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Cardio Diabetes Medicine 2017 595

“Medical Nutritional Therapy in Gestational Diabetes”

DR.MEENAKSHI BAJAJ

PG.DND., M.Sc., C.D.E., R.D., CCN (U.S.A).,(PhD).,
DIETICIAN, Tamil Nadu Govt. Multi Super Specialty Hospital,Chennai

Introduction: Nutrition Therapy During a Pregnancy with
Gestational diabetes mellitus” (GDM) is defined as Diabetes Strives to Achieve Three Important
carbohydrate intolerance with onset or recognition Goals
during pregnancy .GDM is associated with perinatal
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morbidity and mortality in the current pregnancy, risk 1. Minimize blood glucose excursions and maintain
of the mother developing type 2 diabetes, and of in- glucose values within target goal ranges before and
tra-uterine programming of the developing fetus with after meals.
subsequent expression of disorders in later life. 2. Provide a calorie intake that is neither inadequate
Lifestyle change is an essential component of man- nor excessive and will achieve an appropriate for
agement of GDM and may sufβce for the treatment gestational weight gain without maternal ketosis.
for many women. Medical nutrition therapy (MNT) 3. Ensure adequate, and safe, nutrients for maternal
reduces pregnancy and perinatal complications and and fetal health.
brings glycemic control 2
Weight Gain During Pregnancy
Pregnant women who are diagnosed with gestation-
al diabetes mellitus (GDM), should be referred to a The expected weight gain during pregnancy is 300–
registered dietitian (RD) for MNT. Individualized MNT 400 g per week and total weight gain is 10–12 kg by
is important in helping pregnant women with GDM term.
achieve and maintain normal glycemic levels and Nutrition Interventions For Pregnancy With
appropriate weight gain, while meeting essential nu-
trients for pregnancy to promote positive maternal Diabetes
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and fetal outcomes . MNT includes nutrition assessment, patient interview,
clinical data, blood glucose records, food history,
Nutrition Therapy For Diabetes And exercise pattern, psychosocial and economic condi-
Pregnancy tions when developing an individualized meal plan.
Nutritional therapy guidelines include achieving op- Nutrition assessment is organized under five cate-
timal body weight and starting a prenatal meal plan gories
before attempting conception.
These are: Food/Nutrition-Related History; Anthro-
AIM: As preventive medicine starts before birth, to pometric Measurements; Biochemical Data, Medical
provide adequate calorie and nutrients to meet the Tests, and Procedures; Nutrition-Focused Physical
maternal and fetal demands, provide energy intake Findings; Client History
for appropriate weight gain, and avoid excessive
weight gain, decrease the risk of hypoglycemia and Food or Nutrition-Related History 4
avoid postprandial hyperglycemia, avoid ketonemia Dietary history includes a thorough review of usu-
and ketonuria, prevent obesity, impaired glucose tol- al food intake, pattern of intake (timing, meals and
erance and type2diabetes in the offspring.
snacks) and previous history of diet adherence. Edu-
cational knowledge, such as nutrition and meal-plan-

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