Table 1 – Nutrition Recommendations for GDM

 

Energy

·        Include three small- to moderate-sized meals and two to four snacks. Space snacks and meals by at least two hours.

·        A bedtime snack is recommended to diminish the number of hours fasting.

 

Carbohydrate

·        Common carbohydrate guidelines: Two carbohydrate choices (30 grams) at breakfast, three to four choices (45 to 60 grams) at lunch and the evening meal, and one to two choices (15 to 30 grams) for snacks.

·        Recommendations should be modified based on individual assessment and blood glucose monitoring test results.

 

High Sucrose Foods

·        Eliminate foods containing large amounts of simple carbohydrates, such as desserts and sweetened drinks.

·        Recommendations should be individualized based on individual’s ability to maintain blood glucose goals and nutritional adequacy of diet.

 

Protein

·        Protein foods do not raise postmeal blood glucose levels.

·        Add protein to meals and snacks to help provide enough calories and satisfy appetite.

·        Meet recommended daily allowance for protein for adult women (0.8 grams per kilogram desired body weight) plus 25 grams per day to meet additional protein needs of the fetus.

 

Fat

·        Focus on leaner choices.

·        Limit saturated and trans fats.

 

Sodium

·        Sodium is not routinely restricted.

 

Fiber

·        Use whole grains, raw fruits, and raw vegetables.

·        Activity and fluids help relieve constipation.

 

Nonnutritive Sweeteners

·        They are generally safe in pregnancy but use in moderation.

 

Vitamins and Minerals

·        Preconception folate.

·        Assess for specific individual needs.

·        Multivitamin throughout pregnancy.

·        Iron at 12 weeks.

·        Calcium in last trimester and while lactating.

 

Caffeine

·        Limit to less than 300 milligrams per day.

 

Alcohol

·        Avoid completely.

 

—    Source: American Dietetic Association Medical Nutrition Therapy Evidence-Based Guides for Practice: Nutrition Practice Guidelines for Gestational Diabetes Mellitus. Chicago, IL: American Dietetic Association; 2001.

 

 

 

 

 

 

 

 

 

 

 

Table 2 - Metabolic Assessments Recommended After GDM

Time

Test

 

After delivery (one to three days)

Fasting or random plasma glucose

 

Early postpartum (around the time of postpartum visit,

usually within six to 12 weeks)

75 grams two-hour OGTT1

 

One year postpartum

75 grams two-hour OGTT

 

Annually

Fasting plasma glucose

 

Triannually

75 grams two-hour OGTT

 

Prepregnancy

75 grams two-hour OGTT

 

 

1 OGTT = Oral Glucose Tolerance Test