Diet

1. Moderate caloric restriction may be useful in treating obese women (body mass index greater than 30 km/m2) with gestational diabetes. However, ketosis should be avoided.

2. Caloric allotment. The recommended caloric intake is 30 kcal per present weight in kg per day in pregnant women who are 80 to 120 percent of ideal body weight at the start of pregnancy. 24 kcal per present weight in kg per day in overweight pregnant women (120 to 150 percent of ideal body weight). 12 to 15 kcal per present weight in kg per day for morbidly obese pregnant women (>150 percent of ideal body weight). 40 kcal per present weight in kg per day in pregnant women who are less than 80 percent of ideal body weight.

3. Carbohydrate intake. Recommendations for calorie and carbohydrate distribution are 40 percent carbohydrate, 20 percent protein, and 40 percent fat.

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