Gestational diabetes mellitus: diet therapy and pharmacotherapy

The article reflects the recommendations on the features of therapeutic nutrition for gestational diabetes mellitus in addition to current clinical recommendations and considers the issues of micronutrient personalization of the diet, features of cooking technology, issues of nutritional chronobiology, as well as the features of prescribing pharmacotherapy. To prevent GDM, it is important to control body weight before pregnancy. Maintaining a normal body mass index (BMI) reduces the risk of metabolic disorders. Women with excess weight or obesity are advised to lose weight before conception. Healthy eating plays a key role: the diet should be balanced, low in simple carbohydrates and fats, but rich in fiber. Regular physical activity also helps improve insulin sensitivity. Treatment of gestational diabetes mellitus is aimed at maintaining glucose levels within normal limits in order to avoid complications. The main method of therapy is non-drug treatment. Diet therapy plays a key role: meals should be fractional (5-6 meals a day), with a limitation of simple carbohydrates (sweets, sugar, white bread) and an increase in the consumption of foods with a low glycemic index (whole grains, vegetables, legumes). If diet therapy and physical activity do not allow achieving target glucose levels within 1-2 weeks, drug therapy is prescribed. The drug of choice is insulin, since it does not penetrate the placenta and is safe for the fetus. The insulin dose is selected individually based on the glycemia level. In some cases, oral hypoglycemic drugs such as metformin can be used, but their use requires strict medical super vision. Thus, the prevention and treatment of gestational diabetes mellitus require a comprehensive approach, including a healthy lifestyle, regular monitoring of glucose levels, and, if necessary, drug therapy. Timely detection and proper control of GDM helps to avoid serious complications for the mother and child.