Gestational Diabetes

Glycemic Index (2016)

• Intervention
  In women with GDM, what impact do dietary patterns based on the glycemic index have on fetal/neonatal and maternal outcomes?

  • Conclusion
    A low (LGI) or medium glycemic index (MGI) dietary pattern resulted in glycemic control and had similar fetal or neonatal and maternal outcomes in women with gestational diabetes mellitus (GDM) in most studies. In a few studies, an LGI diet (36% to 47% CHO) was found to significantly reduce the need for insulin therapy and prevent excessive maternal weight gain. One study comparing an LGI-MGI diet (40% CHO, 45% fat) to an LGI-MGI diet (60% CHO, 25% fat) found that both diets achieved glycemia within target levels in women with GDM.
    
    Interpretation of results is limited, due to inability to compare diets across studies and none of the studies included a comparison to the high glycemic index (HGI) diet.
  • Grade: III
    • 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: In women with GDM, what impact do dietary patterns based on the glycemic index have on fetal/neonatal and maternal outcomes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Afaghi A, Ghanei L, Ziaee A. Effect of low glycemic load diet with and without wheat bran on glucose control in gestational diabetes mellitus: A randomized trial. Indian J Endocr Metab. 2013; 17: 689-692.
      • Grant SM, Wolever TMS, O'Connor DL, Nisenbaum R, Josse RG. Effect of a low glycaemic index diet on blood glucose in wowen with gestational hyperglycaemia. Diabetes Res Clin Pract. 2011, 91: 15-22.
      • Hernandez TL, Van Pelt RE, Anderson MA, Daniels LJ, West NA, Donahoo WT, Friedman JE, Barbour LA. A higher-complex carbohydrate diet in gestational diabetes achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diabetes Care, 2014 DOI: 10.2337/dc13-2411.
      • Louie JCY, Markovic TP, Perera N, Foote D, Petocz P, Ross GP, Brand-Miller JC. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care, 2011, 34: 2,341-2,346.
      • Moses RG, Barker M, Winter M, Petocz P, Brand-Miller JC. Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? A randomized trial. Diabetes Care. 2009; 32(6): 996-1000.
      • Perichart-Perera O, Balas-Nakash M, Rodriguez-Cano A. Legorreta-Legorreta J, Parra-Covarrubias A, Vadillo-Ortega F. Low glycemic index carbohydrates versus all types of carbohydrates for treating diabetes in pregnancy: A randomized clinical trial to evaluate the effect of glycemic control. International Journal of Endocrinology. 2012; 2012: 296017.
  • Search Plan and Results: GDM: Carbohydrate 2014