OBJECTIVEMedical nutrition therapy based on the control of the amount and distribution of carbohydrates (CHO) is the initial treatment for gestational diabetes mellitus (GDM), but there is a need for randomized controlled trials comparing different dietary strategies. The purpose of this study was to test the hypothesis that a low-CHO diet for the treatment of GDM would lead to a lower rate of insulin treatment with similar pregnancy outcomes compared with a control diet.RESEARCH DESIGN AND METHODSA total of 152 women with GDM were included in this open, randomized controlled trial and assigned to follow either a diet with low-CHO content (40% of the total diet energy content as CHO) or a control diet (55% of the total diet energy content as CHO). CHO intake was assessed by 3-day food records. The main pregnancy outcomes were also assessed.RESULTSThe rate of women requiring insulin was not significantly different between the treatment groups (low CHO 54.7% vs. control 54.7%; P = 1). Daily food records confirmed a difference in the amount of CHO consumed between the groups (P = 0.0001). No differences were found in the obstetric and perinatal outcomes between the treatment groups.CONCLUSIONSTreatment of women with GDM using a low-CHO diet did not reduce the number of women needing insulin and produced similar pregnancy outcomes. In GDM, CHO amount (40 vs. 55% of calories) did not influence insulin need or pregnancy outcomes.

The pharmacokinetic parameters of doxycycline (DOX) were determined in 3 day, 3-, 6- and 12-week-old fasted turkeys, after a single intravenous (i.v.) dose of 25 mg doxycycline. HCl/kg body weight. Doxycycline disposition fitted an open two-compartment model. The mean (+/-SD) elimination half-life was 10.6 +/- 0.7, 10.8 +/- 1.5, 7.9 +/- 1.4 and 10.0 +/- 0.9 h in 3 day, 3-, 6- and 12-week-old turkeys, respectively. Mean (+/- SD) total body clearance was 0.19 (+/-0.01), 0.27 (+/-0.03), 0.11 (+/-0.03) and 0.06 (+/-0.01) L/h.kg in 3 day, 3-, 6- and 12-week-old turkeys, respectively. The steady-state volume of distribution was 1.77 (+/-0.2), 2.1 (+/-0.2), 0.7 (+/-0.4) and 0.5 (+/-0.2) L/kg in turkeys of the above mentioned ages, respectively. The AUC value significantly increased with the age of the turkeys. An oral doxycycline solution at a single dose of 25 mg/kg of body weight was administered to 3 day. 3-, 6- and 12-week-old turkeys. The maximal plasma concentrations in fasted turkeys were 3.8, 5.6, 7.4 and 5.7 micrograms/mL. with tmax values of 4.7, 1.5, 2.8 and 5.4 h, for the different ages, respectively. In fed turkeys the Cmax values were 2.5, 6.1, 4.8 and 3.0 micrograms/mL. with tmax values of 4.2, 5.3, 4.5 and 7.5 h, respectively. The absolute bioavailability in fasted turkeys varied between 25.0 +/- 9.0% (for 12-week-old birds) and 63.5 +/- 7.1% (for 3-week-old birds). The relative bioavailability varied between 40.0 +/- 13.0% (for 12-week-old birds) and 83.7 +/- 14.3% (for 3-week-old birds).

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