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Nutrition and Diet in Maternal Diabetes pp 253–261Cite as

Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus

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Abstract

It is clearly assumed that the first step on the treatment of gestational diabetes mellitus (GDM) is medical nutrition therapy (MNT) and that carbohydrates (CHO) are the cornerstone due to their impact onto glycaemia. However, it is not clear the optimal dietary method to control them. On the basis that all pregnant women need a minimum of 175 g of CHO per day, low-CHO diets have been the traditional approach for GDM treatment, as they have demonstrated to be safe. Nevertheless, in global they have shown no advantages compared with higher CHO diets. In this chapter, we will review the literature surrounding low-CHO diets for GDM and we will show that, despite this lack of enough data, most guidelines across the world recommend this MNT. Finally, we concluded that more high-quality research is needed to elucidate what amount of CHO is the best option for pregnant women with GDM and that the glycaemic load could be taken into account.

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Abbreviations

ADA:

American Diabetes Association

AUC:

Area under the curve

CHO:

Carbohydrate/s

CI:

Confidence interval

GDM:

Gestational diabetes mellitus

GI:

Glycaemic index

GL:

Glycaemic load

MNT:

Medical nutrition therapy

RCT(s):

Randomized controlled trial (trials, in plural)

RR:

Relative risk

References

  1. Peterson CM, Jovanovic-Peterson L. Percentage of carbohydrate and glycemic response to breakfast, lunch, and dinner in women with gestational diabetes. Diabetes. 1991;40(Suppl 2):172–4.

    Article  PubMed  Google Scholar 

  2. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Australian carbohydrate intolerance study in pregnant women (ACHOIS) trial group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–86.

    Article  CAS  PubMed  Google Scholar 

  3. Metzger E, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al, HAPO Study Cooperative Research Group, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002.

    Google Scholar 

  4. Langer O, Yogev Y, Most O, Xenakis EMJ. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol. 2005;192:989–97.

    Article  PubMed  Google Scholar 

  5. Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity. Diabetes. 2000;49:2208–11.

    Article  CAS  PubMed  Google Scholar 

  6. Silverman BL, Rizzo T, Green OC, Cho NH, Winter RJ, Ogata ES, et al. Long-term prospective evaluation of offspring of diabetic mothers. Diabetes. 1991;40(Suppl 2):S121–5.

    Article  Google Scholar 

  7. Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diab Care. 2007;30(Suppl 2):S251–60.

    Article  CAS  Google Scholar 

  8. Tundidor D, García-Patterson A, María MA, et al. Perinatal, maternal and neonatal outcomes in women with gestational diabetes mellitus according to fetal sex. Gend Med. 2012;9:411–7.

    Article  PubMed  Google Scholar 

  9. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. Eunice Kennedy Shriver national institute of child health and human development maternal-fetal medicine units network. N Engl J Med. 2009;361:1339–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Panel on dietary reference intakes for macronutrients. Institute of Medicine. Dietary carbohydrates: sugars and starches. In: Dietary reference intakes: energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients).Washington, DC: National Academy Press; 2005. p. 265–338.

    Google Scholar 

  11. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach iin diabetes management: critical review and evidence base. Nutrition. 2015;31:1–13.

    Article  CAS  PubMed  Google Scholar 

  12. Jenkins DJA, Wolever TMS, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 1981;34:362–6.

    CAS  PubMed  Google Scholar 

  13. Salmerón J, Ascherio A, Rimm EB, Colditz GA, Spiegelman D, Jenkins DJ, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diab Care. 1997;20:545–50.

    Article  Google Scholar 

  14. Bao J, Atkinson F, Petocz P, Willett WC, Brand-Miller JC. Prediction of postprandial glycemia and insulinemia in lean, young, healthy adults: glycemic load compared with carbohydrate content alone. Am J Clin Nutr. 2011;93:984–6.

    Article  CAS  PubMed  Google Scholar 

  15. Brand-Miller J, Holt SH, Petocz P. Reply to R. Mendosa (letter).Am J ClinNutr. 2003;77:994–5.

    Google Scholar 

  16. Reader DM. Medical nutrition therapy and lifestyle interventions. Diab Care. 2007;30(Suppl 2):S188–93.

    Article  CAS  Google Scholar 

  17. American Diabetes Association. Strategies for improving care. Sec. 1. In Standards of medical care in diabetes 2016. Diab Care. 2016;39(Suppl 1):S13–22.

    Google Scholar 

  18. Nolan CJ. Improved glucose tolerance in gestational diabetic women on a low fat, high unrefined carbohydrate diet. Aust NZ J Obstet Gynaec. 1984;24:174–7.

    Article  CAS  Google Scholar 

  19. Major CA, Henry MJ, De Veciana M, Morgan MA. The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes. Obstet Gynecol. 1998;91:600–4.

