We investigated the nutritional intake status of 165 patients with gestational diabetes mellitus (GDM) and evaluated nutritional intake status and dietary changes after GDM diagnosis. The population was divided into two groups: Group 1 consisted of patients that changed their diet habits after GDM diagnosis, and Group 2 consisted of patients that did not change their diet habits after GDM diagnosis. In all patients, energy, protein, and carbohydrate intake were lower than nutritional requirements. Group 1 (n = 53) had significantly lower carbohydrate intake compared to Group 2 (n = 112), and the intake of grains and potatoes by food group was significantly lower. There was no significant difference in the amount or content of snacking between the groups. There were significantly more urinary ketone body-positive patients in Group 1. GDM diagnosis was associated with insufficient intake of complex carbohydrates. When providing dietary guidance for GDM, our findings suggest the necessity of : (1) appropriate staple food intake, (2) vegetable intake, (3) milk and dairy product intake, and (4) transition from favorite foods to a diverse diet centered on complex carbohydrates. Continuous nutritional care by registered dietitians from the early stages of pregnancy is necessary.

Although dietitian who have specialist qualification may be actively conducting nutrition management that satisfies standard of reimbursements for nutrition management service in the Japanese Long-Term Care Insurance (LTCI) System, there were no study report about this hypothesis. We thereby conducted a cross-sectional study based on data from a web-based survey conducted in January-February 2020 by the Japan Dietetic Association to full-time registered dietitians in LTCI facilities. The present analyses included the facilities with only one full-time registered dietitian, and we defined the presence of a full-time registered dietitian with any specialist qualification as an explanatory variable. The outcome variable was the presence of each reimbursement for nutrition management services (medical care meals, maintenance of oral feeding, nutritional coordination upon reentry, improving the risk of undernutrition), and multivariate adjusted odds ratios were calculated using logistic regression models. As results, odds ratios of getting these four types of reimbursements tended to be higher in the facilities with a dietitian who had obtained any specialist qualification, particularly for maintenance of oral feeding (odds ratio=2.00, p=0.04). These findings suggest that obtaining specialist qualifications may lead to a conducting nutrition management that satisfies standard of the reimbursements.