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Πέμπτη 26 Μαΐου 2022

Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant women with type 1 diabetes; insights from the Diabetes and Pre‐eclampsia Intervention Trial (DAPIT)

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Abstract

Aim

To explore the relationships between carbohydrate intake, body mass index and glycaemic control (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM)

Methods

Secondary analysis of data was undertaken to assess dietary intake in a cohort of women who participated in a randomized controlled trial (RCT) of antioxidant supplementation to prevent pre-eclampsia (DAPIT10). Study specific peripheral venous blood samples were obtained for HbA1c at 26 weeks and 34 weeks. Diet was collected using a validated semi-quantitative food frequency questionnaire at 26-28 weeks gestation which assessed dietary intake over 2 weeks. Mean daily average nutrient intakes were analysed using Q Builder nutritional software (Tinuviel Software, UK) and SPSS Version 25).

Results

Dietary data were available for 547 pregnant women (72% of cohort) aged 29 years (95% CI 28.9-29.9) with average diabetes duration 11.8 years (95% CI 11.1-12.6). Averag e BMI (<16 weeks gestation) was 26.7 kg/m2 (95% CI 26.3 -27 range 18.8-45.6 kg/m2); 43% (n=234) were overweight (BMI 25.0 - 29.9kg/m2) and 20% (n= 112) were obese (BMI>30kg/m2). Differences in HbA1c and carbohydrate quantity and quality were found when adjusted for age and insulin dose. No differences between BMI group were observed in total carbohydrate and glycaemic control, however, differences were noted in fibre and glycaemic index.

Conclusion

Average quantity of dietary carbohydrate influenced HbA1c when adjusted for insulin dose however, BMI had less impact. More research is required on the relationship between carbohydrate consumption and glycaemic control in pregnancy.

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