Nutrition Pearls for Optimal Gestational Diabetes Mellitus Management

The American Diabetes Association (ADA) recommends that gestational diabetes mellitus (GDM) should initially be managed with diet and exercise, with medication added only if blood sugars remain elevated. The goal of medical nutrition therapy (MNT) in GDM management is to promote adequate maternal weight gain, healthy growth of fetus, and normoglycemia. A referral to a registered dietitian can help patients navigate a GDM diagnosis by assessing their beliefs, practices, barriers, weight status/ goals, and caloric needs. Furthermore, a majority of women with GDM can adequately manage their blood sugars with diet and lifestyle modifications. However, talking about macronutrients does not mean very much if patients do not understand how to adjust the foods they actually eat. Nutrition and lifestyle information should be provided in a way that is easy to digest and not too overwhelming. The Dos and Don’ts provided here are meant to guide the clinician working with patients who have GDM to help patients feel more in control of their diet and glucose levels. GDM Nutrition Dos 1. Assess typical dietary intake and patient’s knowledge by having them rank foods they commonly eat as having a low, medium, or high impact on their blood sugar. Based on the patient’s knowledge and ranking of foods, the dietitian can clarify which foods, quantities, and combinations are likely to increase blood sugars the most. Diet recommendations need to be tailored to limit foods that cause post-meal spikes and be inclusive of foods that have a more benign effect on the patient’s blood sugar. 2. Decode and simplify eating by demonstrating “real meals” using a plate planner. Go even further by helping patients identify where the foods they regularly consume fit on the plate. 3. encourage food label reading, but keep it simple.