Carbohydrate intake behaviours and associations with elevated glycaemia in gestational diabetes — ASN Events
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Carbohydrate intake behaviours and associations with elevated glycaemia in gestational diabetes (#124)

Roslyn A Smith 1 2 , Renee Borg 3 , Vincent Wong 1 4 , Hamish Russell 1 4 , Ka Hi Mak 2 4
  1. Liverpool Hospital Diabetes and Endocrine Service, Liverpool, NSW
  2. Dietetics Department, Liverpool Hospital, South West Sydney, NSW
  3. Nutrition & Dietetics, School of Health and Society, University of Wollongong, NSW
  4. University of New South Wales, Sydney, NSW

Background/Aim: Carbohydrate intake (CI) guidance for gestational diabetes (GDM) varies. It is unclear whether fasting and post‑prandial dysglycaemia arise from different dietary patterns. This study examined CI behaviours in women with newly diagnosed GDM (WHO 2013 criteria) and their associations with self‑monitored blood glucose.

Methods: Women completed detailed food and glucose diaries for 5–9 days following initial group education. Attendees were informed about the study and included unless they opted out. CI amounts, types, and timing were evaluated using manual and computerised methods. The computerised assessment also captured broader macronutrient and micronutrient intake. Associations between dietary variables and elevated fasting or post‑prandial glycaemia (>20% readings above target) were analysed.

Results1: Ninety‑seven women participated; 12 opted out. Median (IQR) age was 32(8) years and BMI 25.1(5.9) kg/m².

Elevated fasting glycaemia (EFG) was associated with lower total CI (10.8 vs. 12.5 servings/day, p = 0.006)a, more missed meals (1.4 vs. 0.0/week, p = 0.007)a, more missed snacks (10.5 vs. 7.5/week, p = 0.038)a, and higher numbers of low‑carbohydrate meals (<30 g; 4.3 vs. 2.0/week, p = 0.004)a. Women with EFG also consumed a greater proportion of energy from fat (35% vs. 33%, p = 0.047)a, while protein and micronutrient intakes did not differ.

In contrast, elevated post‑prandial glycaemia (EPG) was associated with lower intakes of energy (7650 vs. 9070 kJ/day, p = 0.031)a, protein (91 vs. 109 g/day, p = 0.015)a, fat (61 vs. 84 g/day, p = 0.003)a, and 12 micronutrients (p < 0.05), as well as more high‑glycaemic‑index meals (lunch: 1.6 vs. 0.9/week, p = 0.026; dinner: 0.9 vs. 0.0/week, p = 0.023). Unlike EFG, total CI and the frequency of low or high carbohydrate loads were not associated with EPG.

Conclusions: The differing dietary patterns associated with EFG and EPG suggest that fasting and post‑meal hyperglycaemia reflect distinct nutritional profiles within GDM. These findings support GDM subtype‑specific dietary guidance rather than uniform CI recommendations. Interventional studies are needed to determine whether increasing CI improves glycaemic outcomes for women presenting with EFG.

 

1Previously published: Smith R et al., Nutrients 2025;17(3):400. https://doi.org/10.3390/nu17030400     amedian comparison