Aim: Maternal glucose is the primary metabolic substrate for fetal growth and a diet low in carbohydrates is common among young women in the Western world. To secure sufficient carbohydrate consumption in pregnancy, the Institute of Medicine (IOM) recommends a minimum daily consumption of 175 grams of carbohydrates, corresponding to approximately 150 grams from the major carbohydrate sources. We aimed to explore the carbohydrate consumption in early pregnancy among women with type 2 diabetes and, for comparison, in women with type 1 diabetes.
Methods: As part of routine care, all pregnant women with type 2 and type 1 diabetes have since 2013 been asked to hand in a 3-day dietary record focusing on carbohydrates at their first antenatal visit. In the present study, total daily self-reported carbohydrate consumption from major carbohydrate sources, presence of ketonuria, HbA1c, weight and daily physical activity were evaluated.
Results: Dietary records were available from 96 women with type 2 diabetes vs. 1women with type 1 diabetes at median 71 (range 60-87) vs. 63 (56-76) gestational days (p=0.003) where HbA1c was 6.6 ±1.2% (49 ±13 mmol/mol) vs. 6.5 ±0.8% (48 ±8 mmol/mol) (P=0.8), respectively. Body weight was 90.8 (±22) vs. 75.5 (±15) kg (P<0.001), but average daily carbohydrate consumption was similar in the two groups (159 ±56 vs. 167 ±48 g, P=0.3), as was the level of physical activity (246 ±104 vs. 233 ±96 metabolic equivalent of task (MET)-hour/week, P=0.5). A high proportion of the women consumed fewer carbohydrates than recommended by the IOM (52% vs. 40%, P=0.08). There was a low prevalence of ketonuria (>4 mmol/L, equivalent to blood ketones of approx. 0.2 mmol/L) (2% vs. 1%, P=0.6).
Conclusion: In early pregnancy, women with type 2 diabetes had similar carbohydrate consumption to women with type 1 diabetes, despite higher body weight. Lower carbohydrate consumption than recommended by the IOM was prevalent, and ketonuria was rare.
B. ásbjörnsdóttir: None. H. Ronneby: None. M. Vestgaard: None. L. Ringholm: None. D.M. Jensen: None. A. Raben: None. P. Damm: Advisory Panel; Self; Novo Nordisk A/S. Other Relationship; Self; Novo Nordisk A/S. E.R. Mathiesen: Speaker's Bureau; Self; Novo Nordisk A/S. Other Relationship; Self; Novo Nordisk A/S, Novo Nordisk Foundation, Novo Nordisk A/S.