ABSTRACT
Preexisting diabetes mellitus complicates approximately 0.3% of all pregnancies in the United States, while gestational diabetes mellitus complicates 5% to 10%. The resultant criteria were at one time recommended by the American Diabetes Association (ADA) and the American College of Obstetricians and Gynecologists and were widely utilized in the United States. The management of diabetes in pregnancy brings together advances in internal medicine, obstetrics, pediatrics, physiology, and metabolism. Although there are marked similarities in the management of pregnancies complicated by preexisting diabetes and those complicated by gestational diabetes mellitus, the differences in the degree of risk and maternal glycemic stability make it most convenient to consider each separately. Approaches to dietary management of diabetic pregnancy have varied greatly over the years (63), and there is no single generally accepted dietary prescription. The ADA has published a set of recommendations for dietary management of diabetes during pregnancy that emphasize individualization of the prescription for medical nutrition therapy.
