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The Role of Dietary Carbohydrates in Gestational Diabetes
Open AccessArticle

Effect of High Versus Low Carbohydrate Intake in the Morning on Glycemic Variability and Glycemic Control Measured by Continuous Blood Glucose Monitoring in Women with Gestational Diabetes Mellitus—A Randomized Crossover Study

1
Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Copenhagen, Denmark
2
Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
3
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
4
Steno Diabetes Center Copenhagen, Niels Steensens Vej 2-4, 2820 Gentofte, Denmark
5
Clinic for Clinical Metabolic Research, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte Hospitalsvej 7, 3. Sal, 2800 Hellerup, Denmark
6
Steno Diabetes Center Aarhus, Aarhus University Hospital, Hedeager 3, 8200 Aarhus N, Denmark
*
Author to whom correspondence should be addressed.
Shares first author ship.
Nutrients 2020, 12(2), 475; https://doi.org/10.3390/nu12020475
Received: 27 December 2019 / Revised: 30 January 2020 / Accepted: 10 February 2020 / Published: 13 February 2020
(This article belongs to the Special Issue Nutrition for Gestational Diabetes)
Carbohydrate is the macronutrient that has the greatest impact on blood glucose response. Limited data are available on how carbohydrate distribution throughout the day affects blood glucose in women with gestational diabetes mellitus (GDM). We aimed to assess how a high-carbohydrate morning-intake (HCM) versus a low-carbohydrate-morning-intake (LCM), affect glycemic variability and glucose control. In this randomized crossover study continuous glucose monitoring (CGM) was performed in 12 women with diet treated GDM (75 g, 2-h OGTT ≥ 8.5 mmol/L), who went through 2 × 3 days of HCM and LCM. A within-subject-analysis showed a significantly higher mean amplitude of glucose excursions (MAGE) (0.7 mmol/L, p = 0.004) and coefficient of variation (CV) (5.1%, p = 0.01) when comparing HCM with LCM, whereas a significantly lower mean glucose (MG) (−0.3 mmol/L, p = 0.002) and fasting blood glucose (FBG) were found (−0.4 mmol/L, p = 0.01) on the HCM diet compared to the LCM diet. In addition, insulin resistance, expressed as Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), decreased significantly during HCM. Results indicate that a carbohydrate distribution of 50% in the morning favors lower blood glucose and improvement in insulin sensitivity in women with GDM, but in contrary gives a higher glycemic variability. View Full-Text
Keywords: glycemic variability; carbohydrate distribution; gestational diabetes mellitus; mean amplitude of glucose; breakfast diet glycemic variability; carbohydrate distribution; gestational diabetes mellitus; mean amplitude of glucose; breakfast diet
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Rasmussen, L.; Christensen, M.L.; Poulsen, C.W.; Rud, C.; Christensen, A.S.; Andersen, J.R.; Kampmann, U.; Ovesen, P.G. Effect of High Versus Low Carbohydrate Intake in the Morning on Glycemic Variability and Glycemic Control Measured by Continuous Blood Glucose Monitoring in Women with Gestational Diabetes Mellitus—A Randomized Crossover Study. Nutrients 2020, 12, 475.

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