The Role of Medical Nutritional Therapy in Gestational Diabetes

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Gestational Diabetes
Diabetes develops when the body can't efficiently produce or use insulin made by the pancreas. Insulin is a hormone made by the pancreas that lets cells change glucose into fuel. When glucose accumulates in the blood in large amounts, it means that cells aren't getting the fuel they need. Gestational diabetes (GD) is a type of diabetes that can develop in a pregnant woman who did not necessarily have diabetes before becoming pregnant. This condition is caused by changes in a pregnant woman’s metabolism and hormone production where the body does not produce enough insulin to deal with the increased blood sugar of pregnancy. Symptoms of GD can include excessive thirst, more frequent urination, vaginal infections, and high blood pressure. GD almost always disappears once the baby is born and is usually not an indicator of the child developing diabetes later in life.
While a woman is generally safe from complications from gestational diabetes, there are some very big risks to the baby. If gestational diabetes goes undiagnosed, there is a greater risk of stillbirth. Other complications can include a condition called macrosomia, where the baby is born weighing 9 ¾ pounds or more. Excessively large babies can make delivery more difficult for both mother and child and as a result, birth injuries are more common in these babies. Other problems include hypoglycemia in the baby shortly after birth. The risk of gestational diabetes is higher in women who are over 30 years old, have a family history of diabetes, are obese, and those who have previously had a macrosomic baby.
Diagnosis and Management of Gestational Diabetes
Screening for gestational diabetes has become routine in prenatal care and usually takes place ...

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...insulin adjustments becomes a primary goal.
Most women with gestational diabetes return to normal glucose tolerance postpartum, however, they are at increased risk of developing gestational diabetes in any additional pregnancies and for getting type 2 diabetes later in life. Lifestyle modifications aimed at reducing or preventing weight gain and increasing physical activity after pregnancy is recommended and can reduce the risk of subsequent diabetes.
Medical nutrition therapy for people with GD should be individualized based on a persons, height, weight, physical activity, food aversions, and other medical conditions. Monitoring of metabolic parameters, including glucose, lipids, blood pressure, and body weight, as well as the health of the developing baby, is important to assess the need for changes in medical nutrition therapy and to ensure successful outcomes.
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