Dietary management of gestational diabetes: the ethics of balancing fetal outcomes with maternal psychological and metabolic health

Gestational diabetes mellitus is defined as hyperglycemia in pregnancy that is not overt type 1 or type 2 diabetes. Gestational diabetes affects approximately 4-9% of live births in the United States and has implications for short term birth outcomes as well as long term maternal and child metabolic health. Medical nutrition therapy provided by a registered dietitian nutritionist is crucial in facilitating blood glucose management for clients with gestational diabetes. There are multiple dietary strategies that may be effective for optimal blood glucose control in women with gestational diabetes. This paper discusses strategies reviewed by the Academy of Nutrition and Dietetics as well as those proposed by diabetes in pregnancy programs across the US and by an individual registered dietitian nutritionist with experience managing gestational diabetes. Registered dietitian nutritionists must also take into consideration maternal mental health as well as systemic maternal health inequities that exist in the United States when providing ethical nutrition care. Mindful and intuitive eating approaches are proposed as strategies that can be incorporated with medical nutrition therapy to help ethically balance fetal outcomes with overall maternal psychological and metabolic health.Master of Public Healt