Nutrition and weight gain recommendations during pregnancy for women with pre-existing diabetes
Ideally, refer all pregnant women with pre-existing diabetes to an accredited practising dietitian.
General recommendations for healthy eating for patients with diabetes apply, with consideration of the altered nutritional demands of pregnancy. Adequate carbohydrate intake should be maintained to meet pregnancy needs and avoid ketosis; the usual recommended carbohydrate intake is 150 to 180 g per day for a singleton pregnancy.
The postprandial glycaemic response is accentuated in pregnancy, so more emphasis should be placed on managing dietary carbohydrate intake at each meal and snack, choosing carbohydrates with a lower glycaemic index (GI).
Excessive weight gain in a pregnant woman with diabetes contributes to fetal macrosomia. Advise the woman of the recommended weight gain according to her prepregnancy body mass index (BMI); see Recommended weight gain in singleton pregnancies.
|
Prepregnancy BMI (kg/m2) |
Total weight gain range |
Mean rate of weight gain in second and third trimester (range [kg/week]) [NB1] |
|---|---|---|
|
less than 18.5 (underweight) |
12.5 to 18 kg |
0.51 kg/week (0.44 to 0.58) |
|
18.5 to 24.9 (normal weight) |
11.5 to 16 kg |
0.42 kg/week (0.35 to 0.50) |
|
25 to 29.9 (overweight) |
7 to 11.5 kg |
0.28 kg/week (0.23 to 0.33) |
|
30 or higher (obese) |
5 to 9 kg |
0.22 kg/week (0.17 to 0.27) |
|
Note:
BMI = body mass index NB1: Calculations assume a 0.5 to 2 kg weight gain only during the first trimester, and presume a linear gestational weight gain throughout the second and third trimesters. Source: Institute of Medicine (US). Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009. | ||