Maternal risks include the development of diabetes after pregnancy, as well as having an infant with macrosomia, with elevated risk of developing
obesity and diabetes in childhood. The main goal of treatment is to maintain an adequate
glycemic control during pregnancy and guarantee the recommended
weight gain. The first treatment strategy is
diet therapy, however, some women need
insulin therapy to achieve adequate
glycemic control. The risk of diabetic fetopathy decreases when maintaining postprandial glycemic levels within normal ranges. These levels are directly associated with the amount and type of
carbohydrates consumed during meals. So,
nutrition therapy should be an integral part of
gestational diabetes treatment.
Nutrition therapy includes a complete nutrition assessment, an individual food plan that meets energy and
protein requirements for pregnancy (in obese women never lesser than 1,700 kcal/day), in which
lipids and
carbohydrates may provide lesser than 40 and between 40 and 45% of total energy intake. Education about food groups that provide
carbohydrates, portion sizes and how to achieve an equal
carbohydrate distribution throughout the day should be provided. Orientation about eating healthy
fats and increasing the consumption of high-fiber foods should also be included. This approach requires that treatment of women with
gestational diabetes should be provided by a multidisciplinary team, including nutrition specialists.