South
Dakota
Gestational Diabetes Care Guidelines
Medical Nutrition Therapy
Dietary Recommendations
- The diagnosis of GDM or 1 abnormal value on a 3-hour 100 g OGTT requires the patient to see a Registered Dietitian (RD) for Medical Nutrition Therapy (MNT).
- Preprinted meal plans are inadequate for long-term management, but can be used in the interval between diagnosis and the patient’s appointment with the RD for MNT.
- Some patients will require follow-up nutrition counseling visits. Adjustments may be needed during pregnancy based on clinical factors such as weight loss, hunger, abnormal fetal growth, and ketonuria.
- The nutrition consultation should include an individual nutrition assessment based on the patient’s culture, food preferences, lifestyle, and home glucose monitoring results.
- Specific recommendation for caloric intake*
| Prepregnancy Body Mass Index |
Kcal/kg/day |
Kcal/lb/day |
|---|---|---|
| BMI of 19.8-26.0 |
30 |
13.6 |
| BMI of 26.1-29.0 |
24 |
10.9 |
| BMI of greater than 29.0 |
18 |
8.2 |
| BMI of less than 19.8 |
36-40 |
16.3-18.2 |
| *These recommendations are based on calorie requirements for optimal weight gain and for prevention of starvation ketosis during the 2nd and 3rd trimester and may need to be adjusted based on individual activity level. | ||
- Specific recommendations for weight gain
Weight status |
Acceptable weight gain |
|---|---|
| Underweight (<19.8 BMI) |
28-40 lbs |
| Average (19.8-26 BMI) |
25-35 lbs |
| Overweight (26-29 BMI) |
15-25 lbs |
| Obese (BMI > or equal to 26.0) |
15 lbs |
| Twin gestation |
35-45 lbs |
| Triplet gestation |
45-55 lbs |
Academy of Nutrition
and Dietetics, formerly the American Dietetic Association, 2002 |
|
- Efforts to lose weight should be discouraged.
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