Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis
To evaluate the impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus. Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate,...
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| creator | Wong, Martin Ming Him Yuen-Man Chan, Mandy Ng, Tsoi Pan Louie, Jimmy Chun Yu |
| description | To evaluate the impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus.
Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate, low-glycaemic index, or low-glycaemic load diets with usual care in gestational diabetes mellitus. Mean differences and risk ratios were extracted.
Thirteen studies with 877 participants were included. Low-carbohydrate diet did not significantly differ from usual care for fasting blood glucose (3 studies; mean difference: 1.60 mmol/L; 95 % confidence interval: −1.95, 5.15), insulin requirement (2 studies; risk ratio: 1.01; 95 % confidence interval: 0.31, 3.05), birthweight (4 studies; mean difference: −0.23 kg; 95 % confidence interval: −1.90, 1.45), caesarean delivery (5 studies; risk ratio: 1.11; 95 % confidence interval: 0.66, 1.85), macrosomia (3 studies; risk ratio: 0.35; 95 % confidence interval: 0.00, 2130.64), large-for-gestational-age (2 studies; risk ratio: 0.46; 95 % confidence interval: 0.03, 7.20), and small-for-gestational-age infants (2 studies; risk ratio: 0.94; 95 % confidence interval: 0.00, 231.18). Low-glycaemic index diet did not significantly differ from usual care for the above outcomes either. However, low-glycaemic load diet reduced macrosomia risk (2 studies; risk ratio: 0.51; 95 % confidence interval: 0.43, 0.59).
Low-carbohydrate and low-glycaemic index diets do not differ from usual care for most maternal and foetal outcomes in gestational diabetes mellitus. But low-glycaemic load diet may reduce macrosomia risk.
•Gestational diabetes is common in pregnancy, but optimal carbohydrate intake remains uncertain.•We reviewed impact of carbohydrate quantity and quality on maternal, fetal outcomes in gestational diabetes mellitus.•Low-carbohydrate and low-glycaemic index diets similar to usual care; low-glycaemic load diet may reduce macrosomia.•Larger randomised controlled trials with better compliance measures, reporting guidelines needed for robust evidence. |
| doi_str_mv | 10.1016/j.dsx.2024.102941 |
| format | Article |
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Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate, low-glycaemic index, or low-glycaemic load diets with usual care in gestational diabetes mellitus. Mean differences and risk ratios were extracted.
Thirteen studies with 877 participants were included. Low-carbohydrate diet did not significantly differ from usual care for fasting blood glucose (3 studies; mean difference: 1.60 mmol/L; 95 % confidence interval: −1.95, 5.15), insulin requirement (2 studies; risk ratio: 1.01; 95 % confidence interval: 0.31, 3.05), birthweight (4 studies; mean difference: −0.23 kg; 95 % confidence interval: −1.90, 1.45), caesarean delivery (5 studies; risk ratio: 1.11; 95 % confidence interval: 0.66, 1.85), macrosomia (3 studies; risk ratio: 0.35; 95 % confidence interval: 0.00, 2130.64), large-for-gestational-age (2 studies; risk ratio: 0.46; 95 % confidence interval: 0.03, 7.20), and small-for-gestational-age infants (2 studies; risk ratio: 0.94; 95 % confidence interval: 0.00, 231.18). Low-glycaemic index diet did not significantly differ from usual care for the above outcomes either. However, low-glycaemic load diet reduced macrosomia risk (2 studies; risk ratio: 0.51; 95 % confidence interval: 0.43, 0.59).
Low-carbohydrate and low-glycaemic index diets do not differ from usual care for most maternal and foetal outcomes in gestational diabetes mellitus. But low-glycaemic load diet may reduce macrosomia risk.
