Carbohydrate Content in the GDM Diet: Two Views: View 2: Low-Carbohydrate Diets Should Remain the Initial Therapy for Gestational Diabetes

Abstract

IN BRIEF The appropriate dietary intervention for gestational diabetes mellitus (GDM) is not clear. Traditionally, a low-carbohydrate diet has been prescribed. Recently, there has been a movement to prescribe a diet higher in nutrient-dense carbohydrate as the initial treatment for GDM. At this time, there is insufficient outcome data to support this type of diet.

Treating Type 2 Diabetes with Therapeutic Carbohydrate Restriction

“…When it comes to TCR, pregnancy and breastfeeding must be considered. Although moderate carbohydrate restriction has long been used to treat pregnant women with gestational diabetes [32], carbohydrates are rarely restricted to the very low levels used for weight loss or type 2 diabetes treatment. The amount of Treating Type 2 Diabetes with Therapeutic Carbohydrate Restriction DOI: http://dx.doi.org/10.5772/intechopen.107184 carbohydrate restriction should be individualized for the patient based on her medical history, but it should usually be at least 50 grams per day.…”

Modulation of gut microbiota by diet and probiotics: potential approaches to prevent gestational diabetes mellitus

“…The major focus of MNT is to lower postprandial plasma glucose levels, either by adjusting CHO distribution or by altering the glycaemic load (GL; Hernandez et al, 2013). The first steps of diet manipulation were taken during the 1950s and 60s, focusing on CHO restriction, with approximately 40% of total daily calories (Hernandez, 2016), considering the principle that it could help lower postprandial glucose and prevent foetal hyperinsulinemia (Mulla, 2016). Currently, it is recommended by the Institute of Medicine (United States of America – USA) a minimum of 175 g CHO/day for pregnant women, equivalent to 35% of a 2000 calories diet, with an extra 45 g compared with non-pregnant women, since an average of 33g glucose/day are required to support foetal brain development and functioning (Trumbo et al, 2002), and also 71 g of protein and 28 g of fibre.…”

“…Low-CHO diets remain the conventional diet therapy for GDM in some countries. Hence, more studies are needed to construct solid evidence about CHO restriction diets (Trumbo et al, 2002; Moreno-Castilla et al, 2016; Mulla, 2016). Moderation seems to be key, since proportions greater than 55% CHO are associated with increased postprandial plasma glucose (Filardi et al, 2019).…”