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Consider high-carb, low-fat diet in gestational diabetes.


CHICAGO -- Women with gestational diabetes on a conventional low-carbohydrate, high-fat diet were more insulin resistant, and their infants had slightly higher rates of adiposity, than did with women who consumed a diet high in complex carbohydrates and low in fat, according to a randomized pilot study of 11 women.

Both diets controlled maternal glucose and weight. "So, they're both okay, except that tissue data and fasting levels imply that higher fat content is exacerbating insulin resistance during pregnancy," Teri L. Hernandez, Ph.D., said in an interview after presenting her findings at the annual scientific sessions of the American Diabetes Association.

In a recent unpublished systematic review of prospective, randomized, controlled trials of diet interventions in women with GDM, Dr. Hernandez and her colleagues found that women tolerated higher complex carb/low glycemic index diets and that diets higher in unrefined carbs effectively blunted postprandial glycemia, reduced the need for insulin therapy, and improved insulin sensitivity, hemoglobin Alc, and systolic blood pressure.

Dr. Hernandez of the University of Colorado at Denver in Aurora, said that she has a larger number women in her ongoing study, but the findings so far "lend evidence to the idea that women can tolerate more carb than we thought.

"What this says is that they can actually have toast and other carbs in their diet and still have a great outcome, and it could even help improve their insulin resistance," she said in an interview.

Researchers randomized five women to the conventional lowcarb/high-fat diet and 6 women to the high-carb/low-fat diet. The low-carb/high fat diet comprised 40% CHO, 45% fat, and 15% protein; the high-carb/low fat diet contained 60% CHO, 25% fat, and 15% protein. Simple sugars made up about 18% or less of total daily calories.

Weight gain was similar in both groups, and their glycemic profiles were below target, but the high-carb/low-fat diet group had lower fasting glucose and fasting insulin at 6 and 7 weeks, compared with the low-carb/high-fat diet group.

Results also showed that the post-prandial free fatty acids were significantly higher in the low-carb/high-fat diet group. And, at week 37, fasting glucose, insulin, and maternal insulin resistance (HOMA-IR) were significantly higher in the low-carb/high-fat diet, compared with the low-fat /high-carb diet.

Meanwhile, infant adiposity was slightly higher in the infants of the low-carb/high-fat groups, compared with the high-carb/low-fat group (14% v. 11%).

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Major finding: At week 37, fasting glucose, insulin, and maternal insulin resistance were significantly higher in the low carb/high fat diet, compared with the low fat/high carb diet.

Data source: Randomized pilot study of 11 women.

Disclosures: Dr. Hernandez had no disclosures.



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Title Annotation:WOMEN'S HEALTH
Author:Miller, Naseem S.
Publication:Family Practice News
Article Type:Clinical report
Date:Jul 1, 2013
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