GDM: Introduction (2008)
Gestational Diabetes Mellitus (2008) Evidence-Based Nutrition Practice Guideline
Guideline Narrative Overview
The focus of this guideline is on medical nutrition therapy (MNT) for women with gestational diabetes mellitus. The primary goals of MNT for women with gestational diabetes mellitus is to achieve and maintain normal blood glucose levels as safely as possible.
- The provision of MNT for pregnant women with impaired glucose tolerance or gestational diabetes mellitus
- Caloric intake
- Macronutrient and micronutrient intake
- Physical activity
- Promotion of breastfeeding
- Blood glucose monitoring and ketone testing
- Indications for pharmacologic therapy
- Monitoring and evaluation
- Prevention of gestational diabetes mellitus recurrence and type 2 diabetes
- Recommendations: 15
- Conclusion Statements: 13
- Evidence Summaries: 13
- Article Worksheets: 164
Application of the Guideline
This guideline will be accompanied by a set of companion documents (i.e., a toolkit) to assist the practitioner in applying the guideline. The toolkit will contain materials such as the Medical Nutrition Therapy protocol, documentation forms, outcomes management tools, client education resources and case studies. The toolkit is currently under development and will undergo pilot-testing through the ADA's Dietetic Practice-Based Research Network prior to publication.
The literature search will be repeated for each guideline topic on an annual basis to identify new research that has been published since the previous search was completed. Based on the quantity and quality of new research, a determination will be made about whether the new information could change the published recommendation or rating.
When the analysis is completed, the expert workgroup will approve and re-grade the conclusion statements and recommendations. The guideline will undergo a complete revision every three to five years.
Medical Nutrition Therapy and Gestational Diabetes Mellitus
Scientific evidence supports the effectiveness of medical nutrition therapy for gestational diabetes mellitus. Topics included in this guideline are:
- Medical nutrition therapy and dietitian intervention
- Reduction of blood glucose levels
- Reduction of risk factors for poor maternal and neonatal outcomes
The registered dietitian plays an integral role on the interdisciplinary healthcare team by making the optimal nutrition prescription and developing the nutrition intervention plan for patients undergoing gestational diabetes therapy. Based on the client's treatment plan and comorbid conditions, other nutrition practice guidelines, such as diabetes, may be needed in order to provide optimal treatment.
Populations to Whom This Guideline May Apply
This guideline applies to pregnant women with gestational diabetes mellitus.
Other Guideline Overview Material
For more details on the guideline components, click an item below:
- Scope of Guideline
- Statement of Intent and Patient Preference
- Guideline Methods
- Implementation of the Guideline
- Benefits and Harms of Implementing the Recommendations.
Clinical judgment is crucial in the application of these guidelines. Careful consideration should be given to the application of these guidelines for individuals with significant medical co-morbidities.