•Gestational diabetes is common in pregnancy, but optimal carbohydrate intake remains uncertain.•We reviewed impact of carbohydrate quantity and quality on maternal, fetal outcomes in gestational diabetes mellitus.•Low-carbohydrate and low-glycaemic index diets similar to usual care; low-glycaemic load diet may reduce macrosomia.•Larger randomised controlled trials with better compliance measures, reporting guidelines needed for robust evidence.</description><identifier>ISSN: 1871-4021</identifier><identifier>EISSN: 1878-0334</identifier><identifier>DOI: 10.1016/j.dsx.2024.102941</identifier><identifier>PMID: 38218096</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Carbohydrate quality ; Carbohydrate quantity ; Carbohydrates ; Diabetes, Gestational ; Diet, Carbohydrate-Restricted ; Female ; Fetal Macrosomia - etiology ; Fetal Macrosomia - prevention & control ; Gestational diabetes ; Glycaemic index ; Glycaemic load ; Humans ; Pregnancy ; Pregnancy Outcome - epidemiology ; Weight Gain</subject><ispartof>Diabetes & metabolic syndrome clinical research & reviews, 2024-01, Vol.18 (1), p.102941-102941, Article 102941</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c348t-40477daf3c06b070886e5f3585416252d90ae09645ebf722e640ed85fd6eaf8c3</cites><orcidid>0000-0001-7736-605X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S187140212400002X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38218096$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wong, Martin Ming Him</creatorcontrib><creatorcontrib>Yuen-Man Chan, Mandy</creatorcontrib><creatorcontrib>Ng, Tsoi Pan</creatorcontrib><creatorcontrib>Louie, Jimmy Chun Yu</creatorcontrib><title>Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis</title><title>Diabetes & metabolic syndrome clinical research & reviews</title><addtitle>Diabetes Metab Syndr</addtitle><description>To evaluate the impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus.
Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate, low-glycaemic index, or low-glycaemic load diets with usual care in gestational diabetes mellitus. Mean differences and risk ratios were extracted.
Thirteen studies with 877 participants were included. Low-carbohydrate diet did not significantly differ from usual care for fasting blood glucose (3 studies; mean difference: 1.60 mmol/L; 95 % confidence interval: −1.95, 5.15), insulin requirement (2 studies; risk ratio: 1.01; 95 % confidence interval: 0.31, 3.05), birthweight (4 studies; mean difference: −0.23 kg; 95 % confidence interval: −1.90, 1.45), caesarean delivery (5 studies; risk ratio: 1.11; 95 % confidence interval: 0.66, 1.85), macrosomia (3 studies; risk ratio: 0.35; 95 % confidence interval: 0.00, 2130.64), large-for-gestational-age (2 studies; risk ratio: 0.46; 95 % confidence interval: 0.03, 7.20), and small-for-gestational-age infants (2 studies; risk ratio: 0.94; 95 % confidence interval: 0.00, 231.18). Low-glycaemic index diet did not significantly differ from usual care for the above outcomes either. However, low-glycaemic load diet reduced macrosomia risk (2 studies; risk ratio: 0.51; 95 % confidence interval: 0.43, 0.59).
Low-carbohydrate and low-glycaemic index diets do not differ from usual care for most maternal and foetal outcomes in gestational diabetes mellitus. But low-glycaemic load diet may reduce macrosomia risk.
•Gestational diabetes is common in pregnancy, but optimal carbohydrate intake remains uncertain.•We reviewed impact of carbohydrate quantity and quality on maternal, fetal outcomes in gestational diabetes mellitus.•Low-carbohydrate and low-glycaemic index diets similar to usual care; low-glycaemic load diet may reduce macrosomia.•Larger randomised controlled trials with better compliance measures, reporting guidelines needed for robust evidence.</description><subject>Carbohydrate quality</subject><subject>Carbohydrate quantity</subject><subject>Carbohydrates</subject><subject>Diabetes, Gestational</subject><subject>Diet, Carbohydrate-Restricted</subject><subject>Female</subject><subject>Fetal Macrosomia - etiology</subject><subject>Fetal Macrosomia - prevention & control</subject><subject>Gestational diabetes</subject><subject>Glycaemic index</subject><subject>Glycaemic load</subject><subject>Humans</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Weight Gain</subject><issn>1871-4021</issn><issn>1878-0334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uctu1DAUjRAVfcAHsEFessngVxIHVlUFpVKlbsracuyb4tHEntoOJT_C9_ZmprBkdV_nHt17TlW9Z3TDKGs_bTcu_95wyiXWvJfsVXXGVKdqKoR8fchZLSlnp9V5zltKm6bn_ZvqVCjOFO3bs-rPzbQ3tpA4EmvSEH8uLpkC5HE2ofiyEBPcWuzWPAYy4TAFszv09wkeggkWJ3OxcYJMfCAPkIspPq4o580ABfsT7JBizp_JJclLLoBE3pIEvzw8HcgmKKY2uLRkn99WJ6PZZXj3Ei-qH9--3l99r2_vrm-uLm9rK6Qq-JvsOmdGYWk70I4q1UIzikY1krW84a6nBvBP2cAwdpxDKyk41YyuBTMqKy6qj0fefYqPMx6uJ58t3moCxDlrjnpRwUXHEcqOUJtizglGvU9-MmnRjOrVDr3VaIde7dBHO3Dnwwv9PEzg_m381R8BX44AwCdRiqSz9RAsOJ_AFu2i_w_9M6jYnhU</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Wong, Martin