The influence of carbohydrate consumption on glycemic control in pregnant women with type 1 diabetes.
OBJECTIVE
To study the influence of the quantity and the quality of carbohydrate consumption on glycemic control in early pregnancy among women with type 1 diabetes.


METHODS
A retrospective study of 107 women with type 1 diabetes who completed 1-3days of diet recording before first antenatal visit, as a part of routine care. The total daily carbohydrate consumption from the major sources (e.g. bread, potatoes, rice, pasta, dairy products, fruits, candy) was calculated. A dietician estimated the overall glycemic index score (scale 0-7).


RESULTS
At least two days of diet recording were available in 75% of the 107 women at mean 64 (SD±14) gestational days. The quantity of carbohydrate consumption from major sources was 180 (±51)g/day. HbA1c was positively associated with the quantity of carbohydrate consumption (β=0.41; 95% CI 0.13-0.70, P=0.005), corresponding to an increase of 0.4% in HbA1c per 100g carbohydrates consumed daily, when adjusted for insulin dose/bodyweight and use of insulin pump treatment. The median (IQR) glycemic index score was 2 (0-3). An adjusted association between HbA1c and glycemic index score was not demonstrated. The women using carbohydrate counting daily (45%) had lower HbA1c compared to the remaining women (6.4 (±0.5) vs. 6.8 (±0.9)% (47±6 vs. 51±10mmol/mol), P=0.01).


CONCLUSIONS
HbA1c in early pregnancy was positively associated with the quantity of carbohydrate consumption regardless of insulin treatment. Carbohydrate counting is probably important for glycemic control in pregnant women with type 1 diabetes.
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; Department of Endocrinology, Rigshospitalet, Ole Måløes Vej 24 - 7551, 2100 Copenhagen Ø, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark. Electronic address: bjoerg.asbjoernsdottir.01@regionh.dk.
Björg
B
Ásbjörnsdóttir
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; The Nutrition Unit, Rigshospitalet, Henrik Harpestrengs Vej 4 - 5711, 2100 Copenhagen Ø, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen N, Denmark. Electronic address: kfc705@alumni.ku.dk.
Cecelia E
CE
Akueson
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; The Nutrition Unit, Rigshospitalet, Henrik Harpestrengs Vej 4 - 5711, 2100 Copenhagen Ø, Denmark. Electronic address: Helle.Ronneby@regionh.dk.
Helle
H
Ronneby
The Nutrition Unit, Rigshospitalet, Henrik Harpestrengs Vej 4 - 5711, 2100 Copenhagen Ø, Denmark. Electronic address: ane.rytter@regionh.dk.
Ane
A
Rytter
Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen N, Denmark. Electronic address: jra@nexs.ku.dk.
Jens R
JR
Andersen
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; Department of Obstetrics, Rigshospitalet, Blegdamsvej 9 - 4031, 2100 Copenhagen Ø, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark. Electronic address: pdamm@dadlnet.dk.
Peter
P
Damm
Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9 - 4001, 2100 Copenhagen Ø, Denmark; Department of Endocrinology, Rigshospitalet, Ole Måløes Vej 24 - 7551, 2100 Copenhagen Ø, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark. Electronic address: elisabeth.reinhardt.mathiesen@regionh.dk.
Elisabeth R
ER
Mathiesen
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D011247:Pregnancy; D012189:Retrospective Studies
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin
Carbohydrate counting; Carbohydrates; Glycemic control; Pregnancy; Type 1 diabetes