Gestational Diabetes

GDM: Weight Management (2001)

Weight management (Gestational Diabetes Mellitus 2001)

Gestational Diabetes Medical Nutrition Therapy Protocol (2001)

The ADA 2001 Gestational Diabetes MNT Evidence-based guide for practice was originally published in a compact disk (CD) format. This 2001 project was published to the online Evidence Analysis Library for the benefit of ADA members, even though it does not follow the current online format and may be missing some of the components. (The current evidence analysis projects include the following components: question, conclusion, grade, search plan and results, evidence summary, overview table, worksheets, and quality check lists.)

• Assessment
  Gestational Diabetes Mellitus Conclusion Statements: Hypocaloric Diets for Obese Women (2001 CD)

  • Conclusion

    Random control trials have shown that restricting calories to 1200 kcal/day in obese women (BMI>30) with GDM results in ketonemia/ketonuria whereas restricting calories to ~1800 kcal/day does not result in ketonemia or ketonuria.

  • 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: Gestational Diabetes and Hypocaloric Diets for Obese Women (2001 CD)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Churchill JA, Berendes HW, Nemore J.  Neuropsychological deficits in children of diabetic mothers.  Am J Obstet Gynecol 1969; 105:257-268.
      • Knopp RH, Magee MS, Raisys V, Benedetti T, Bonet B.  Hypocaloric diets and ketogenesis in the management of obese gestational diabetic women.  J Am Coll Nutr. 1991;10:649-667.
      • Magee MS, Knopp RH, Benedetti TJ.  Metabolic effects of 1200-kcal diet in obese pregnant women with gestational diabetes.  Diabetes 1990; 39:234-240. 
  Gestational Diabetes Mellitus Conclusion Statements: Weight Gain (2001 CD)

  • Conclusion

    Optimum neonatal outcomes occur in women who gain the recommended weight based on prepregnancy BMI of the Institute of Medicine Guidelines. Overweight and obese women with GDM benefit from nutrition counseling by a dietitian to decrease the rate of weight gain, fasting and postpartum serum glucose, and normalize infant birthweight.

  • 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: Gestational Diabetes and Weight Gain (2001 CD)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Lederman SA.  Pregnancy weight gain and postpartum loss:  avoiding obesity while optimizing the growth and development of the fetus.  JAMWA 2001;56:53-58.
      • Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK.  Gestational weight gain, pregnancy outcome, and postpartum weight retention.  Obstet Gynecol 1995;86(3):423-427.
      • Siega-Riz AM, Adair LS, Hobel CJ.  Maternal underweight status and inadequate rate of weight gain during the third trimester of pregnancy increases the risk of preterm delivery.  J Nutr 1996; 126:146-153.