    CAS  PubMed  Google Scholar 

  20. Romon M, Nuttens MC, Vambergue A, Vérier-Mine O, Biausque S, Lemaire C, et al. Higher carbohydrate intake is associated with decreased incidence of newborn macrosomia in women with gestational diabetes. J Am Diet Assoc. 2001;101:897–902.

    Article  CAS  PubMed  Google Scholar 

  21. Cypryk K, Kaminska P, Kosinski M, Pertynska-Marczewska M, Lewinski A. A comparison of the effectiveness, tolerability and safety of high and low carbohydrate diets in women with gestational diabetes. Endokrynol Pol. 2007;58:314–9.

    PubMed  Google Scholar 

  22. Moreno-Castilla C, Hernandez M, Bergua M, Alvarez MC, Arce MA, Rodriguez K, et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus. Diab Care. 2013;36:2233–8.

    Article  CAS  Google Scholar 

  23. Lichtenstein AH, Schwab US. Relationship of dietary fat to glucose metabolism. Atherosclerosis. 2000;150(2):227–43.

    Article  CAS  PubMed  Google Scholar 

  24. Hernandez TL, Van Pelt RE, Anderson MA, Daniels LJ, West NA, Donahoo WT, et al. A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diab Care. 2014;37:1254–62.

    Article  CAS  Google Scholar 

  25. Hernandez TL, Van Pelt RE, Anderson MA, Reece MS, Reynolds RM, de la Houssaye BA, et al. Women with gestational diabetes randomized to a higher-complex carbohydrate/low-fat diet manifest lower adipose tissue insulin resistance, inflammation, glucose, and free fatty acids: a pilot study. Diab Care. 2015;1–4. Epub 2005 Jul 29.

    Google Scholar 

  26. Moreno-Castilla C, Mauricio D, Hernandez M. Role of medical nutrition therapy in the management of gestational diabetes mellitus. Curr Diab Rep. 2016;16:22.

    Google Scholar 

  27. Thomas AM, Gutierrez YM. American dietetic association guide to gestational diabetes mellitus. Chicago, IL: American Dietetic Association; 2005. [cited 2016 Jun 15]. Available from http://www.eatright.org/Public/ProductCatalog/SearchableProducts/104_20728.cfm.

  28. Blumer I, Hadar E, Hadden DR, Jovanovic L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4227–49.

    Article  CAS  PubMed  Google Scholar 

  29. Thompson D, Berger H, Feig D, Gagnon R, Kader T, Keely E, et al. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Clinical practice guidelines: diabetes and pregnancy. Can J Diab. 2013;37:S168–83.

    Article  Google Scholar 

  30. Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, et al. Gestational diabetes mellitus (GDM) diagnosis, therapy and follow-up care. Practice guideline of the German Diabetes Association (DDG) and the German Association for Gynaecology and Obstetrics (DGGG). Exp Clin Endocrinol Diab. 2014;122:395–405.

    Article  CAS  Google Scholar 

  31. Yusof BNM, Firouzi S, Shariff ZM, Mustafa N, Ismail NAM, Kamaruddin NA. Weighing the evidence of low glycemic index dietary intervention for the management of gestational diabetes mellitus: an Asian perspective. Int J Food Sci Nutr. 2014;65(2):144–50.

    Article  Google Scholar 

  32. Reader D, Splett P, Gunderson EP. Impact of gestational diabetes mellitus nutrition practice guidelines implemented by registered dietitians on pregnancy outcomes. J Am Diet Assoc. 2006;106:1426–33.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, Rovira Roure, 80, 25198, Lleida, Spain

    Cristina Moreno-Castilla

  2. Department of Endocrinology and Nutrition, Institut de Recerca Biomèdica de Lleida (IRBLleida), Hospital Universitari Arnau de Vilanova, Rovira Roure, 80, 25198, Lleida, Spain

    Marta Hernandez

  3. Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Hospital Universitari Germans Trias I Pujol, Carretera de Canyet S/N, 08916, Badalona, Spain

    Dídac Mauricio

Authors
  1. Cristina Moreno-Castilla
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  2. Marta Hernandez
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  3. Dídac Mauricio
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Corresponding author

Correspondence to Dídac Mauricio .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King’s College London, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Moreno-Castilla, C., Hernandez, M., Mauricio, D. (2018). Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus. In: Rajendram, R., Preedy, V., Patel, V. (eds) Nutrition and Diet in Maternal Diabetes. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-56440-1_20

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  • DOI: https://doi.org/10.1007/978-3-319-56440-1_20

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-56438-8

  • Online ISBN: 978-3-319-56440-1

  • eBook Packages: MedicineMedicine (R0)

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