4.3.0.0 Med­i­cal Nu­tri­tion Ther­a­py

Med­i­cal nu­tri­tion ther­apy for GDM is an in­di­vid­u­al­ized nu­tri­tion plan de­vel­oped be­tween the woman and a reg­is­tered di­eti­tian fa­mil­iar with the man­age­ment of GDM (38,39). The food plan should pro­vide ad­e­quate calo­rie in­take to pro­mote fetal/neona­tal and ma­ter­nal health, achieve glycemic goals, and pro­mote ap­pro­pri­ate ges­ta­tion­al weight gain. There is no defini­tive re­search that iden­tifies a specific op­ti­mal calo­rie in­take for women with GDM or sug­gests that their calo­rie needs are dif­fer­ent from those of preg­nant women with­out GDM. The food plan should be based on a nu­tri­tion as­sess­ment with guid­ance from the Di­etary Ref­er­ence In­takes (DRI). The DRI for all preg­nant women rec­om­mends a min­i­mum of 175 g of car­bo­hy­drate, a min­i­mum of 71 g of pro­tein, and 28 g of fiber. As is true for all nu­tri­tion ther­apy in pa­tients with di­a­betes, the amount and type of car­bo­hy­drate will im­pact glu­cose lev­els, es­pe­cial­ly post­meal ex­cur­sions.