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Dietary Advice and Glycaemic Control in Women with Type 1 Diabetes During Preconception Counselling, Pregnancy and Breastfeeding

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Nutrition and Diet in Maternal Diabetes

Part of the book series: Nutrition and Health ((NH))

Abstract

In women with type 1 diabetes preconception counselling is important to assess the risk for the mother and the foetus. Optimizing glycaemic status without increasing hypoglycaemia is pivotal. HbA1c should be below 53 mmol/mol (7.0%) before pregnancy and at least below 42 mmol/mol (6.0%) during pregnancy. It is also important to address appropriate gestational weight gain in the effort to achieve appropriate foetal growth and improved pregnancy outcome. Based on the pre-pregnancy BMI, a gestational weight gain within the lower range of the guidelines of the Institute of Medicine (IOM) is generally recommended. The current recommendation on carbohydrate consumption during pregnancy is a minimum total daily intake of 175 g, mainly via low glycaemic index and minimally via high glycaemic index carbohydrates. Daily folic acid supplementation should be initiated before conception and taken during the first 12 gestational weeks to minimize the risk of foetal malformations. Women with type 1 diabetes are encouraged to breastfeed. During breastfeeding insulin requirements are markedly lower than before and during pregnancy. Focus should be centred on appropriate quantity and quality of carbohydrate intake and good glycaemic control including prevention of hypoglycaemia and weight retention.

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Abbreviations

ADA:

American Diabetes Association

Kcal:

Kilogram calories

LGA:

Large for gestational age

NICE:

National Institute for Health and Care Excellence

IOM:

Institute of Medicine

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Author information

Authors and Affiliations

  1. Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, Gentofte, 2820, Denmark

    Lene Ringholm & Henrik Ullits Andersen

  2. Center for Pregnant Women with Diabetes, Department of Endocrinology PE7831, Rigshospitalet University Hospital of Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark

    Björg Ásbjörnsdóttir & Elisabeth R. Mathiesen

  3. Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark

    Peter Damm

  4. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Peter Damm

Authors
  1. Lene Ringholm
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  2. Björg Ásbjörnsdóttir
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  3. Henrik Ullits Andersen
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  4. Peter Damm
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  5. Elisabeth R. Mathiesen
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Corresponding author

Correspondence to Lene Ringholm .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King’s College London, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Ringholm, L., Ásbjörnsdóttir, B., Andersen, H.U., Damm, P., Mathiesen, E.R. (2018). Dietary Advice and Glycaemic Control in Women with Type 1 Diabetes During Preconception Counselling, Pregnancy and Breastfeeding. In: Rajendram, R., Preedy, V., Patel, V. (eds) Nutrition and Diet in Maternal Diabetes. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-56440-1_30

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  • DOI: https://doi.org/10.1007/978-3-319-56440-1_30

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-56438-8

  • Online ISBN: 978-3-319-56440-1

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