title: Lower glycemic load meals reduce diurnal glycemic oscillations in women with risk factors for gestational diabetes.
abstract: OBJECTIVE
  Maternal glycemia plays a key role in fetal growth. We hypothesized that lower glycemic load (GL) meals (lower glycemic index, modestly lower carbohydrate) would substantially reduce day-long glucose variability in women at risk of gestational diabetes mellitus (GDM).
  
  
  METHODS
  A crossover study of 17 women (mean±SD age 34.8±4 years; gestational weeks 29.3±1.3; body mass index 23.8±4.7 kg/m2) who consumed a low GL or a high GL diet in random order, 1-day each, over 2 consecutive days. Diets were energy-matched and fiber-matched with 5 meals per 24 hours. All food was provided. Continuous glucose monitoring was used to assess diurnal glycemia.
  
  
  RESULTS
  Maternal glucose levels were 51% lower on the low GL day with lower incremental area under the curve (iAUC±SEM 549±109 vs 1120±198 mmol/L min, p=0.015). Glycemic variability was significantly lower on the low GL day, as demonstrated by a lower average SD (0.7±0.1 vs 0.9±0.1, p<0.001) and lower mean amplitude of glycemic excursions (2.1±0.2 vs 2.7±0.2 mmol/L, p<0.001).
  
  
  CONCLUSIONS
  A lower GL meal plan in pregnancy acutely halves day-long maternal glucose levels and reduces glucose variability, providing further evidence to support the utility of a low GL diet in pregnancy.
authors.affiliation: Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Nathalie V
authors.initials: NV
authors.lastname: Kizirian
authors.affiliation: Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia; IEL-Nutritional Epidemiology, University of Bonn, DONALD Study, Dortmund, Germany.
authors.forename: Janina
authors.initials: J
authors.lastname: Goletzke
authors.affiliation: Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia; Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Shannon
authors.initials: S
authors.lastname: Brodie
authors.affiliation: Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Fiona S
authors.initials: FS
authors.lastname: Atkinson
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia; Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Tania P
authors.initials: TP
authors.lastname: Markovic
authors.affiliation: Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Glynis P
authors.initials: GP
authors.lastname: Ross
authors.affiliation: IEL-Nutritional Epidemiology , University of Bonn, DONALD Study , Dortmund , Germany.
authors.forename: Anette
authors.initials: A
authors.lastname: Buyken
authors.affiliation: Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia; Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jennie P
authors.initials: JP
authors.lastname: Brand-Miller
keywords: Continuous Glucose Monitoring; Gestational Diabetes Mellitus; Glycemic Index; Pregnancy