Can a Low–Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus?

A randomized trial

  1. Robert G. Moses, MD1,
  2. Megan Barker, APD1,
  3. Meagan Winter, APD1,
  4. Peter Petocz, PHD2 and
  5. Jennie C. Brand-Miller, PHD3
  1. 1Illawarra Diabetes Service, South Eastern Sydney and Illawarra Area Health Service, Wollongong, New South Wales, Australia;
  2. 2Department of Statistics, Macquarie University, Sydney, New South Wales, Australia;
  3. 3Human Nutrition Unit, University of Sydney, New South Wales, Australia.
  1. Corresponding author: Professor Robert G. Moses, robert.moses{at}sesiahs.health.nsw.gov.au.

Abstract

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.

RESEARCH DESIGN AND 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.

Footnotes

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received January 3, 2009.
    • Accepted February 27, 2009.
  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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  1. Diabetes Care vol. 32 no. 6 996-1000
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