How do I install the Pdm Carbohydrate Intake skill?

Run npx skillmds@latest add dromlakhani/pdm-carbohydrate-intake in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

What does the Pdm Carbohydrate Intake skill do?

Guidance for clinicians managing pregnant individuals with preexisting diabetes mellitus (PDM) who are evaluating daily carbohydrate intake; consider a carbohydrate-restricted diet ( 175 g/day) based on patient factors. Trigger when assessing nutrition in pregnancy for PDM, especially when discussing glycemic targets, weight gain, or fetal growth concerns. It is listed under Marketing & Growth on SkillMD.

Is Pdm Carbohydrate Intake safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Pdm Carbohydrate Intake?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Pdm Carbohydrate Intake free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Pdm Carbohydrate Intake?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Pdm Carbohydrate Intake by dromlakhani

Name: Pdm Carbohydrate Intake
Rating: 4.5 (4 reviews)
Author: dromlakhani

Pdm Carbohydrate Intake

Guidance for clinicians managing pregnant individuals with preexisting diabetes mellitus (PDM) who are evaluating daily carbohydrate intake; consider a carbohydrate-restricted diet (<175 g/day) or usual diet (>175 g/day) based on patient factors. Trigger when assessing nutrition in pregnancy for PDM, especially when discussing glycemic targets, weight gain, or fetal growth concerns.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Carbohydrate intake guidance in pregnancy for preexisting diabetes

STEP 1 — Gather Information

Collect diabetes type (T1DM/T2DM), current carbohydrate intake, HbA1c or CGM metrics, pregnancy trimester, gestational weight gain, fetal growth measurements, comorbidities (obesity, hypertension), history of ketosis or hypoglycemia, folate status, patient preferences, cultural dietary habits, and ability to adhere to meal plans.

STEP 2 — Rule In / Rule Out

If the patient has a history of ketosis, hypoglycemia, or is in the first trimester with low folate intake (risk of neural tube defects), rule out a carbohydrate-restricted diet (<175 g/day) and proceed to usual diet (>175 g/day); otherwise, continue to classification.

STEP 3 — Classify or Stratify

Stratify by patient preference and glycemic goals: Prefer carbohydrate-restricted diet (<175 g/day) if seeking tighter postprandial control and able to maintain ≥95 g/day carbs; prefer usual diet (>175 g/day) if prioritizing fetal growth simplicity or experiencing nausea/vomiting.

STEP 4 — Decide

For carbohydrate-restricted choice: prescribe individualized meal plan targeting 130–170 g/day carbs, adjust insulin to prevent hypoglycemia, and monitor urine or blood ketones weekly. For usual diet choice: prescribe meal plan >175 g/day carbs with focus on complex carbohydrates, adjust insulin based on postprandial glucose, and monitor gestational weight gain.

Clinical Guardrails / Mimics / Pitfalls

Do not recommend <95 g/day carbohydrates due to increased neural tube defect risk; avoid ignoring individual variability in insulin sensitivity; do not overlook cultural food preferences that affect adherence; remember to adjust insulin when changing carbohydrate intake to prevent hypoglycemia or hyperglycemia; do not use carbohydrate restriction as sole therapy without glucose monitoring.

Concrete Clinical Example

A 32-year-old woman with T2DM at 12 weeks gestation, HbA1c 7.2%, baseline intake ~200 g/day carbs, no ketosis history, normal folate, desires lower carb to limit weight gain. After discussion, she chooses carbohydrate-restricted diet targeting 150 g/day carbs; meal plan provided, insulin reduced by 10%, weekly ketone checks negative, and postprandial glucose improved.

Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society and European Society of Endocrinology, 2025, DOI: 10.1210/clinem/dgaf288

TODO: consider adding scripts/calc.py for the pdm-carbohydrate-intake calculator

---name: pdm-carbohydrate-intakedescription: Guidance for clinicians managing pregnant individuals with preexisting diabetes mellitus (PDM) who are evaluating daily carbohydrate intake; consider a carbohydrate-restricted diet (<175 g/day) or usual diet (>175 g/day) based on patient factors. Trigger when assessing nutrition in pregnancy for PDM, especially when discussing glycemic targets, weight gain, or fetal growth concerns.---# Carbohydrate intake guidance in pregnancy for preexisting diabetes## STEP 1 — Gather InformationCollect diabetes type (T1DM/T2DM), current carbohydrate intake, HbA1c or CGM metrics, pregnancy trimester, gestational weight gain, fetal growth measurements, comorbidities (obesity, hypertension), history of ketosis or hypoglycemia, folate status, patient preferences, cultural dietary habits, and ability to adhere to meal plans.## STEP 2 — Rule In / Rule OutIf the patient has a history of ketosis, hypoglycemia, or is in the first trimester with low folate intake (risk of neural tube defects), rule out a carbohydrate-restricted diet (<175 g/day) and proceed to usual diet (>175 g/day); otherwise, continue to classification.## STEP 3 — Classify or StratifyStratify by patient preference and glycemic goals: Prefer carbohydrate-restricted diet (<175 g/day) if seeking tighter postprandial control and able to maintain ≥95 g/day carbs; prefer usual diet (>175 g/day) if prioritizing fetal growth simplicity or experiencing nausea/vomiting.## STEP 4 — DecideFor carbohydrate-restricted choice: prescribe individualized meal plan targeting 130–170 g/day carbs, adjust insulin to prevent hypoglycemia, and monitor urine or blood ketones weekly. For usual diet choice: prescribe meal plan >175 g/day carbs with focus on complex carbohydrates, adjust insulin based on postprandial glucose, and monitor gestational weight gain.## Clinical Guardrails / Mimics / PitfallsDo not recommend <95 g/day carbohydrates due to increased neural tube defect risk; avoid ignoring individual variability in insulin sensitivity; do not overlook cultural food preferences that affect adherence; remember to adjust insulin when changing carbohydrate intake to prevent hypoglycemia or hyperglycemia; do not use carbohydrate restriction as sole therapy without glucose monitoring.## Concrete Clinical ExampleA 32-year-old woman with T2DM at 12 weeks gestation, HbA1c 7.2%, baseline intake ~200 g/day carbs, no ketosis history, normal folate, desires lower carb to limit weight gain. After discussion, she chooses carbohydrate-restricted diet targeting 150 g/day carbs; meal plan provided, insulin reduced by 10%, weekly ketone checks negative, and postprandial glucose improved.**Source:** Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society and European Society of Endocrinology, 2025, DOI: 10.1210/clinem/dgaf288> **TODO:** consider adding scripts/calc.py for the pdm-carbohydrate-intake calculator

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