Nutrition Therapy in Gestational Diabetes Mellitus: Time to Move Forward
Open accessAbstract
Nutrition therapy remains the conventional first-line approach to treatment of gestational diabetes mellitus (GDM). It will reach every woman with GDM across differing diagnostic criteria (1) and phenotypic heterogeneity (2). The goal of nutrition in pregnancy is to support maternal, placental, and fetal metabolic needs, and it may be the first introduction to a lifetime of healthy eating (3). In this way, nutrition therapy in GDM becomes an early-stage intervention in the vicious cycle of intergenerational obesity and diabetes (4). Importantly, because the prevalence of GDM has reached an alarming ≥20% of pregnancies (5), a cost-effective approach to management is urgently needed. While controlling fetal exposure to maternal hyperglycemia and overnutrition, effective nutrition can treat GDM in a way that is fiscally reasonable and culturally sensitive, ultimately reducing the need for medication and intensified health care resource use (1). The importance of nutrition therapy in GDM is a premise unlikely to be contested. Yet, the widely accepted approach rooted in carbohydrate restriction was challenged more than a decade ago based on concerns related to higher fat intake and exacerbation of maternal insulin resistance by free fatty acids (6,7). The dietary management of diabetes in pregnancy has remained in limbo ever since, with no specific guidelines for nutrition therapy in GDM, a travesty that has resulted in non–evidence-based, fragmented, and inconsistent approaches globally (8–12). Action is necessary not only because of the powerful influence of nutrition on fetal programming and development (13,14) but also because of the ability to positively impact the health of millions of mother-infant dyads. Currently, nutrition therapy appears to have become our Achilles heel, such that despite our strength, we have limped forward in generating clinical evidence to substantiate …
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The challenge of MNT lies in achieving a balance between meeting the nutritional demands of pregnancy and ensuring effective blood glucose control to reduce the risk of macrosomia while simultaneously preventing starvation ketosis.
“The challenge of MNT lies in achieving a balance between meeting the nutritional demands of pregnancy and ensuring effective blood glucose control to reduce the risk of macrosomia while simultaneously preventing starvation ketosis [14].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [14]
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- Authors
- Hernandez, T. L., & Brand-Miller, J. C.
- Affiliations
- University of Colorado Anschutz (US)
- The University of Sydney (AU)
- Corresponding author
- Hernandez, Teri L.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-06-14
- Volume
- 41
- Issue
- 7
- Pages
- 1343-1345
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC6014541
- OpenAlex
- W2809684920
- Cited by
- 52
- References
- 34
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 6 · 2022: 9 · 2021: 5 · 2020: 14 · 2019: 8
- FWCI
- 7.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Janssen Research & Development
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK101659)
- National Health and Medical Research Council
- Glycemic Index Foundation
- Food Innovation Australia Limited
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- gestational diabetes mellitus, nutritional therapy, carbohydrate restriction, maternal hyperglycemia, fetal programming, maternal insulin resistance, free fatty acids, intergenerational obesity, cost-effective care, dietary guidelines
- MeSH terms
- Female, Humans, Insulin, Pregnancy, Diabetes, Gestational, Nutrition Therapy
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