Medical nutrition therapy for pregnant women with gestational diabetes mellitus—A retrospective cohort study

Shi, Mai; Liu, Zhaolan; Steinmann, Peter; Chen, Jie; Chen, Che; Ma, Xingjie; Han, Su-Hui

doi:10.1016/j.tjog.2016.01.005

Cited by 14 publications

(26 citation statements)

References 29 publications

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“…Food exchange tables is a great tool to enhance individualization of dietary advice as it empowers patients to add variety to the prescribed meal plan while at the same time ensuring a balanced intake of all necessary nutrients. A retrospective cohort study showed reduced adverse events in the group receiving MNT using the food exchange tables as compared to the group not receiving MNT [59].…”

Section: Interventions To Enhance Healthy Eating and Meal Planningmentioning

confidence: 99%

Nutrition Management of Gestational Diabetes Mellitus

Kapur

Hod

2020

Ann Nutr Metab

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Medical nutrition therapy (MNT) is the bedrock for the management of gestational diabetes mellitus (GDM). Several different types of dietary approaches are used globally, and there is no consensus among the various professional groups as to what constitutes an ideal approach. The conventional approach of limiting carbohydrates at the cost of increasing energy from the fat source may not be most optimal. Instead, allowing higher levels of complex, low-to-medium glycaemic index carbohydrates and adequate fibre through higher consumption of vegetables and fruits seems more beneficial. No particular diet or dietary protocol is superior to another as shown in several comparative studies. However, in each of these studies, one thing was common – the intervention arm included more intensive diet counselling and more frequent visits to the dieticians. For MNT to work, it is imperative that diet advice and nutrition counselling is provided by a dietician, which is easy to understand and use and includes healthy food options, cooking methods, and practical guidance that empower and motivate to make changes towards a healthy eating pattern. Various simple tools to achieve these objectives are available, and in the absence of qualified dieticians, they can be used to train other health care professionals to provide nutrition counselling to women with GDM. Given the impact of GDM on the future health of the mother and offspring, dietary and lifestyle behaviour changes during pregnancy in women with GDM are not only relevant for immediate pregnancy outcomes, but continued adherence is also important for future health.

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Section: Interventions To Enhance Healthy Eating and Meal Planningmentioning

confidence: 99%

Nutrition Management of Gestational Diabetes Mellitus

Kapur

Hod

2020

Ann Nutr Metab

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“…MNT has been identified as the fundamental approach in the prevention and management of GDM. This therapy should ideally be developed, implemented and monitored by an RD or nutritionist [126–128].…”

Section: Medical Nutrition Therapy For the Management Of Gestational mentioning

confidence: 99%

Insights on Medical Nutrition Therapy for Type 2 Diabetes Mellitus: An Indian Perspective

Viswanathan

Krishnan²,

Kalra

et al. 2019

Adv Ther

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It is critical to integrate medical nutrition therapy (MNT) provided by a registered dietician (RD) into primary care of type 2 diabetes mellitus (T2DM). This is necessary to achieve the goals of improving overall metabolic measures beyond calorie restriction and weight loss. Misconceptions about nutrition in T2DM add to the challenges of executing MNT in a culturally sensitive population. The current review provides insights into MNT for the prevention and management of T2DM in India, based on both evidence and experience. It revisits historical Indian studies and provides information on appropriate dietary intake of carbohydrates (60–70%), proteins (~ 20%) and fats (10%) that will be acceptable and beneficial in an Indian T2DM population. It discusses nuances of types of carbohydrates and fats and explains associations of increased dietary fiber intake, balanced intake of low and high glycemic index foods and substitution of saturated fats with plant-based polyunsaturated fats in improving outcomes of T2DM and attenuating risk factors. The article also deliberates upon special patient populations with comorbid conditions and diseases and the necessary adjustments needed in their nutritional care. It outlines a step-wise approach to MNT involving a careful interplay of nutrition assessment, diagnosis, individualization and patient counseling. Overall, the success of MNT relies on providing accurate, acceptable and appropriate dietary choices for continued patient adherence. Collaborative efforts from diabetologists, endocrinologists, internists and RDs are required to prioritize and implement MNT in diabetes practice in India.Funding: Signutra Inc.

