Moderate caloric restriction in obese women with gestational diabetes.

The effect of moderate caloric restriction on weight gain during pregnancy and fetal outcome in 22 obese women with gestational diabetes mellitus was assessed. A new tool was used to assess dietary compliance in an outpatient setting. The authors observed that obese gestational diabetics gained less weight during pregnancy than ten normal pregnant women or 31 lean women with gestational diabetes. Paradoxically, the placentas of obese gestational diabetics were larger (P not significant), and infants of these mothers were significantly heavier than those of normal women or lean women with gestational diabetes (P less than .03). The authors suggest that the currently recommended daily caloric allowances for normal women may be excessive for obese gestational diabetics who are not prone to ketosis but have a complex metabolic problem characterized by hyperinsulinemia and insulin resistance.