title: Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial.
abstract: BACKGROUND
  Gestational Diabetes Mellitus (GDM) increases risks for type 2 diabetes and weight management is recommended to reduce the risk. Conventional dietary recommendations (energy-restricted, low fat) have limited success in women with previous GDM. The effect of lowering Glycaemic Index (GI) in managing glycaemic variables and body weight in women post-GDM is unknown.
  
  
  OBJECTIVE
  To evaluate the effects of conventional dietary recommendations administered with and without additional low-GI education, in the management of glucose tolerance and body weight in Asian women with previous GDM.
  
  
  METHODS
  Seventy seven Asian, non-diabetic women with previous GDM, between 20- 40y were randomised into Conventional healthy dietary recommendation (CHDR) and low GI (LGI) groups. CHDR received conventional dietary recommendations only (energy restricted, low in fat and refined sugars, high-fibre). LGI group received advice on lowering GI in addition. Fasting and 2-h post-load blood glucose after 75 g oral glucose tolerance test (2HPP) were measured at baseline and 6 months after intervention. Anthropometry and dietary intake were assessed at baseline, three and six months after intervention. The study is registered at the Malaysian National Medical Research Register (NMRR) with Research ID: 5183.
  
  
  RESULTS
  After 6 months, significant reductions in body weight, BMI and waist-to-hip ratio were observed only in LGI group (P<0.05). Mean BMI changes were significantly different between groups (LGI vs. CHDR: -0.6 vs. 0 kg/m2, P= 0.03). More subjects achieved weight loss ≥5% in LGI compared to CHDR group (33% vs. 8%, P=0.01). Changes in 2HPP were significantly different between groups (LGI vs. CHDR: median (IQR): -0.2(2.8) vs. +0.8 (2.0) mmol/L, P=0.025). Subjects with baseline fasting insulin≥2 μIU/ml had greater 2HPP reductions in LGI group compared to those in the CHDR group (-1.9±0.42 vs. +1.31±1.4 mmol/L, P<0.001). After 6 months, LGI group diets showed significantly lower GI (57±5 vs. 64±6, P<0.001), GL (122±33 vs. 142±35, P=0.04) and higher fibre content (17±4 vs.13±4 g, P<0.001). Caloric intakes were comparable between groups.
  
  
  CONCLUSIONS
  In women post-GDM, lowering GI of healthy diets resulted in significant improvements in glucose tolerance and body weight reduction as compared to conventional low-fat diets with similar energy prescription.
authors.affiliation: School of Post Graduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia. sangeeshyam@gmail.com
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Shyam
authors.forename: Fatimah
authors.initials: F
authors.lastname: Arshad
authors.forename: Rohana
authors.initials: R
authors.lastname: Abdul Ghani
authors.forename: Norasyikin A
authors.initials: NA
authors.lastname: Wahab
authors.forename: Nik Shanita
authors.initials: NS
authors.lastname: Safii
authors.forename: Mohd Yusof Barakatun
authors.initials: MY
authors.lastname: Nisak
authors.forename: Karuthan
authors.initials: K
authors.lastname: Chinna
authors.forename: Nor Azmi
authors.initials: NA
authors.lastname: Kamaruddin
mesh_terms: D000328:Adult; D001208:Asia; D044466:Asian People; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D016640:Diabetes, Gestational / Q000097:blood*; D004032:Diet; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage; D023381:Endpoint Determination; D002149:Energy Intake; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D009043:Motor Activity; D011247:Pregnancy; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio; D015431:Weight Loss; D055815:Young Adult
chemical_list: D004043:Dietary Fiber; D007328:Insulin