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Key Components of Care for Women With Gestational Diabetes

	Introduction

 
Nutrition practice guidelines for diabetes provide direction to professionals on the best way to practice clinical care and achieve improved blood glucose control. Nutrition practice guidelines have been available since 1995 for type 2 diabetes¹ and since 1996 for type 1 diabetes.²

Medical nutrition therapy (MNT) for diabetes has been proven to lower HbA_1c concentrations 1–2% and is crucial to effective care.¹,² MNT is recommended for the management of gestational diabetes mellitus (GDM), and it is often the only diabetes treatment offered to women with this condition.

Unfortunately, few research studies have been devoted to the nutrition issues involved in the care of GDM. Without adequate research data, there has been no consensus on the nature and definition of MNT for patients with GDM. This has resulted in:

• inconsistent or nonexistent nutrition care for women with GDM,
  
• a lack of knowledge relating to the costs and potential benefits of nutrition care for GDM,
  
• unnecessary complications for women with GDM, and
  
• an absence of a clear message about the importance of nutrition to other professionals and organizations who deal with GDM.
  

These concerns led the Diabetes Care and Education and the Women and Reproductive Nutrition practice groups of the American Dietetic Association to collaborate on the development of practice guidelines for GDM (Table 1). These guidelines seek to define the level and nature of MNT that has been shown to promote normoglycemia, provide optimum nutrition, and reduce complications in GDM.

• MNT is essential to achieving glycemic control for women with GDM.
  
• Intensive treatment of hyperglycemia can reduce the fetal risk of excessive size for gestational age.
  
• Registered dietitians are the health care providers best prepared to provide MNT. Dietitians should work in collaboration . . . [Full Text of this Article]

	SMBG

	CHO Recommendations

	Calories and Weight Gain

	Dietitian Intervention and Contacts

	Postpartum Care

	Validation and Field Testing

	Acknowledgments

	Footnotes

	References

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