Low energy diets in the treatment of gestational diabetes

Gillmer, M. D. G.; Maresh, Michael; Beard, R. W.; Elkeles, R.S.; Alderson, C S; Bloxham, Barbara

doi:10.1530/acta.0.111s0044

Cited by 15 publications

(3 citation statements)

References 7 publications

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“…Severe calorie restriction by 50% or intakes in the range of 1200 to 1500 kcal/d result in weight loss, ketonuria, and improved blood glucose control [32,33,35,36]. Overall, moderate calorie restriction at levels of 1700 to 1800 kcal/d has resulted in lower maternal weight gain without ketonuria among obese women with GDM [14,[32][33][34].…”

Section: Evidence For Efficacy Of Calorie Restriction In Obese Gdmmentioning

confidence: 99%

Gestational diabetes and nutritional recommendations

Gunderson

2004

Curr Diab Rep

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The goals of medical nutrition therapy for gestational diabetes mellitus (GDM) are to meet the maternal and fetal nutritional needs, as well as to achieve and maintain optimal glycemic control. Nutrition requirements during pregnancy are similar for women with and without GDM. The American Diabetes Association and the American College of Obstetrics and Gynecology recommend nutrition therapy for GDM that emphasizes food choices to promote appropriate weight gain and normoglycemia without ketonuria, and moderate energy restriction for obese women. Current controversies in GDM nutrition therapy involve manipulation of dietary composition (amounts and types of carbohydrates and fats), gestational weight gain, and energy and carbohydrate restriction. Randomized controlled trials are needed to determine which dietary compositions and patterns promote normoglycemia as well as optimal maternal and infant outcomes. Until better evidence is available, nutrition therapy will remain a cornerstone of GDM management with potential benefits that cannot be fully realized in clinical practice.

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Section: Evidence For Efficacy Of Calorie Restriction In Obese Gdmmentioning

confidence: 99%

Gestational diabetes and nutritional recommendations

Gunderson

2004

Curr Diab Rep

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“…For individuals with metabolic diseases and not obesity, 800-1,800 kcal/day can be supplied via diet. [21][22][23][24] The energy-restricted diet should be balanced with all essential nutrients, vitamins and minerals. The balanced LED may contain 45-65% carbohydrate, 20-35% fat and 10-35% proteins, vitamins, fibre and minerals.…”

Section: Nutritional Interventionmentioning

confidence: 99%

Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification

Li¹,

Jeeyavudeen²,

Arunagirinathan³

et al. 2023

European Endocrinology

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The prevalence of type 2 diabetes mellitus (T2DM) is steadily rising worldwide due to an increasingly sedentary lifestyle combined with unhealthy food habits. Currently, the burden of diabetes on healthcare systems is unprecedented and rising daily. Several observational studies and randomized controlled trials provide clinical evidence that T2DM remission is possible by adopting dietary interventions and a strict exercise training protocol. Notably, these studies provide ample evidence for remission in patients with T2DM or for prevention in those with risk factors for the disease through various non-pharmacological behavioural interventions. In this article, we present two clinical cases of individuals who showed remission from T2DM/prediabetes via behavioural changes, especially through the adoption of a low-energy diet and exercise. We also discuss the recent advances in T2DM and obesity research, focusing on nutritional interventions and exercise and their benefits for weight loss, improved metabolic profile, enhanced glycaemic control and remission of diabetes.

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“…Although weight loss is unanimously contraindicated during pregnancy [ 8 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ], energy restriction appears to be a valid recommendation for high-risk women with GDM, including those with greater adiposity [ 8 , 12 , 24 , 26 ]; to date, clinical trials have offered as low as 1200 kcal daily [ 27 , 28 ], raising concerns over possible ketogenetic effects of very low energy diets (VLED) [ 29 , 30 ]. Research is still inconclusive regarding the optimal energy restriction in women with GDM.…”

Section: Introductionmentioning

confidence: 99%

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

et al. 2021

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Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37–42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0–2.5) for all mother-infant pairs, indicating a “risk-free” pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes.

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Low energy diets in the treatment of gestational diabetes

Cited by 15 publications

References 7 publications

Gestational diabetes and nutritional recommendations

Gestational diabetes and nutritional recommendations

Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

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