Medical nutritional therapy in pregnant women with pregestational diabetes mellitus.
OBJECTIVE
Diabetic women now can have the same chances as nondiabetic women to have a healthy infant. The reduction of risk associated with pregnancies complicated by diabetes can only be assured if normoglycemia is achieved before and during pregnancy. This review is intended to provide guidelines and scientific evidence for the optimal diet for the Type 1 or Type 2 diabetic woman.


METHODS
The literature over the past 10 years is presented. Those diets which achieved the best outcome of pregnancies complicated by diabetes (as evidenced by term delivery of a healthy, normal weight infant) are then outlined.


RESULTS
Diets which provide adequate calories without causing postprandial hyperglycemia or premeal ketosis are found to be based on body weight and gestational week of the pregnancy. Quantity of carbohydrate in the meal plan emerges as the most important component in achieving and maintaining glucose control.


CONCLUSIONS
The medical nutritional therapy for the Type 1 and Type 2 diabetic woman is a necessary component of the overall strategy to achieve and maintain normoglycemia and thus achieve the best outcome of pregnancy.
Jovanovic
L
L
Sansum Medical Research Institute, Santa Barbara, California 93105, USA. lois@sansum.org
D001786:Blood Glucose / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005502:Food; D005865:Gestational Age; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007328:Insulin / Q000008:administration & dosage; D007662:Ketosis / Q000517:prevention & control; D009747:Nutritional Physiological Phenomena; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000178:diet therapy* / Q000188:drug therapy
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin