Impatto della consulenza nutrizionale sui miglioramenti dietetici, sul controllo glicemico e sugli esiti neonatali in donne in gravidanza con diabete mellito pregestazionale: uno studio di analisi delle cartelle cliniche elettroniche in un centro medico di terzo livello

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. 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. 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. 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.