Gestational diabetes mellitus and nutrient intake in regards to carbohydrate, fat, saturated fat, protein and fiber consumption versus blood glucose levels

Abstract

Medical management of Gestational Diabetes Mellitus (GDM) has shown that lowering blood glucose levels to normoglycemic may help prevent diabetic complications for infant and mother. The objective of this experiment was to determine if consumption of carbohydrate, saturated fat, total fat, protein, and fiber affected blood glucose levels in pregnant women diagnosed with GDM. The study included forty-two adult women from eight different medical facilities, which included Minnesota, Georgia, Florida, Tennessee, and New Mexico. The women were diagnosed by two abnormal values from an oral glucose tolerance test (OGTT) of 100 grams (g). The additional criteria for inclusion in the study were age 18-45 years, carrying a singleton pregnancy, and entry into trial between 28 to 32 weeks gestation. Three-day food records were collected. Only thirty-four women had the required data completed for final analysis. Means and frequencies were determined for carbohydrate, protein, total fat, saturated fat, fiber, and calorie intake as well as blood glucose levels at fasting, breakfast, lunch, and supper. Results showed participants in the study had a mean Body Mass Index (BMI) of 29.04 ± 7.27 during the time of diagnosis (28 to 32 weeks of pregnancy). Participants had a mean total caloric intake of 1645.04 kilocalories for six meals throughout the day. Mean total daily intake of carbohydrate, protein, fat, saturated fat, and dietary fiber were 188.31 g, 81.62g, 65.09 g, 22.46 g, and 14.35 g, respectively. Blood glucose levels for fasting, 1 hour postprandial for breakfast, 1 hour postprandial for lunch, and 1 hour postprandial for supper were 90.80, 107.38, 109.26, and 109.01 mg/dL, respectively. Statistical analyses performed included three separate regression analyses and Pearson correlations on blood glucose level after breakfast, dinner, and supper to different combinations of variables that included carbohydrates, total fat, saturated fat, protein, fiber, body mass index, and body weight. Regression analyses indicated that there was a significant negative relationship between pregnancy weight and blood glucose levels, one hour after breakfast (F= 6.04, Significance= 0.01), however no correlation was found between BMI and blood glucose. The second regression analyses negatively correlated both pregnancy weight and BMI to carbohydrate intake at breakfast (F= 2.93, Significance= 0.05). The final regression analyses showed that protein negatively correlated to breakfast blood glucose levels (F= 3.2838, Significance= 0.05). The negative correlation of carbohydrate intake as well as the negative correlation of blood glucose levels at breakfast to body weight supports the medical nutrition practice of limiting carbohydrate intake at the breakfast meal for women with GDM. This practice of limiting carbohydrate at breakfast was further highlighted by the negative correlation of protein to blood glucose. Thus more protein at the breakfast meal decreased blood glucose 1 hour after breakfast. Strategies are required to decrease Gestational Diabetes Mellitus prevalence among pregnant women throughout the United States and to help maintain normal blood glucose levels. Targeting all health care professionals to educate women on the importance of diet and blood glucose maintain to promote a healthy pregnancy is needed. In this study of women with GDM who were followed closely by Registered Dietitians showed tight regulation of blood glucose levels is possible. When carbohydrate intake was within recommended levels, no relationship of carbohydrate to blood glucose other than the breakfast meal could be identified. Research was conducted and funded by the International Diabetes Center, Minneapolis, Minnesota. Analyses and interpretation of data was conducted at the University of Wisconsin-Stout.