A comparison of the effectiveness, tolerability and safety of high and low carbohydrate diets in women with gestational diabetes.
BACKGROUND
Nutrition therapy is an integral part of the management of gestational diabetes mellitus (GDM). Most women with GDM are treated by nutritional management alone. The goal of our study was to compare low and high carbohydrate diets in their effectiveness, safety and tolerability in women with GDM.


METHODS
The study group consisted of 30 Caucasian women newly diagnosed with GDM, with a mean age of 28.7 +/- 3.7 years and pregnancy duration of 29.2 +/- 5.4 weeks. The patients were randomised into two groups: those on a low and those on a high carbohydrate diet (45% vs. 65% respectively of energy supply coming from carbohydrates). The presence of urine ketones was controlled every day. After two weeks daily glucose profiles and compliance with the recommended diets were analysed.


RESULTS
Glucose concentration before implementation of the diet regimen did not differ between groups. No changes in fasting blood glucose were noticed in the group that had followed a low carbohydrate diet, although a significant decrease in glucose concentration was observed after breakfast (102 +/- 16 vs. 94 +/- 11 mg/dl), lunch (105 +/- 12 vs. 99 +/- 9 mg/dl) and dinner (112 +/- 16 vs. 103 +/- 13 mg/dl) (p < 0.05). In the high carbohydrate diet group fasting and after-breakfast glucose concentration did not change. A significant decrease in glycaemia was noticed after lunch (106 +/- 15 vs. 96 +/- 7 mg/dl) and dinner (107 +/- 12 vs. 97 +/- 7 mg/dl) (p < 0.05). Ketonuria was not observed in either group. Obstetrical outcomes did not differ between groups.


CONCLUSIONS
Both high and low carbohydrate diets are effective and safe. A diet with carbohydrate limitation should be recommended to women who experience the highest glycaemia levels after breakfast.
Cypryk
Katarzyna
K
Department of Diabetology and Metabolic Diseases, Medical University of Łódź. kcypryk@mp.pl
Kamińska
Patrycja
P
Kosiński
Marcin
M
Pertyńska-Marczewska
Magdalena
M
Lewiński
Andrzej
A
D000328:Adult; D001786:Blood Glucose; D016640:Diabetes, Gestational / Q000178:diet therapy*; D050528:Diet, Carbohydrate-Restricted; D004040:Dietary Carbohydrates; D005260:Female; D005865:Gestational Age; D006801:Humans; D007659:Ketones / Q000652:urine; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007659:Ketones