Thursday, July 07, 2016
How effective is carbohydrate-restricted diet on maternal and infant outcomes in women with gestational diabetes mellitus?
Gestational diabetes mellitus (GDM) is characterised by high blood glucose levels during pregnancy. Dietary management is the cornerstone of GDM treatment; however; in case dietary management fails, some may require exogenous insulin or an oral hypoglycaemic medication.
During pregnancy, increased blood glucose levels cross the placenta, resulting in augmented foetal glucose and insulin levels. This may be associated with an increased risk of childhood obesity 5–7 years after birth. A randomised controlled trial published in the journal Diabetes Spectrum compared the effects of a maternal carbohydrate-restricted diet with the usual pregnancy diet, on maternal and infant outcomes among women with GDM.
A convenience sample of participants (aged 18–45 years) diagnosed with GDM was recruited from urban and low-income sites, as well as suburban and affluent sites. Women with GDM were grouped into an intervention group (n=37 subjects with a lower-carbohydrate diet consisting of 35%–40% of total calories) and a control group (n=31 subjects with usual pregnancy diet consisting of 50–55% carbohydrate). The subjects were screened using a 50-g oral glucose tolerance test.
The results revealed that there was no significant difference between the lower-carbohydrate and usual-care diets in terms of blood glucose or maternal-infant outcomes. However, participants from suburban areas had lower postprandial blood glucose levels compared to those from urban locations, even though there was no difference in the carbohydrate intake.
In conclusion, a lower carbohydrate diet during pregnancy did not have a significant impact on maternal and infant outcomes in pregnant women with GDM. A well-designed trial with a larger number of subjects is required to determine optimal diets for pregnant women with GDM. Future research may be directed towards investigating the social determinants that affect the health of infants and mothers with GDM.
News source - Trout KK, Homko CJ, Wetzel-Effinger L, Mulla W, Mora R, McGrath J, Basel-Brown L, Arcamone A, Sami P, Makambi KH. Macronutrient Composition or Social Determinants? Impact on Infant Outcomes with Gestational Diabetes Mellitus. Diabetes Spectrum. 2016 May 1; 29(2):71-78