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Gestational Diabetes Care Guidelines

Medical Nutrition Therapy

Dietary Recommendations

  • The diagnosis of GDM or 1 abnormal value on a 3-hour 100 g OGTT requires the patient to see a Registered Dietitian (RD) for Medical Nutrition Therapy (MNT).
  • Preprinted meal plans are inadequate for long-term management, but can be used in the interval between diagnosis and the patient’s appointment with the RD for MNT.
  • Some patients will require follow-up nutrition counseling visits. Adjustments may be needed during pregnancy based on clinical factors such as weight loss, hunger, abnormal fetal growth, and ketonuria.
  • The nutrition consultation should include an individual nutrition assessment based on the patient’s culture, food preferences, lifestyle, and home glucose monitoring results.
  • Specific recommendation for caloric intake*

Prepregnancy Body Mass Index

Kcal/kg/day

Kcal/lb/day

BMI of 19.8-26.0

30

13.6

BMI of 26.1-29.0

24

10.9

BMI of greater than 29.0

18

8.2

BMI of less than 19.8

36-40

16.3-18.2
*These recommendations are based on calorie requirements for optimal weight gain and for prevention of starvation ketosis during the 2nd and 3rd trimester and may need to be adjusted based on individual activity level.
  • Specific recommendations for weight gain

Weight status

Acceptable weight gain

Underweight (<19.8 BMI)

28-40 lbs

Average (19.8-26 BMI)

25-35 lbs

Overweight (26-29 BMI)

15-25 lbs

Obese (BMI > or equal to 26.0)

15 lbs

Twin gestation

35-45 lbs

Triplet gestation

45-55 lbs
American Dietetic Association, 2002
  • Efforts to lose weight should be discouraged.

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