The influence of fasting insulin level in post-gestational diabetes mellitus women receiving low-glycaemic-index diets

Abstract

Post-gestational diabetes mellitus (GDM) women are recommended weight loss to manage increased cardio-metabolic risks. We investigated the effects of lowering diet glycaemic index (GI) on fasting blood glucose (FBG), serum lipids, body weight and composition of post-GDM women with varying fasting insulin levels (INS). Seventy-seven Asian, non-diabetic women with previous GDM (aged 20–40 years, mean BMI: 26.4±4.6 kg m−2) were recruited. At baseline, 20 subjects with INS <2 μIU ml−1 and 18 with INS ⩾2 μIU ml−1 received conventional dietary recommendations (CHDR) only. CHDR emphasised energy and fat intake restriction and encouraged increase in dietary fibre intakes. Twenty-four subjects with INS <2 μIU ml−1 and 15 with INS ⩾2 μIU ml−1, in addition to CHDR, received low-GI education (LGI). Changes in FBG, serum lipids, body weight and body composition were evaluated. Subjects with INS <2 μIU ml−1 had similar outcomes with both diets. After 1 year, subjects with INS ⩾2 μIU ml−1 who received LGI education had reductions in FBG and triglycerides. Subjects who received CHDR observed increase in both FBG and triglycerides (P<0.05). Among all subjects, diet GI was lower and dietary fibre intakes were higher in LGI compared with CHDR subjects (all P<0.05). Thus, in Asian post-GDM women with normal/higher INS, adding low-GI education to CHDR improved management of FBG and triglycerides.

The Role of Diet in the Prevention of Diabetes among Women with Prior Gestational Diabetes: A Systematic Review of Intervention and Observational Studies

“…Of these, 12 met the inclusion criteria. Multiple articles were published based on data from a Malaysian dietary intervention (n¼2) 19,20 and the Nurses' Health Study II (NHSII) (n¼4). 21-24 Therefore, this review includes five articles 19,20,[25][26][27] reporting on findings from four intervention studies, and seven articles 21-24,28-30 reporting on findings from four observational studies.…”

“…The Newcastle-Ottawa Scale was used to assess the quality of nonrandomized studies, including case-control and cohort studies. 19 A star system is used to classify the studies as good, fair, or poor quality in relation to the selection of study groups, the comparability of groups and the ascertainment of either the exposure or outcome of interest for caseecontrol and cohort studies, respectively. Any discrepancies were discussed between reviewers and resolved.…”

“…Intervention studies included RCTs conducted in Malaysia (n¼65 to 77) 19,20 and Australia (n¼193), 26 and randomized crossover studies from the United States (n¼17) 25 and Sweden (n¼7) 27 (Table 1). Women had a mean baseline age between 31 and 40 years, and mean baseline body mass index (BMI) between 25 and 28.…”

“…Women had a mean baseline age between 31 and 40 years, and mean baseline body mass index (BMI) between 25 and 28. The studies from Malaysia, the United States, and Sweden recruited high-risk women who were overweight or obese, 19,20,25 had prediabetes or a family history of diabetes, 19,20 or had a diagnosis of impaired glucose tolerance at 12-months postpartum. 27 recruited at a median of 4 months post-GDM pregnancy in the Malaysian RCT 19,20 and 1 to 3 years post-GDM in the Swedish crossover trial, 27 whereas the time since GDM pregnancy was not reported in the studies from Australia or the United States.…”

Assessment of adherence to the dietary recommendations concerning the amount of carbohydrates intake in type 1 diabetic patients treated with continuous subcutaneous insulin infusion during pregnancy and 8 weeks after the delivery

“…221 of carbohydrates of low glycemic index daily has positive effect on the fasting blood glucose level in women after gestational diabetes [16]. Chun Yu Louie et al proved that women with gestational diabetes do not have an appropriate diet, which is related mainly to intake and quality of consumed carbohydrates.…”