Role of Medical Nutrition Therapy in Gestational Diabetes Mellitus: A Review

Gestational diabetes mellitus (GDM), characterized by hyperglycemia during pregnancy, has become a significant health concern for women and is increasingly recognized as a major public health issue in India. Timely detection and strict control of blood glucose levels are essential to improving maternal and neonatal outcomes. Initial management relies on lifestyle modifications, primarily medical nutrition therapy (MNT) along with physical activity. If these measures do not achieve the desired glycemic targets, pharmacological interventions such as insulin are introduced. Consistent monitoring of blood glucose and maintaining records are vital to support treatment adherence and assess effectiveness. MNT in GDM refers to a structured meal plan with controlled carbohydrate intake, designed to provide adequate nutrition, ensure healthy weight gain, and promote both maternal and fetal well-being, while preventing ketosis and achieving normal blood glucose. Emphasis is placed on nutrient-rich carbohydrate sources with low-to-moderate glycemic index and load, as well as the proper quantity and distribution of carbohydrates across meals to reduce postprandial spikes, which represent one of the key challenges in GDM management. Due to increased insulin resistance in the morning, often related to the dawn phenomenon, maintaining glucose control can be difficult at breakfast. Splitting the morning meal has shown effectiveness in lowering post-breakfast glucose levels. This article consolidates evidence from current guidelines and scientific studies on dietary management in GDM, with the objective of achieving normoglycemia, safeguarding maternal and fetal health, and reducing pregnancyrelated complications. Literature was sourced from databases including PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews using relevant search terms.