High protein, low carbohydrate diet reduces postprandial blood sugar in women with gestational diabetes

Written By : Dr Kartikeya Kohli |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-10-13T11:45:23+05:30 | Updated On 13 Oct 2022 3:32 PM IST

USA: Carbohydrate restriction is considered to be primary diet therapy for gestational diabetes, but there is limited evidence regarding optimal amounts of carbohydrate, protein, and fat for blood sugar control in patients with gestational diabetes.

Researchers have found in a new study that Women with gestational diabetes who consume a higher protein, lower carbohydrate diet, especially in breakfast are more likely to have lower values of postprandial blood sugar.

Previous studies have manipulated levels of carbohydrate, adjusting fat intake to compensate, but we have found none in women with gestational diabetes that have evaluated the impact of varied protein loads with compensatory carbohydrate manipulation on blood sugar control in a controlled feeding environment.

The purpose of this study was to investigate the impact of a higher protein and lower carbohydrate diet on maternal blood sugar levels in a well-controlled feeding trial in women with GDM not treated by insulin or other medication.

Gestational diabetes mellitus (GDM) affects both women and their infants, and increasing studies have supported that the intrauterine environment in pregnancy impacted by GDM may impact both mother and child that lasts lifelong. Since control of dietary energy intake is an essential factor in gestational diabetes management, there is an urgent need to establish an evidence base for recommendations on the proportions of macronutrients for the optimized nutritional management of GDM.

Against the above background, Kimberly K. Trout, University of Pennsylvania, Philadelphia, Pennsylvania, USA, and colleagues aimed to compare isocaloric diets differing in carbohydrate, protein content, and fats held constant among women with GDM. They worked on the hypothesis that the glucose area under the curve (AUC) would be lower with the intake of higher protein/more deficient carbohydrate meals.

The researchers used a random order crossover design within a controlled research unit environment for their study. Out of nineteen women randomized to the intervention, 12 completed the study. Blood sampling was preprandial and at t = 30, 60, 120, and 180" relative to meals.

Women with confirmed diet-controlled GDMA1, singleton gestation, and absence of pre-existing medical comorbidities. The mean gestational age was 32 (±1.76) weeks. Mean prepregnant body mass index of participants = 28.7 (±5.3) kg/m2. Initially, women were either given an increased protein/low carbohydrate diet or a lower protein/higher carbohydrate diet for an inpatient stay of 36 hours. The preparation of all meals and snacks was done in a metabolic kitchen. The women were given the opposite treatment after a 3–7 day washout period.

In the treatment arm, where the women were given an increased protein/low carbohydrate meal (17395.20 ± 2493.47 vs. 19172.47 ± 3484.31), the average 3-hour pre- through postprandial glucose AUC was more down on day 2 (with confirmed overnight fasting).

"Our study is the first to show that a meal with higher protein and lower carbohydrate content, especially at breakfast, resulted in lower postprandial blood sugar values in women with gestational diabetes," the authors wrote. "A lack of significant differences at other collection time points could be due to various factors, but most likely due to small sample size."

"There is a need for longer-term outcomes of a higher protein diet, including nitrogen balance, maternal glycemic control, and affect on growth outcomes of the fetus," they concluded.

Reference:

Trout KK, Compher CW, Dolin C, Burns C, Quinn R, Durnwald C. Increased Protein with Decreased Carbohydrate Intake Reduces Postprandial Blood Glucose Levels in Women with Gestational Diabetes: The iPRO Study. Womens Health Rep (New Rochelle). 2022 Aug 31;3(1):728-739.

doi: 10.1089/whr.2022.0012. PMID: 36147835; PMCID: PMC9436385

Womenblood sugarGestational diabetespostprandial blood sugar

Source : Women's Health Reports

Dr Kartikeya Kohli

Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751