EAL

GDM: Medical Nutrition Therapy (2016)

Intervention
In women with GDM, what is the effectiveness of MNT intervention, provided by an RDN on fetal/neonatal and maternal outcomes?
- Conclusion
  Medical nutrition therapy (MNT), provided by an RDN (or international equivalent), as part of a comprehensive intervention is effective in improving blood glucose control and fetal or neonatal and maternal outcomes in women with gestational diabetes mellitus (GDM). Improved outcomes included lower birth weight and a reduction in the following: Incidence of macrosomia (LGA), need for insulin therapy, hypertensive disorders of pregnancy and maternal hospitalizations, neonatal intensive care unit admissions and neonatal deaths, premature births and rate of shoulder dystocia, bone fracture, and nerve palsy.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In women with GDM, what is the effectiveness of MNT intervention, provided by an RDN on fetal or neonatal and maternal outcomes?
- Search Plan and Results: GDM: Medical Nutrition Therapy 2015
In women with GDM, what is the optimal frequency and duration of MNT visits by an RDN to improve fetal/neonatal and maternal outcomes?
- Conclusion
  No evidence was identified to evaluate the optimal frequency and duration of MNT visits by an RDN (or international equivalent) to improve fetal or neonatal and maternal outcomes.
- Grade: V
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Search Plan and Results: GDM: Medical Nutrition Therapy 2015
In pregnant women at risk for GDM, what is the effectiveness of MNT intervention by an RDN to prevent the development of GDM?
- Conclusion
  Medical nutrition therapy (MNT) intervention provided by an RDN (or international equivalent), either alone or as part of a lifestyle counseling or an intensive obstetric intervention, reduced the incidence of GDM in overweight or obese pregnant women, or those with a history of GDM, in three of six reported studies. In addition, MNT intervention improved one or more of the following outcomes: Fasting glucose, fasting insulin concentration, insulin resistance, maternal gestational weight gain and the quality of dietary fat or folate intake.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women at risk for GDM, what is the effectiveness of MNT intervention by an RDN to prevent the development of GDM?
- Search Plan and Results: GDM: MNT and Prevention of GDM 2015