Cheong Louisa, Law Lawrence Siu-Chun, Tan Li Ying Lyeann, Amal Amal Al-Amri, Khoo Chin Meng, Eng Pei Chia
Division of Endocrinology, Department of Medicine, National University Hospital, Singapore 119074, Singapore.
Department of Internal Medicine, Nizwa Hospital, Nizwa P.O. Box 1222, Oman.
Nutrients. 2025 Mar 30;17(7):1210. doi: 10.3390/nu17071210.
Gestational diabetes mellitus (GDM) is a complication that affects 20% of pregnancies worldwide. It is associated with adverse short- and long-term cardiometabolic outcomes for both mother and infant. Effective management of GDM involves lifestyle modifications, including medical nutrition therapy (MNT) and physical activity (PA), with the addition of insulin or metformin if glycaemic control remains inadequate. However, substantial gaps persist in the determination of optimal medical nutrition therapy (MNT) for women with GDM. Challenges in MNT include individual variation in glucose tolerance and changing maternal physiology and dietary requirements during pregnancy. Achieving optimal glycaemic control depends on careful macronutrient balance, particularly the distribution and quality of carbohydrate intake and sufficient protein and fat intake. Additionally, micronutrient deficiencies, such as inadequate vitamin D, calcium, and essential minerals, may exacerbate oxidative stress, inflammation, and glycaemic dysregulation, further impacting foetal growth and development. Cultural beliefs and dietary practices among pregnant women can also hinder adherence to recommended nutritional guidelines. Conditions like hyperemesis gravidarum (HG) affect ~1% to 2% of pregnant women can result in unintended energy and nutrient deficits. This special issue explores the current evidence and major barriers to optimising dietary therapy for women with GDM. It also identifies future research priorities to advance clinical practice, improve maternal and foetal outcomes, and address gaps in personalised nutrition interventions.
妊娠期糖尿病（GDM）是一种并发症，影响着全球20%的妊娠。它与母婴不良的短期和长期心脏代谢结局相关。GDM的有效管理包括生活方式的改变，包括医学营养治疗（MNT）和体育活动（PA），如果血糖控制仍然不足，则加用胰岛素或二甲双胍。然而，在确定GDM女性的最佳医学营养治疗（MNT）方面仍存在很大差距。MNT面临的挑战包括葡萄糖耐量的个体差异以及孕期母亲生理和饮食需求的变化。实现最佳血糖控制取决于仔细的宏量营养素平衡，特别是碳水化合物摄入的分布和质量以及足够的蛋白质和脂肪摄入。此外，微量营养素缺乏，如维生素D、钙和必需矿物质不足，可能会加剧氧化应激、炎症和血糖失调，进一步影响胎儿的生长发育。孕妇的文化信仰和饮食习惯也可能阻碍对推荐营养指南的遵守。妊娠剧吐（HG）等情况影响约1%至2%的孕妇，可导致意外的能量和营养缺乏。本期特刊探讨了优化GDM女性饮食治疗的现有证据和主要障碍。它还确定了未来的研究重点，以推进临床实践、改善母婴结局并解决个性化营养干预方面的差距。
