Purpose/Aim: There has been little exploration on the effect of varied dietary intake on glycemic control in women with gestational diabetes (GDM). We evaluated the effects of diet with varying protein (Pro) and carbohydrate (CHO) with fat held constant on maternal glucose levels.
Methods: A random order cross over design was used in women diagnosed with GDM between 28-35 weeks gestation by Carpenter and Coustan criteria who were diet controlled for 3-10 days on standard GDM diet. In random order, women admitted to the research unit were allocated to one of two diets (30% kcal as Protein/35% kcal as CHO versus 15% Pro/50% CHO) using standardized meals and snacks and crossed over to the other diet treatment after a 3-7 day washout period. Maternal glucose was measured at 30” intervals post-meal via YSI analysis during 2 overnight admissions with weighed and measured meals and snacks provided.
Results: Twelve women were enrolled, 7 African-American; 3 non-Hispanic white; 1 Asian;1 Hispanic. Mean age= 33.9±5.4 years, pre-pregnancy BMI=28.7±5.3. At day 2 breakfast, mean glucose values were lower in the 30%Pro/35%CHO arm after 30 and 60” (90.7 vs. 101.6 mg/dL and 109.8 vs. 120.9 mg/dL), and 3-hour post-breakfast AUC was lower (17395.20 ±2493.47 vs. 19172.47 ±3484.31, p=0.01). The 3-hour post-lunch AUC was also lower in the 30% Pro/35% CHO arm (14365.81 ±1502.61 vs. 15077.30 ±2179.03, p<0.03).
Discussion: The higher protein/lower carbohydrate dietary strategy ameliorated the expected post-prandial rise in glucose in these women with GDM and was well-tolerated by all subjects. Longer term outcomes of such an approach, including both maternal glycemic control, nitrogen balance and fetal growth outcomes are needed.
K.K. Trout: None. C. Compher: None. C.P. Durnwald: None.
National Institutes of Health