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 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.

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 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.