Carb Counting, DASH Diet Improve Blood Glucose Control in Gestational Diabetes

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Carb Counting, DASH Diet Improve Blood Glucose Control in Gestational Diabetes

Following the Dietary Approaches to Stop Hypertension (DASH) diet with carbohydrate counting led to improved blood glucose control in women with gestational diabetes, according to a new study published in the journal Clinical Nutrition.

High blood pressure is a common problems in people with diabetes — especially people with type 2 diabetes, but also pregnant women with gestational diabetes. While high blood pressure is concerning in its own right, there is also evidence that it may have a harmful effect on blood glucose control. Lowering high blood pressure has been shown to reduce the risk for type 2 diabetes, showing that blood pressure may directly affect blood glucose regulation in the body. Both high blood pressure and high blood glucose are immediate concerns for women with gestational diabetes, which affects up to 10% of pregnancies in the United States each year. Gestational diabetes is linked to a higher risk for postpartum depression, as well as a higher risk for future type 2 diabetes both in mothers and in their children. Previous studies have shown that gestational diabetes often responds well to dietary changes, although other treatment options are sometimes needed as well.

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For the latest study, researchers looked at the effect of carbohydrate counting — both alone and in combination with following a DASH diet — in 70 pregnant women with gestational diabetes who enrolled in the study in their 24th to 30th week of gestation. Fasting blood samples were taken at the beginning of the study and at the end — to measure fasting glucose, fasting insulin, and A1C (a measure of long-term blood glucose control). Participants also took at least four blood glucose readings each day during the study period. Medical records were used to track outcomes in the study participants and their children, and participants’ diet was assessed using a three-day food frequency questionnaire at both the beginning and the end of the study.

Participants were randomly assigned to one of three diet groups as part of the study — carb counting, carb counting plus the DASH diet, or a control group. The control diet contained about 45% to 55% carbohydrate, 15% to 20% protein, and 25% to 30% fat. Members of the carb counting group had similar proportions of carbohydrate, protein, and fat in their diet, and also received education on portion size, reading food package labels, and more. Members of the carb counting plus DASH diet group received additional dietary advice, and ended up eating more fruits and vegetables, whole grains, low-fat dairy products, and nuts — and less meat — than other study participants, as noted in an article on the study at Healio.

Carb counting plus DASH improves blood glucose, insulin levels

After participants gave birth 8 to 12 weeks following enrollment in the study, all three groups showed improvement in fasting blood glucose. But the two carb counting groups had lower average fasting glucose levels — 78.5 mg/dl in the carb counting group and 80.9 mg/dl in the carb counting plus DASH group, compared with 86.7 mg/dl in the control group. When it came to insulin levels, the carb counting plus DASH group had the lowest average level at 48.7 pmol/L, followed by the carb counting group at 79.3 pmol/L and the control group at 86.6 pmol/L.

When the researchers looked at blood glucose self-monitoring results over the course of the study, they found again that members of both carb counting groups had lower average fasting glucose levels — 81.3 mg/dl in the carb counting group and 81.8 mg/dl in the carb counting plus DASH group, compared with 88.4 mg/dl in the control group. But members of the carb counting plus DASH group had the lowest glucose levels an hour after eating, particularly after breakfast and dinner.

“The carbohydrate counting combined with DASH diet appears to be a safe alternative to the conventional pregnancy diet for women with gestational diabetes,” the researchers concluded, noting that this finding “enlarges the range of dietary strategies that can be recommended” to pregnant women with gestational diabetes.

Want to learn more about gestational diabetes? Read “Gestational Diabetes: Are You at Risk?,” “Treating Gestational Diabetes” and “What to Eat If You Have Gestational Diabetes.”

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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