GDM: Dietary Vitamin and Mineral Intake
➤ The RDN should encourage women with GDM to make healthy food
choices and consume a variety of foods to meet the micronutrient needs
of pregnancy. The micronutrient needs of women with GDM are the same
as for pregnant women without diabetes (emphasis on dietary intake of
iron, folate, calcium, vitamin D, choline and iodine). The consumption
of more food to meet caloric needs and the increased absorption and
efficiency of nutrient utilization that occurs in pregnancy, are generally
adequate to meet the needs for most nutrients, when good food choices
are consistently made. (Consensus, Imperative)
GDM: Vitamin and Mineral Supplementation
➤ The RDN should consider recommending dietary supplementation within
the DRI for pregnancy with a prenatal multivitamin/mineral or specific
vitamin or mineral supplement(s) to address inadequate dietary vitamin
and mineral intake (e.g., iron, folate, calcium, vitamin D, choline and
iodine) or documented micronutrient deficiency. Dietary supplements may
be indicated in pregnant women at high risk for inadequate micronutrient
intake, such as food insecurity; alcohol, tobacco or other substance
dependency; anemia; strict vegetarian (vegan) diet; or poor eating habits.
(Consensus, Imperative)
GDM: Meal and Snack Distribution
➤ In women with GDM, the RDN should distribute the total calories and CHO
into smaller meals and multiple snacks per day. The distribution should
be individualized, based on blood glucose levels, physical activity and
medication, if any (e.g., insulin) and adjusted as needed. Three meals
and two or more snacks helps to distribute CHO intake and reduce post-
prandial blood glucose fluctuations. (Consensus, Imperative)
GDM: Use of High-Intensity Sweeteners
➤ In pregnant women with GDM, who choose to consume high-intensity
sweeteners, the RDN should educate the woman to select only those
approved or generally recognized as safe (GRAS) by the US Food and Drug
Administration (FDA) and to limit her intake to the acceptable daily intake
(ADI), established by the FDA. The FDA has concluded the safety of six high-
intensity sweeteners [saccharin, aspartame, acesulfame potassium (Ace-K),
sucralose, neotame and advantame] when consumed within the ADI by the
general population, including pregnant women. Steviol glycosides and Luo
Han Guo (monk fruit) extracts are also GRAS when consumed within the ADI.
(Consensus, Conditional)
