ABSTRACT
Introduction ............................................................................................................ 170 Risks and Consequences of GDM ......................................................................... 170 Endocrine and Metabolic ProŠles in Healthy Pregnancy and GDM ..................... 171
Healthy Pregnancy ............................................................................................ 171 GDM Pregnancy ................................................................................................ 171
Medical Management of GDM and the Need for New Nutritional Strategies ...... 172 Sweet Taste Changes and Diet in Type 2 Diabetes ................................................ 172 Changes in Sweet Taste and Cravings in Healthy Pregnancy ................................ 173
Food Cravings in Healthy Pregnancy ................................................................ 174 Changes in Taste Perception and Preference in Healthy Pregnancy ................. 174
Sweet Taste Changes and Appetite in GDM: Empirical Studies ........................... 174 Liking for Sweet Taste and Glucose Intolerance in GDM ................................ 175 Liking for Sweet-Fat Dairy Drinks in Mild GDM ............................................ 175 A Role for the Gestational Hormones in Sweet Taste Changes in Mild GDM.... 178 Sweet Cravings and Dietary Intake in Mild GDM ............................................ 179
Conclusions and Future Research Needs ............................................................... 182 Summary and Implications for Clinical Practice ................................................... 183 References .............................................................................................................. 184
Gestational diabetes mellitus (GDM) is a form of carbohydrate intolerance of variable severity that is Šrst recognized during pregnancy (Metzger et al. 2007). Its metabolic proŠle and management are similar to those of diabetes mellitus type 2 (type 2 DM) (American Diabetes Association, 2010b). GDM is associated with a variety of obstetric complications and signiŠcant perinatal morbidity (Metzger et al. 2007). Women with previous GDM are also at increased risk of developing insulin resistance and type 2 DM later in life (Verma et al. 2002). As many as 50 percent of women with a GDM pregnancy will develop type 2 diabetes within Šve years of the index pregnancy (Kim et al. 2002). Thus, GDM can be considered a sentinel event for the future development of type 2 DM, which currently affects 17 million Americans and is predicted to rise to 29 million cases by 2050 (Winer and Sowers, 2004). Recent projections indicate that prevention and control of GDM with subsequent lifestyle changes could substantially improve the health of women and save millions of dollars in health care costs (Winer and Sowers, 2004). Currently, there is no consensus on what the optimum nutritional strategy should be for the management of GDM.
