The Role of Dietary Carbohydrates in Gestational Diabetes

• Published in: Nutrients Vol. 12; no. 2; p. 385
• Main Authors: Mustad, Vikkie A, Huynh, Dieu T T, López-Pedrosa, José M, Campoy, Cristina, Rueda, Ricardo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31-01-2020; MDPI
• Subjects: Blood glucose; Blood Glucose - drug effects; Carbohydrates; continuous glucose monitoring; Diabetes mellitus; Diabetes, Gestational - blood; Diabetes, Gestational - diet therapy; Diabetes, Gestational - etiology; diabetes-specific formula; Diet, Diabetic - methods; dietary carbohydrates; Dietary Carbohydrates - analysis; Etiology; Female; Fermentation; Gestational diabetes; gestational diabetes mellitus; Glucose; Glucose monitoring; Glycemic Index - drug effects; Humans; Hyperglycemia; Insulin; Insulin resistance; Intestinal microflora; Intestine; Lipids; Maternal Nutritional Physiological Phenomena; Microbiota; Microorganisms; Neonates; Nutrition; Offspring; Pregnancy; Prenatal Care - methods; Review; Saccharides; Sugar; Womens health; China; dietary carbohydrates; diabetes-specific formula; gestational diabetes mellitus; continuous glucose monitoring; pregnancy
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12020385

Gestational diabetes (GDM) is hyperglycemia that is recognized for the first time during pregnancy. GDM is associated with a wide range of short- and long-term adverse health consequences for both mother and offspring. It is a complex disease with a multifactorial etiology, with disturbances in glucose, lipid, inflammation and gut microbiota. Consequently, its management is complex, requiring patients to self-manage their diet, lifestyle and self-care behaviors in combination with use of insulin. In addition to nutritional recommendations for all pregnant women, special attention to dietary carbohydrate (CHO) amount and type on glucose levels is especially important in GDM. Dietary CHO are diverse, ranging from simple sugars to longer-chain oligo- and poly- saccharides which have diverse effects on blood glucose, microbial fermentation and bowel function. Studies have established that dietary CHO amount and type can impact maternal glucose and nutritional recommendations advise women with GDM to limit total intake or choose complex and low glycemic CHO. However, robust maternal and infant benefits are not consistently shown. Novel approaches which help women with GDM adhere to dietary recommendations such as diabetes-specific meal replacements (which provide a defined and complete nutritional composition with slowly-digested CHO) and continuous glucose monitors (which provide unlimited monitoring of maternal glycemic fluctuations) have shown benefits on both maternal and neonatal outcomes. Continued research is needed to understand and develop tools to facilitate patient adherence to treatment goals, individualize interventions and improve outcomes.