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“…Likewise, similar outcomes were produced by an intensive MNT programme and routine obstetric care in insulin use, prematurity, macrosomia, low birth weight, and intrauterine death 38 . MNT counselling produced superior outcomes in maternal weight, rates of adverse events, and exclusive breast feeding than a no MNT control 37 . Similarly, an intensive MNT programme produced better outcomes in rates of perinatal complications, preeclampsia, maternal hospitalisations, neonatal intensive care unit admissions, and had no neonatal deaths compared with routine obstetric care 38 .…”

Section: Effectiveness Of Medical Nutrition/diet Therapy Interventionsmentioning

confidence: 85%

“…Nine studies examined medical nutrition/diet therapy programmes which involved low-glycaemic index (LGI) diet [31][32][33] , oat bran plus routine diet for gestational diabetes 34 , dietary approaches to stop hypertension (DASH) diet that is rich in fruits, vegetables, whole grains and low-fat diary products 35 , 3-day intensive diet therapy 36 , medical nutrition therapy counselling [37][38][39] .…”

Section: Medical Nutrition/diet Therapy Interventionsmentioning

confidence: 99%

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Community-based non-pharmacological interventions for pregnant women with gestational diabetes mellitus: a systematic review

Igwesi-Chidobe

Okechi

Emmanuel

et al. 2022

Preprint

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BackgroundNon-pharmacological interventions are the first line of Gestational diabetes mellitus (GDM) management. Community-based interventions are cheaper, more accessible, with higher patient satisfaction. ObjectivesTo systematically review community-based non-pharmacological interventions and evaluate their effectiveness for GDM. Search StrategyTwelve bibliographic databases and reference list of related studies from inception until January 2022. Selection CriteriaAll primary studies of community-based non-pharmacological interventions for GDM reported in English which investigated any behavioural or clinical outcome(s). Data Collection and AnalysisData were extracted using modified Cochrane’s data extraction template. Studies were evaluated using Cochrane Collaboration’s risk of bias tool. Narrative synthesis was used to summarise findings. This study is registered with PROSPERO (CRD42021257634).Main Results27 studies involving 6,242 pregnant women with GDM involved self-management programmes, medical nutrition/diet therapy, exercise/physical activity, combined diet and exercise, calcium plus vitamin D supplementation, and continuous glucose monitoring. Self-management programmes were more effective than routine care in improving self-efficacy, two-hour postprandial blood glucose, and lifestyle behaviours but were as effective as routine care in improving infant birth weight. Self-management programmes were superior to or as effective as usual care in improving fasting blood glucose, blood glucose control, glycated haemoglobin, macrosomia, and preterm delivery. Medical nutrition/diet therapy was more effective than usual care in improving postprandial blood glucose levels. Limited/conflicting evidence was found for other outcomes and interventions. ConclusionsCommunity-based non-pharmacological interventions are more effective than placebo; and are more or as effective as usual care. Self-management programmes and medical nutrition/diet therapy had the most promising GDM outcomes.

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Medical nutrition therapy for pregnant women with gestational diabetes mellitus—A retrospective cohort study

Abstract: MNT can reduce the incidence of pregnancy complications, increase the exclusive breastfeeding rate, and improve pregnancy outcomes.

Cited by 14 publications

References 29 publications

Nutrition Management of Gestational Diabetes Mellitus

Nutrition Management of Gestational Diabetes Mellitus

Insights on Medical Nutrition Therapy for Type 2 Diabetes Mellitus: An Indian Perspective

Community-based non-pharmacological interventions for pregnant women with gestational diabetes mellitus: a systematic review

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