II.Understanding the Nutrition Therapy.

8. Describe the components of nutrition therapy for GDM. Do they differ from
recommendations for other disagnosis of diabetes?

The main goal for apatient with GDM is to provide optimun nutritoin for the fetus as well
as opttimum nutirtion for the mother then alter nutrition to prevent the reoccurance of
GDM and the oset of type 2 diabetes later on. The major nutritional components for
MNT are:

(i) caloric allotment

(ii) carbohydrate intake
(iii) caloric distribution.
Nutrition therapy is recommended for all people with type 1 and type 2 diabetes as an
effective component of the overall treatment plan. The goal is to maintain nutritional
status, control blood glucose, control blood lipid profile and blood pressure . It is
recommended that patients with DM 1&2 monitor their
(i)total carb intake and sources
(ii) dietaary fat
(iii) Protein
(iv) alcohol
(v) physical activity
III. Nutrition Assessment
Evaluate Mrs. Delgado's anthropometric information. Compare her weight gain at this
time to the recommended rate of weight gain during pregnancy.
Her current weight is 175, she has gained 5 more pounds than recommended. A weight
gain of .5 pounds a week for the remainder of her pregnancy will put her at a total weight
gain of 19 pounds. This is within the limits for both the overweight and obese categories
and a good goal
11. Identify any nutriton problems regarding nody weight and body compsition using the
correct diagnostic term.
according to Mrs. Delgado's nutriton history, she has an increased appetite, increased
weight due to body stature
B. Calculations of Nutritent Requirements
12. Estimate Mrs. Delgado's caloric and protein requirements.
Energy requirements are increased in the second and third trimesters to accommodate
fetal growth and the metabolic demands of pregnancy. In women with GDM who are
overweight (BMI >30 kg/m2), a 33% calorie restriction of their estimated energy needs is
recommended(~ 25 kcal/kg/day based on their present pregnant weight).
.TEE = 448 - 7.95 x age [y] + PA x { (11.4 x weight [kg]) + (619 x height [m]) }
448-7.95 x 31 + 1.14 (11.4 x 79.3kg) + (619 x 1.60)
TEE = 2450
For Second trimester = TEE + 340 = 2790
Third trimester = TEE + 452 = 2902
Protein requirements- During the first half of pregnancy protein requirement stay the
same at .8g/kg/day and then second half of pregnancy protein needs increase to 71g/day,
which is based on 1.1g/kg/day of pre-pregnant weight . Protein deficiency should be
avoided due to adverse consequences.
Protein requirements for Mrs. Delgado: 1.1(79.3) = 87.2g/day
https://www.researchgate.net/publication/274698499_Medical_Nutrition_Therapy_in_Ge
stational_Diabetes_Mellitus
https://www.google.tt/search?
q=difference+between+gestational+diabetes+and+diabetes+mellitus+nutrition+therapy&
oq=difference+between+gestational+diabetes+and+diabetes+mellitus+nutrition+therapy
&aqs=chrome..69i57.45526j0j4&sourceid=chrome&ie=UTF-8
http://saynotohighglucose.blogspot.com/2012/12/medical-nutrition-therapy-type-1-dm-
and_21.html
http://journal.diabetes.org/clinicaldiabetes/V17N41999/pg170.htm