A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes.
A randomised controlled trial was designed to determine the effect of moderate 30% maternal dietary energy restriction on the requirement for maternal insulin therapy and the incidence of macrosomia in gestational diabetes. Although the control group restricted their intake to a level similar to that of the intervention group (6,845 kiloJoules (kJ) versus 6,579 kJ), the resulting cohort could not identify any adverse effect of energy restriction in pregnancy. Energy restriction did not alter the frequency of insulin therapy (17.5% in the intervention group and 16.9% in the control group). Mean birthweight (3,461 g in the intervention group and 3,267 g in the control group) was not affected. There was a trend in the intervention group towards later gestational age at commencement of insulin therapy (33 weeks versus 31 weeks) and lower maximum daily insulin dose (23 units versus 60 units) which did not reach statistical significance. Energy restriction did not cause an increase in ketonemia.
Rae
A
A
King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Australia.
Bond
D
D
Evans
S
S
North
F
F
Roberman
B
B
Walters
B
B
D020155:3-Hydroxybutyric Acid / Q000097:blood; D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D004038:Diet, Reducing; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007659:Ketones / Q000652:urine; D016015:Logistic Models; D009765:Obesity / Q000150:complications* / Q000178:diet therapy* / Q000378:metabolism; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D015431:Weight Loss
D020155:3-Hydroxybutyric Acid; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D007659:Ketones