Management of gestational diabetes mellitus

Figures & data

Table 1 Glycemic target in pregnancy

	ADA^Citation3 4th IWC 1998^Citation22	ACOG 2001^Citation52	Parretti 2001^Citation26 SBGM	Yogev 2003 ^Citation27 CGMS	Siegmund 2007^Citation28 CGMS
FPG (mg/dL)	<95	60–90	62 ± 4.5	75 ± 12	77.3 ± 9.0
1 h PPPG (mg/dL)	<140	<130–140	94 ± 6	105 ± 13	100.0 ± 12.6
2 h PPPG (mg/dL)	<120	<120	81.4 ± 5.7	97 ± 11	–
Mean blood glucose (mg/dL)	–	100	74.7 ± 5.2	83.7 ± 18	87.2 ± 7.2

Abbreviations: FPG, fasting plasma glucose; 1 hPPPG, 1 hour postprandial plasma glucose; 2 hPPPG, 2 hour postprandial plasma glucose; SBGM, self blood glucose monitoring; CGMS, continuous glucose monitoring system.

Table 2 Calorie intake and distribution in GDM women

Calorie intake in accordance with BMI (kcal/kg actual weight)		Caloric distribution
•<19.8	36–40	•Breakfast 10%–15%
•19.8–26	30	•Snack 5%–10%
•26.1–33	24	•Lunch 20%–30%
•>33	12–18	•Snack 5%–10%
+340–452 kcal/die in 2nd and 3rd trimester		•Dinner 30%–40%
		•Snack 5%–10% (25 g CHO + 10 g P)
Nutrient distribution
CHO 45%–50% (complex carbohydrate and fiber)
P 15%–20%
L 30%–35% (mono and polyunsaturated)

Abbreviations: CHO, carbohydrates; P, proteins; L, lipids.

Table 3 Guidelines of the ACOG for exercise during pregnancy

Exercise recommended in pregnancy	Exercise to be avoided in pregnancy
1. walking	1. skiing
2. jogging/running	2. horseback riding
3. aerobic dance	3. ice hockey
4. swimming	4. socce
5. cycling	5. basketball
6. dancing	6. scuba diving
Intensity of exercise 60%–90% of maximal heart rate 50%–85% of either maximal oxygen uptake or heart rate reserve
Duration and frequency 30 minutes a day (in absence of either medical or obstetric complications)

Figure 1 Management of gestational diabetes.

Abbreviations: FPG, fasting plasma glucose; 2 h PP, 2 h postprandial glucose; MPG, mean plasma glucose.

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