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Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: a randomized control trial

Abstract Objective The present study aimed to compare the effects of a general dietary intervention and an intervention with low glycaemic load (GL) on glycaemic control, blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus. Design Participants were randomly assigned to two groups, receiving either an individualized general dietary intervention (Control group) or an intensive low-GL intervention (Low-GL group) every two weeks, from 24–26 weeks of gestation to delivery. Setting The Center of Maternal Primary Care in Guangdong General Hospital, China. Subjects Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009. Results After the intervention, both groups significantly decreased their dietary intakes of energy, fat and carbohydrate. The Low-GL group had significantly lower values for GL (122 v. 136) and glycaemic index (50 v. 54) but greater dietary fibre intake (33 v. 29 g/d) than did the Control group (all P<0·01). Significantly greater decreases in fasting plasma glucose (−0·33 v. −0·02 mmol/l, P<0·01) and 2 h postprandial glucose (−2·98 v. −2·51 mmol/l, P<0·01), significantly lower increases in total cholesterol (0·12 v. 0·23 mmol/l) and TAG (0·41 v. 0·56 mmol/l) and a significantly lower decrease in HDL cholesterol (−0·01 v. −0·11 mmol/l) were also observed in the Low-GL group compared with the Control group (all P<0·05). There were no significant differences in body weight gain, birth weight or other maternal–fetal perinatal outcomes between the two groups. Conclusions The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus.