Intelligent diabetes care designed for pregnancy.

When a patient is diagnosed with gestational diabetes mellitus (GDM), one of the first and most essential changes they need to make is their diet. In fact, diet and exercise form the foundation of effective management for the vast majority of individuals with GDM.¹

While the concept of making dietary changes may seem straightforward, altering eating habits is a complex and often difficult process. Managing glucose levels effectively depends on tailored dietary adjustments, which is why Medical Nutrition Therapy (MNT) - personalized nutrition counseling by a registered dietitian - is a cornerstone of successful GDM management.

Not only is MNT associated with positive outcomes for both mom and baby, but it is also a covered service by most insurance companies. Below we outline the benefits of MNT for GDM.

TLDR: Medical Nutrition Therapy (MNT) is a covered service and essential for managing gestational diabetes (GDM). It helps maintain glucose levels, supports maternal and fetal health, and reduces the need for medication and future diabetes risk. MNT programs for GDM should consider the specialized needs of pregnancy and cover meal planning, nutrient balance, and lifestyle adjustments.

What is Medical Nutrition Therapy?

Medical Nutrition Therapy (MNT) is individualized nutrition counseling provided by a Registered Dietitian to prevent, manage, and treat medical conditions like hypertension, heart disease, and diabetes.

For gestational diabetes (GDM), MNT involves a rigorous, in-depth assessment that goes far beyond basic dietary advice. It involves a detailed assessment of the patient’s medical history, food preferences, food sensitivities, eating behaviors, and cultural/religious influences. It also includes anthropometric measurements, lab results, and the patient’s current knowledge of nutrition. Additionally, MNT addresses psychosocial factors that may impact dietary changes. By considering all these variables, MNT provides a holistic, individualized approach to managing GDM, ensuring the most effective and sustainable results.

After the assessment, the dietitian will work with the patient to set personalized goals involving:

• Carbohydrate management
• Meal and snack timing/frequency
• Overall nutrient balance
• Hydration
• Physical activity
• Meal planning and prepping
• Grocery shopping
• Eating behaviors (e.g.., distracted eating or food cravings)

MNT visits are highly interactive and enhance patient engagement by implementing individualized strategies.

Goals of Medical Nutrition Therapy in Gestational Diabetes

While MNT is personalized, common goals for GDM include:

1. Maintain blood glucose within target range
2. Self-monitoring of blood glucose
3. Monitor maternal weight gain and educate about recommended amount
4. Support the nutrition needs of mom and baby
5. Reduce the need for pharmacological treatment of GDM
6. Prevent the development of diabetes later in life

Patients with GDM who participate in MNT are more likely to reach their goals and have better outcomes.

Benefits of Medical Nutrition Therapy

Research supports the value of creating a focused space to discuss eating habits and develop actionable goals for GDM patients.

Women with GDM who participate in MNT have better glucose balance, improved insulin sensitivity, and reduced risk of complications throughout the pregnancy.² For the baby, MNT can reduce oxidative damage and excessive weight gain.

The benefits aren’t just short-term. A major concern for those with GDM is the risk of type 2 diabetes later in life. Nutrition therapy can help reduce the risk of diabetes in those who are predisposed.³ MNT can also reduce the occurrence of other metabolic disorders like hypertension.⁴

MNT is a valuable service and an experienced dietitian can help address some of the nuances of GDM.

How MNT differs for GDM from general Type 2

MNT benefits all people with diabetes, but GDM patients have unique needs:

Optimizing Prenatal Nutrition and Glucose Levels

Balancing increased nutrient needs of pregnancy with carbohydrate moderation is challenging. Nausea, food aversions, and other pregnancy-related issues can complicate dietary changes.

Placental hormones increase insulin resistance, making post-breakfast glucose harder to manage. Frequent adjustments to the diet may be necessary. ‍

Food Safety

Foodborne illness is more concerning in pregnancy due to the risk of complications like preterm labor or miscarriage. MNT addresses food safety to prevent bacterial and viral contamination.

Increased Insulin Demands

As insulin demands rise during pregnancy, managing glucose levels can become more difficult. Diet changes that worked one week may need adjustment the next. Regular follow-ups help keep glucose levels on track.

Advancement to insulin may occur faster in GDM than in type 2 diabetes. MNT helps patients navigate this transition.

Limited Time

Managing blood glucose levels during pregnancy is time-sensitive. Delays in getting MNT can complicate delivery and affect the baby’s health. If there are limited GDM specialists available, it may take time to get an appointment.

How To Find a Dietitian Who Works with Gestational Diabetes?

Referring a patient to a dietitian as soon as GDM is diagnosed is ideal.

There are a number of ways to get connected with a dietitian:

1. Local networks like a hospital or endocrinologist’s office
2. Professional databases such as the Association of Diabetes Care and Education Specialists search tool
3. Online platforms that offer telehealth dietitian services
4. Community resources like Women, Infants, and Children (WIC)

LilyLink has a team of registered dietitians with GDM expertise who can provide virtual care to improve outcomes. Contact us today to learn more about our platform that simplifies GDM care.

Key Takeaways

MNT customizes nutrition education for patients with GDM, leading to better pregnancy outcomes and lower future diabetes risk. Goals include glucose control, self-monitoring, healthy weight gain, and reduced need for medication. A collaborative approach to GDM care ensures better results.

Frequently Asked Questions

How many MNT visits are recommended for gestational diabetes?

Research suggests a minimum of three dietitian visits for GDM to prevent the need for pharmacotherapy.⁵ Insurance typically covers at least three hours of MNT.

Can you bill for MNT as a physician?

Only registered dietitians and qualified nutrition professionals can bill for MNT. Some states and insurance companies require a physician referral for MNT (like this one).

Can MNT be provided via telehealth?

Yes, MNT is a qualified telemedicine service and can be delivered via secure, HIPAA-compliant platforms like Zoom for Healthcare.

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References:

1. Yin Z, Li T, Zhou L, Fei J, Su J, Li D. Optimal delivery time for patients with diet-controlled gestational diabetes mellitus: a single-center real-world study. BMC Pregnancy Childbirth. 2022;22(1):356. Published 2022 Apr 23. doi:10.1186/s12884-022-04683-2
2. Wei X, Zou H, Zhang T, et al. Gestational Diabetes Mellitus: What Can Medical Nutrition Therapy Do?. Nutrients. 2024;16(8):1217. Published 2024 Apr 19. doi:10.3390/nu16081217
3. Evert AB, Dennison M, Gardner CD, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019;42(5):731-754. doi:10.2337/dci19-0014
4. Senkus KE, Dudzik JM, Lennon SL, et al. Medical nutrition therapy provided by a dietitian improves outcomes in adults with prehypertension or hypertension: a systematic review and meta-analysis. Am J Clin Nutr. 2024;119(6):1417-1442. doi:10.1016/j.ajcnut.2024.04.012
5. Meloncelli N, Barnett A, de Jersey S. An implementation science approach for developing and implementing a dietitian-led model of care for gestational diabetes: a pre-post study. BMC Pregnancy Childbirth. 2020;20(1):661. Published 2020 Nov 3. doi:10.1186/s12884-020-03352-6

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