Randomized Controlled Trial Investigating the Effects of a Low–Glycemic Index Diet on Pregnancy Outcomes in Women at High Risk of Gestational Diabetes Mellitus: The GI Baby 3 Study

Markovic, Tania; Muirhead, Ros; Overs, Shannon; Ross, Glynis P.; Louie, Jimmy Chun Yu; Kizirian, Nathalie; Denyer, Gareth; Petocz, Peter; Hyett, Jon; Brand-Miller, Jennie

doi:10.2337/dc15-0572

Cited by 66 publications

(67 citation statements)

References 26 publications

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“…All women were pregnant when intervention had begun in the clinical trials. The diagnosis of GDM was based on the Oral Glucose Tolerance Test (OGTT), although the measurements of the OGTT was not the same in all articles, some considered the fasting glucose level abnormal when ≥ 5.3 mmol/l [9–11], but others consider it to be abnormal when ≥ 4.8 mmol/l [12], ≥5.1 mmol/l [13, 14] or ≥5.5 mmol/l [15]. Furthermore, the glucose level readings at 1 h and at 2 h were also different.…”

Section: Resultsmentioning

confidence: 99%

Primary prevention of gestational diabetes mellitus through nutritional factors: a systematic review

Donazar-Ezcurra

Burgo

Bes–Rastrollo

2017

BMC Pregnancy Childbirth

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BackgroundGestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset during pregnancy, is increasing worldwide, mostly because obesity among women of reproductive age is continuously escalating. GDM is associated with adverse maternal and fetal outcomes. The aim of this article was to systematically review literature on the effectiveness of nutritional factors before or during pregnancy to prevent GDM.MethodsWe assessed the primary prevention of GDM through nutritional factors, as diet and supplements. We searched on PubMed, Cochrane Databases and ClinicalTrials.gov from inception to June 2016. Clinical trials and adjusted prospective cohort studies were included.ResultsEight clinical trials and twenty observational studies assessing the association between dietary factors and primary prevention of GDM were included. Furthermore, six clinical trials and two observational studies related to supplements were also added. Only two nutritional interventions were found to significantly reduce the incidence of GDM, besides the supplements. However, the observational studies showed that a higher adherence to a healthier dietary pattern can prevent the incidence of GDM, especially in high risk population before getting pregnant.ConclusionsThe results indicate that there may be some benefits of some nutritional factors to prevent GDM. However, better-designed studies are required to generate higher quality evidence. At the moment, no strong conclusions can be drawn with regard to the best intervention for the prevention of GDM.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1205-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Primary prevention of gestational diabetes mellitus through nutritional factors: a systematic review

Donazar-Ezcurra

Burgo

Bes–Rastrollo

2017

BMC Pregnancy Childbirth

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“…In this trial, lifestyle intervention was more effective than metformin (850 mg twice daily) at reducing T2DM (by 58%; 95% CI [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]. However, in a sub-analysis of women with previous pregnancies that were complicated by GDM, metformin was as effective at reducing the incidence of T2DM as lifestyle intervention.…”

Section: Pharmacological Preventionmentioning

confidence: 95%

Gestational diabetes mellitus: does an effective prevention strategy exist?

et al. 2016

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The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease. A high degree of heterogeneity exists between trials so a generalised recommendation is problematic. In population studies of dietary or combined lifestyle measures, risk of developing GDM is not improved and those involving a physical activity intervention have yielded conflicting results. In pregnant women with obesity, dietary modification might reduce fetal macrosomia but in these patients, low compliance and no significant reduction in the incidence of GDM has been observed in trials investigating physical activity. Supplementation with probiotics or myoinositol have reduced the incidence of GDM but confirmatory studies are still needed. In randomized controlled trials, metformin does not prevent GDM in certain at-risk groups. Given the considerable potential for reducing disease burden, further research is needed to identify strategies that can be easily and effectively implemented on a population level.

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“…The low glycaemic index (GI) diet in pregnancy is associated with improvements in dietary intakes, reduced gestational weight gain (GWG), and improved glycaemic response . While much research has explored offspring outcomes relating to dietary intakes and GI in pregnancy, there is a paucity of research relating to long‐term maternal outcomes following a low‐GI diet in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Five‐year follow up of a low glycaemic index dietary randomised controlled trial in pregnancy—no long‐term maternal effects of a dietary intervention

O’Brien

Geraghty

O’Sullivan

et al. 2018

BJOG

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Objective To determine whether a dietary intervention in pregnancy had a lasting effect on maternal outcomes of diet, HbA1c and weight retention 5 years post‐intervention; and to establish whether modifiable maternal behaviours were associated with these outcomes. Design Randomised control trial of low glycaemic index (GI) diet in pregnancy with longitudinal follow up to 5 years post‐intervention. Setting Dublin, Ireland (2007–2016). Population In all, 403 women of 759 (53.1%) were followed up at 5 years. A total of 370 (intervention n = 188; control n = 182) were included in this analysis. Methods Fasting glucose was measured at 13 and 28 weeks’ gestation and HbA1c (mmol/mol) at 5‐year follow up. Weight retention (kg) from early pregnancy to 5 years post‐intervention was calculated. Dietary intakes, anthropometry, and lifestyle factors were measured in pregnancy and 5 years post‐intervention. Multiple linear regression models, controlling for confounders, were used for analysis. Outcome Maternal diet, HbA1c, and weight retention at 5 years post‐intervention. Results There was no difference between the intervention and control at 5 years post‐intervention for any long‐term maternal outcomes measured. HbA1c at 5 years post‐intervention was associated with early‐pregnancy fasting glucose (B 1.70, 95% CI 0.36–3.04) and parity ≥3 (B 1.04, 95% CI 0.09–1.99). Weight retention was associated with change in well‐being from pregnancy to 5 years (B −0.06, 95% CI −0.11 to −0.02), gestational weight gain (B 0.19, 95% CI 0.00–0.38), and GI (B 0.26, 95% CI 0.06–0.46) at 5 years. Conclusions The ROLO low‐GI dietary intervention in pregnancy had no impact on maternal dietary intakes, HbA1c or body composition 5 years post‐intervention. Maternal factors and lifestyle behaviours in pregnancy have long‐term effects on glucose metabolism and weight retention up to 5 years later. Tweetable abstract Pregnancy factors are associated with maternal glucose metabolism and weight retention 5 years later—findings from the ROLO Study.

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Randomized Controlled Trial Investigating the Effects of a Low–Glycemic Index Diet on Pregnancy Outcomes in Women at High Risk of Gestational Diabetes Mellitus: The GI Baby 3 Study

Cited by 66 publications

References 26 publications

Primary prevention of gestational diabetes mellitus through nutritional factors: a systematic review

Primary prevention of gestational diabetes mellitus through nutritional factors: a systematic review

Gestational diabetes mellitus: does an effective prevention strategy exist?

Five‐year follow up of a low glycaemic index dietary randomised controlled trial in pregnancy—no long‐term maternal effects of a dietary intervention

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