Impact of nutrition counseling on dietary improvements, glycemic control, and neonatal outcomes in pregnant women with pregestational diabetes mellitus

Pregestational diabetes increases risks for both mother and infant. This study analyzed medical charts to evaluate how individualized nutrition counseling improved diet quality, glycemic control, and neonatal outcomes in women with pregestational diabetes.
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Impact of nutrition counseling on dietary improvements, glycemic control, and neonatal outcomes in pregnant women with pregestational diabetes mellitus: an electronic medical charts analysis study in a tertiary medical center - BMC Pregnancy and Childbirth

Background Pregnant women with pregestational diabetes mellitus (PDM) are at higher risk of adverse maternal and neonatal outcomes, including preterm birth and macrosomia. Nutrition counseling plays a critical role in improving glycemic control; however, its effectiveness in pregnant women with PDM in Taiwan has not been fully evaluated. This study aims to evaluate the effects of nutrition counseling on dietary intake, glycemic control, gestational weight gain (GWG), and neonatal outcomes in pregnant women with PDM. Methods We conducted a retrospective review of electronic medical records from 2012 to 2022 at a tertiary medical center in Taiwan. A total of 106 pregnant women with type 1 or type 2 diabetes were included, of whom 48 received nutrition counseling (NC group) and 58 did not (Non-NC group). Dietary records, blood glucose, and pregnancy outcomes were analyzed. Results There were no significant differences between the groups with and without nutrition counseling in terms of gestational weight gain, preterm birth rate, or the incidence of macrosomia. Nutrition counseling significantly increased the intake of fruits and whole grains and improved dietary fiber consumption (p < 0.001). After the intervention, the proportion of women consuming < 175 g of carbohydrates decreased from 55.3% to 34.2%. Among 24 participants with pre- and post-intervention blood glucose data, fasting glucose and HbA1c levels decreased significantly (p < 0.001 and p = 0.001, respectively). Greater improvements were observed in those receiving multiple counseling sessions. Conclusions Nutrition counseling enhanced fiber intake by increasing the consumption of fruits, vegetables, and whole grains. Repeated counseling sessions significantly improved glycemic control, although no significant changes were observed in pregnancy outcomes. These findings underscore the clinical value of integrating structured nutrition counseling into routine prenatal care and highlight the need for larger prospective studies to confirm its impact on pregnancy outcomes.

Background

Pregestational diabetes mellitus (PGDM) poses significant risks for both mothers and their infants, including macrosomia and neonatal hypoglycemia. Nutrition management is a key component of prenatal diabetes care, yet its real-world effectiveness in Asian clinical settings remains underexplored.

Study Overview

This retrospective study analyzed electronic medical charts from a tertiary medical center to assess how individualized nutrition counseling influenced dietary behavior, glycemic control, and neonatal outcomes in women with PGDM. Participants received structured dietary guidance provided by registered dietitians as part of multidisciplinary prenatal care.

Main Findings

After counseling, participants demonstrated marked improvements in dietary balance and nutrient intake. Consumption of vegetables, dairy products, and whole grains increased significantly, aligning more closely with national dietary guidelines.
Glycemic control also improved: both fasting and postprandial glucose levels decreased following dietary intervention, suggesting enhanced adherence to meal planning and carbohydrate distribution.

Importantly, positive changes in maternal nutrition were associated with better neonatal outcomes. The incidence of large-for-gestational-age infants and neonatal hypoglycemia declined among women who followed nutrition recommendations consistently. These findings highlight the clinical value of personalized nutrition counseling as a non-pharmacological approach to optimize pregnancy management in women with preexisting diabetes.

Implications for Practice

This study emphasizes that nutrition counseling should be an integral part of routine prenatal care for women with PGDM. Early referral to dietitians allows timely dietary modification and supports multidisciplinary coordination among obstetricians, endocrinologists, and nutrition professionals.

Beyond glycemic control, improving maternal diet quality contributes to healthier birth outcomes and long-term metabolic benefits for both mother and child. Our findings provide evidence-based support for the implementation of structured nutrition services in tertiary hospitals and diabetes-in-pregnancy clinics across Asia.

Reference

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Follow the Topic

Nutrition
Life Sciences > Health Sciences > Health Care > Nutrition
Type 2 Diabetes
Life Sciences > Health Sciences > Clinical Medicine > Diseases > Diabetes > Type 2 Diabetes
Maternal and Child Health
Life Sciences > Health Sciences > Public Health > Health Promotion and Disease Prevention > Maternal and Child Health
Counseling
Humanities and Social Sciences > Behavioral Sciences and Psychology > Counseling Psychology > Counseling

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