Gestational Diabetes

GDM: Medical Nutrition Therapy (2008)

Medical Nutrition Therapy

• Monitoring and Evaluation
  What is the evidence regarding Medical Nutrition Therapy on pregnancy outcomes (morbidity, birth weight, glucose control, pharmacological therapy, pre-term delivery, satisfaction with care) in women with gestational diabetes?

  • Conclusion

    Six studies were evaluated to investigate the relationship between Medical Nutrition Therapy on pregnancy outcomes in women with gestational diabetes mellitus.  Medical Nutrition Therapy, initiated within one week of diagnosis and with a minimum of three nutrition visits, results in decreased hospital admissions and insulin use, improves likelihood of normal fetal and placental growth, and reduces risk of perinatal complications, especially when diagnosed and treated early.

     

  • Grade: I
    • 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: What is the evidence to support Medical Nutrition Therapy on pregnancy outcomes (morbidity, birth weight, glucose control, pharmacological therapy, pre-term delivery, satisfaction with care) in women with gestational diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, for the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group.  Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.  N Engl J Med 2005;352:2477-86.
      • Gabbe SG, Gregory RP, Power ML, Williams SB, Schulkin J.  Management of diabetes mellitus by obstetrician-gynecologists.  Obstet Gynecol 2004 Jun;103(6):1229-34.
      • Reader D, Splett P, Gunderson EP, for the Diabetes Care and Education Dietetic
        Practice Group. Impact of gestational diabetes mellitus nutrition practice guidelines
        implemented by registered dietitians on pregnancy outcomes.  J Am Diet Assoc 2006 Sep;106(9):1426-33.
        
      • Sunsaneevithayakul P, Kanokpongsakdi S, Sutanthavibul A, Ruangvutilert P, Boriboohirunsarn D, Keawprasit T, Tantawattana R. Result of ambulatory diet therapy in gestational diabetes mellitus. J Med Assoc Thai. 2006 Jan; 89(1): 8-12.
      • Svare JA, Hansen BB, Molsted-Pedersen L. Perinatal complications in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand 2001;80(10):899-904.
      • Taricco E, Radaelli T, Nobile de Santis MS, Cetin I.  Foetal and placental weights in relation to maternal characteristics in gestational diabetes.  Placenta 2003 Apr;24(4):343-7.
        
  • Search Plan and Results: Medical Nutrition Therapy 2006