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80-90% of all cases of mild gestational diabetes can be treated with lifestyle changes.

This table shows the results of the study, the “Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcome”. This was the first large trial to show a reduction in perinatal complications with intervention, as compared to routine obstetric care.

 

Routine Care

Intervention

Adjusted P  Value

Any serious perinatal complication

4%

1%

.01

Macrosomia

21%

10%

<.001

Shoulder dystocia

3%

1%

.08

C-section

32%

31%

.73

Medical Nutrition Therapy guidelines as set forth by the American Diabetes Association and the Academy for Nutrition and Dietetics strongly recommend that women evaluate the lifestyles before conception. This includes things like any medical conditions or risk factors which could interfere with the baby’s development, achieving a healthy body weight before conception, and stopping smoking, among others.

Identify medical conditions that need treatment
Evaluate risk factors, history, medications, & dietary & exercise habits
Establish a meal & exercise plan to achieve healthy body weight
Initiate folic acid therapy
Smoking cessation
Minimize exposure to lead, mercury, & other toxins

 

 IOM’s Guidelines for Gestational Weight Gain

Excessive maternal weight gain is associated with an increased risk of neonatal hypoglycemia, macrosomia, low Apgar scores, seizures, and polycythemia. These may increase the infant’s risk of obesity later in life. Keeping gestational weight gain within certain parameters also helps to prevent postpartum weight retention. Additionally, a total gestational weight gain of < 69% of the recommended ranges have been associated with an increased risk of preterm birth & low birth weight.

It should be noted that weight gain during the 2nd half of pregnancy is strongly associated with fetal growth. The chart below helps to illustrate these parameters.

 

IOM’s Guidelines for Gestational Weight Gain

BMI

Recommend Weight Gain

< 18.5

28-40 lbs

18.5-24.96

25-35 lbs

25-29.9

15-25 lbs

> 30

11-20 lbs

Rate of weight gain appears to be as important to the infant’s health

as amount of weight gain

1st Trimester……….3-5 lbs

2nd & 3rd Trimester………..3-4 lbs per month

 

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