Gestational diabetes dietary therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

All women diagnosed with GDM require nutritional counseling for the appropriate amount of weight gain during pregnancy as well as dietary control. Women with a normal BMI [20-25], can consume about 30kcal/kg/d while those who are 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 to more complex carbohydrates. 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 or at least most days of the week. It is a critical point in time for changing the lifestyles of these women since they are at a high risk for development of type 2 diabetes.

Dietary Therapy

Specific treatment will be determined by the physician(s) based on:

• age, overall health, and medical history
• extent of the disease
• tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• opinion or preference

Treatment for gestational diabetes focuses on keeping blood glucose levels in the normal range. Treatment may include:

• special diet
• exercise
• daily blood glucose monitoring
• insulin injections
• there is evidence that certain oral glycemic agents such as glyburide are safe in pregnancy, or at least, are significantly less dangerous to the developing fetus than poorly controlled diabetes. However, few studies have been performed as of this time.