Gestational Diabetes

GDM: Macronutrients (2008)

• Intervention
  Is there a specific amount, type, form of carbohydrate, fat and protein for women with gestational diabetes?

  • Conclusion

    Ten studies were evaluated to investigate the consumption of macronutrients in pregnant women and women with gestational diabetes mellitus.  Carbohydrate intake affects postprandial blood glucose levels; Increased postprandial blood glucose levels are associated with increased incidence of large-for-gestational age infants and increased rate of Cesarean sections.  Three studies showed improved outcomes at carbohydrate intakes of less than 45% of energy .  Research is limited regarding protein, fat, fiber and glycemic index in women with gestational diabetes mellitus; further research is needed in these areas.   

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Carbohydrate, fat and protein for women with gestational diabetes
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Clapp JE.  Effect of dietary carbohydrate on the glucose and insulin response to mixed caloric intake and exercise in both nonpregnant and pregnant women.  Diabetes Care 1998; (Suppl 2) 21:B107-B112.
      • Kalkwarf HJ, Bell RC, Khoury JC, Gouge AL, Miodovnik M.  Dietary fiber intakes and insulin requirements in pregnant women with type 1 diabetes.  J Am Diet Assoc 2001;101:305-310. 
      • Lauszus FF, Rasmussen OW, Henriksen JE, Klebe JG, Jensen L, Lauszus KS,
        Hermansen K.  Effect of a high monounsaturated fatty acid (MUFA) diet on blood pressure and glucose metabolism in women with gestational diabetes mellitus.  Eur J Clin Nutr 2001;55(6):436-43.
      • Loosemore ED, Judge MP, Lammi-Keefe CJ.  Dietary intake of essential and long-chain polyunsaturated fatty acids in pregnancy. Lipids 2004;39(5):421-4.
      • Major CA, Henry MJ, De Veciana M, Morgan MA.  The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes.  Obstet & Gynecol 1998;91:600-604. 
      • Parretti E, Mecacci F, Papini M, Cioni R, Carignani L, Mignosa M, La Torre P, Mello G.  Third-trimester maternal glucose levels from diurnal profiles in nondiabetic pregnancies:  correlation with sonographic parameters of fetal growth.  Diabetes Care 2001; 24:1319-1323.
      • 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):172-174. 
      • Romon M, Nuttens MC, Vambergue A, Verier-Mine O, Biausque S, Lemaire C, Fontaine P, Salomez JL, Beuscart R. Higher carbohydrate intake is associated with decreased incidence of newborn macrosomia in women with gestational diabetes.  J Am Diet Assoc 2001;101(8):897-902.
      • Sloan NL, Lederman SA, Leighton J, Himes JH, Rush D.  The effect of prenatal dietary protein intake on birth weight.  Nutrition Research 2001; 21:129-139. 
      • Snyder J, Gray-Donald K, Koski KG.  Predictors of infant birth weight in gestational diabetes.  Am J Clin Nutr 1994;59:1409-14. 
  • Search Plan and Results: Carbohydrate, Fat and Protein 2006