Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? A randomized trial.
OBJECTIVE
A low-glycemic index diet is effective as a treatment for individuals with diabetes and has been shown to improve pregnancy outcomes when used from the first trimester. A low-glycemic index diet is commonly advised as treatment for women with gestational diabetes mellitus (GDM). However, the efficacy of this advice and associated pregnancy outcomes have not been systematically examined. The purpose of this study was to determine whether prescribing a low-glycemic index diet for women with GDM could reduce the number of women requiring insulin without compromise of pregnancy outcomes.


METHODS
All women with GDM seen over a 12-month period were considered for inclusion in the study. Women (n = 63) were randomly assigned to receive either a low-glycemic index diet or a conventional high-fiber (and higher glycemic index) diet.


RESULTS
Of the 31 women randomly assigned to a low-glycemic index diet, 9 (29%) required insulin. Of the women randomly assigned to a higher-glycemic index diet, a significantly higher proportion, 19 of 32 (59%), met the criteria to commence insulin treatment (P = 0.023). However, 9 of these 19 women were able to avoid insulin use by changing to a low-glycemic index diet. Key obstetric and fetal outcomes were not significantly different.


CONCLUSIONS
Using a low-glycemic index diet for women with GDM effectively halved the number needing to use insulin, with no compromise of obstetric or fetal outcomes.
Moses
Robert G
RG
Illawarra Diabetes Service, South Eastern Sydney and Illawarra Area Health Service, Wollongong, New South Wales, Australia. robert.moses@sesiahs.health.nsw.gov.au
Barker
Megan
M
Winter
Meagan
M
Petocz
Peter
P
Brand-Miller
Jennie C
JC
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy; D015930:Diet Records; D004305:Dose-Response Relationship, Drug; D002149:Energy Intake; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D018579:Patient Selection; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012449:Safety; D055815:Young Adult
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin