Current - Issue

Gestational diabetes mellitus (GDM), characterized by glucose intolerance first identified during pregnancy, has emerged as a major global public health challenge due to its increasing prevalence and associated maternal-fetal complications. GDM significantly elevates the risk of macrosomia, preeclampsia, neonatal hypoglycemia, and the future development of type 2 diabetes mellitus (T2DM) in both mother and child. Medical Nutrition Therapy (MNT) remains the primary non-pharmacological strategy for GDM management, with evidence demonstrating effective glycemic control in the majority of affected women. The present study aimed to evaluate the nutritional, clinical, anthropometric, and lifestyle profiles of pregnant women diagnosed with GDM and to develop an individualized low glycemic index (GI)- based MNT intervention to improve maternal and fetal health outcomes. A total of 30 pregnant women diagnosed with GDM were recruited from Ayushman Arogya mandir, Hospital, Chapiri, through purposive random sampling. Socio-demographic characteristics, dietary patterns, and clinical symptoms were assessed using structured questionnaires. Anthropometric parameters, including body mass index (BMI) and gestational weight gain, along with biochemical indicators such as HbA1c, fasting blood glucose, oral glucose tolerance test (OGTT), and lipid profile, were evaluated. Dietary intake was assessed using a 24-hour dietary recall method. GDM diagnosis was confirmed based on DIPSI criteria using a 75 g oral glucose load with plasma glucose levels ≥145 mg/dL. Subsequently, individualized low-GI MNT diet plans were designed and implemented, and post-intervention outcomes were monitored during follow-up antenatal visits. Baseline findings revealed substantial nutritional inadequacies among participants, with energy intake 41.7% below the recommended dietary allowance (RDA), alongside marked deficiencies in carbohydrates, protein, dietary fibre, calcium, folic acid, and iron. Most participants belonged to the 21-25 years age group and were primigravida in the third trimester. HbA1c analysis indicated that 90% of participants were within the non-diabetic range, while 10% were categorized as pre-diabetic at baseline. Following the implementation of individualized low-GI MNT providing balanced macro- and micronutrient intake, participants exhibited improved glycemic control, appropriate gestational weight gain, normalized blood pressure, and alleviation of constipation and food cravings. The study demonstrates that a structured and individualized low glycemic index Medical Nutrition Therapy effectively improves nutritional status, stabilizes blood glucose levels, and minimizes GDM- related complications. Continuous dietary counselling and regular antenatal follow-up are essential for sustaining maternal metabolic health and reducing the long-term risk of T2DM in both mothers and their offspring