Macronutrient Preload effect on Glycaemic Control and Pregnancy Outcome in Gestational Diabetes Mellitus

Abstract

Objective: To investigate the effect of macronutrient preload treatment, MPT, on glycemic control and pregnancy outcome in gestational diabetes mellitus, GDM. Study Design: 40 patients with GDM were randomized to either MPT in addition to health education and dietary guidance (n=25) or health education and dietary guidance only (n=15). MPT was given three times/day, 30 minutes before regular meals and continued until term. Participants were subjected physical examination, laboratory analysis and pregnancy outcomes. Results: The time until the participant reached stable euglycemia was shorter in the preload group compared to controls (P<0.05), in patients ≥30 years old (1.3±0.55 versus 2.5±1.1 weeks, P<0.05), in pre-gestational BMI<24 kg/m 2 (1.3±0.58 versus 1.9±0.69 weeks, P<0.05) and in pre-gestational BMI≥24 kg/m 2 (1.2±0.44 versus 2.6±1.32 weeks, P<0.05). The birth weight in the subgroup of BMI>24 kg/m 2 was lower in the MTP group compared to the control group (3124±523g versus 3780.0±472g, P<0.05). Increase of HbA1c ≥5% was significantly lower after preload treatment. Conclusion; MPT can safely be used in patients with gestational diabetes mellitus for effective control of blood glucose. The significant reduction of birth weight in participants with pre-gestational BMI ≥24kg/m 2 indicates that preload can be used to control negative effects of hyperglycemia, with reduced risk for complications during delivery.