Ming Him</creator><creator>Yuen-Man Chan, Mandy</creator><creator>Ng, Tsoi Pan</creator><creator>Louie, Jimmy Chun Yu</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7736-605X</orcidid></search><sort><creationdate>202401</creationdate><title>Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis</title><author>Wong, Martin Ming Him ; Yuen-Man Chan, Mandy ; Ng, Tsoi Pan ; Louie, Jimmy Chun Yu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-40477daf3c06b070886e5f3585416252d90ae09645ebf722e640ed85fd6eaf8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Carbohydrate quality</topic><topic>Carbohydrate quantity</topic><topic>Carbohydrates</topic><topic>Diabetes, Gestational</topic><topic>Diet, Carbohydrate-Restricted</topic><topic>Female</topic><topic>Fetal Macrosomia - etiology</topic><topic>Fetal Macrosomia - prevention & control</topic><topic>Gestational diabetes</topic><topic>Glycaemic index</topic><topic>Glycaemic load</topic><topic>Humans</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wong, Martin Ming Him</creatorcontrib><creatorcontrib>Yuen-Man Chan, Mandy</creatorcontrib><creatorcontrib>Ng, Tsoi Pan</creatorcontrib><creatorcontrib>Louie, Jimmy Chun Yu</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes & metabolic syndrome clinical research & reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wong, Martin Ming Him</au><au>Yuen-Man Chan, Mandy</au><au>Ng, Tsoi Pan</au><au>Louie, Jimmy Chun Yu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis</atitle><jtitle>Diabetes & metabolic syndrome clinical research & reviews</jtitle><addtitle>Diabetes Metab Syndr</addtitle><date>2024-01</date><risdate>2024</risdate><volume>18</volume><issue>1</issue><spage>102941</spage><epage>102941</epage><pages>102941-102941</pages><artnum>102941</artnum><issn>1871-4021</issn><eissn>1878-0334</eissn><abstract>To evaluate the impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus.
Using a pre-defined search strategy, two researchers systematically searched MEDLINE, CINAHL Plus, and PubMed for randomized controlled trials comparing low-carbohydrate, low-glycaemic index, or low-glycaemic load diets with usual care in gestational diabetes mellitus. Mean differences and risk ratios were extracted.
Thirteen studies with 877 participants were included. Low-carbohydrate diet did not significantly differ from usual care for fasting blood glucose (3 studies; mean difference: 1.60 mmol/L; 95 % confidence interval: −1.95, 5.15), insulin requirement (2 studies; risk ratio: 1.01; 95 % confidence interval: 0.31, 3.05), birthweight (4 studies; mean difference: −0.23 kg; 95 % confidence interval: −1.90, 1.45), caesarean delivery (5 studies; risk ratio: 1.11; 95 % confidence interval: 0.66, 1.85), macrosomia (3 studies; risk ratio: 0.35; 95 % confidence interval: 0.00, 2130.64), large-for-gestational-age (2 studies; risk ratio: 0.46; 95 % confidence interval: 0.03, 7.20), and small-for-gestational-age infants (2 studies; risk ratio: 0.94; 95 % confidence interval: 0.00, 231.18). Low-glycaemic index diet did not significantly differ from usual care for the above outcomes either. However, low-glycaemic load diet reduced macrosomia risk (2 studies; risk ratio: 0.51; 95 % confidence interval: 0.43, 0.59).
Low-carbohydrate and low-glycaemic index diets do not differ from usual care for most maternal and foetal outcomes in gestational diabetes mellitus. But low-glycaemic load diet may reduce macrosomia risk.
•Gestational diabetes is common in pregnancy, but optimal carbohydrate intake remains uncertain.•We reviewed impact of carbohydrate quantity and quality on maternal, fetal outcomes in gestational diabetes mellitus.•Low-carbohydrate and low-glycaemic index diets similar to usual care; low-glycaemic load diet may reduce macrosomia.•Larger randomised controlled trials with better compliance measures, reporting guidelines needed for robust evidence.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>38218096</pmid><doi>10.1016/j.dsx.2024.102941</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-7736-605X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Diabetes & metabolic syndrome clinical research & reviews, 2024-01, Vol.18 (1), p.102941-102941, Article 102941 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Carbohydrate quality Carbohydrate quantity Carbohydrates Diabetes, Gestational Diet, Carbohydrate-Restricted Female Fetal Macrosomia - etiology Fetal Macrosomia - prevention & control Gestational diabetes Glycaemic index Glycaemic load Humans Pregnancy Pregnancy Outcome - epidemiology Weight Gain |
| title | Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis |
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