Department of Medicine - Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Medicine - Division of Endocrinology and Metabolism, Department of Obstetrics and Gynecology, and Alberta Children's Hospital Research Institute Calgary, Cumming School of Medicine - University of Calgary, Calgary, Canada.
Curr Diab Rep. 2019 Aug 31;19(10):94. doi: 10.1007/s11892-019-1208-4.
To review the latest evidence for dietary interventions for treatment of gestational diabetes (GDM).
High-quality systematic reviews demonstrate no major advantages between the low-carbohydrate or calorie-restricted diets. However, the low glycemic index (GI) diet, characterized by intake of high-quality, complex carbohydrates, demonstrated lower insulin use and reduced risk of macrosomia in multiple reviews. Recent evidence suggests the Mediterranean diet is safe in pregnancy, though trials are needed to determine its efficacy over conventional dietary advice. Currently, there are insufficient data to support the safety of the ketogenic diet for the treatment of GDM. The low GI diet may improve maternal and neonatal outcomes in GDM. The liberalized carbohydrate intake is less restrictive, culturally adaptable, and may improve long-term maternal adherence. Further research is needed to establish the optimal, most sustainable, and most acceptable medical nutrition therapy for management of women with GDM.
回顾用于治疗妊娠期糖尿病(GDM)的饮食干预的最新证据。
高质量的系统评价表明,低碳水化合物或热量限制饮食之间没有明显的优势。然而,低升糖指数(GI)饮食的特点是摄入高质量、复杂的碳水化合物,在多项综述中显示出较低的胰岛素使用量和减少巨大儿的风险。最近的证据表明,地中海饮食在怀孕期间是安全的,但需要进行试验来确定其在常规饮食建议方面的疗效。目前,还没有足够的数据支持生酮饮食治疗 GDM 的安全性。低 GI 饮食可能改善 GDM 患者的母婴结局。放宽碳水化合物的摄入量限制较少,更具文化适应性,并且可能提高长期的产妇依从性。需要进一步的研究来确定最佳、最可持续和最可接受的医学营养治疗,以管理患有 GDM 的女性。