]] | |||
[[Category:Medical conditions related to obesity]] | |||
Latest revision as of 21:51, 29 July 2020
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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.