Women With Gestational Diabetes Mellitus Randomized to a Higher–Complex Carbohydrate/Low-Fat Diet Manifest Lower Adipose Tissue Insulin Resistance, Inflammation, Glucose, and Free Fatty Acids: A Pilot Study
| Autor: | Becky A. de la Houssaye, Jacob E. Friedman, Rachael E. Van Pelt, William T. Donahoo, Linda A. Barbour, Catherine Chartier-Logan, Melanie S. Reece, Rachel C. Janssen, Regina M. Reynolds, Linda J. Daniels, Molly A. Anderson, Teri L. Hernandez, Margaret J. R. Heerwagen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty Diet therapy Endocrinology Diabetes and Metabolism medicine.medical_treatment Adipose tissue Pilot Projects 030209 endocrinology & metabolism Fatty Acids Nonesterified Young Adult 03 medical and health sciences 0302 clinical medicine Insulin resistance Pregnancy Internal medicine Diabetes mellitus Diet Diabetic Considerations in the Management of Gestational Diabetes Mellitus Internal Medicine Humans Insulin Medicine Lipolysis Obesity 030212 general & internal medicine Diet Fat-Restricted Inflammation Advanced and Specialized Nursing business.industry Fasting Overweight medicine.disease Gestational diabetes Diabetes Gestational Glycemic index Endocrinology Adipose Tissue Glycemic Index Female Insulin Resistance business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE Diet therapy in gestational diabetes mellitus (GDM) has focused on carbohydrate restriction but is poorly substantiated. In this pilot randomized clinical trial, we challenged the conventional low-carbohydrate/higher-fat (LC/CONV) diet, hypothesizing that a higher–complex carbohydrate/lower-fat (CHOICE) diet would improve maternal insulin resistance (IR), adipose tissue (AT) lipolysis, and infant adiposity. RESEARCH DESIGN AND METHODS At 31 weeks, 12 diet-controlled overweight/obese women with GDM were randomized to an isocaloric LC/CONV (40% carbohydrate/45% fat/15% protein; n = 6) or CHOICE (60%/25%/15%; n = 6) diet. All meals were provided. AT was biopsied at 37 weeks. RESULTS After ∼7 weeks, fasting glucose (P = 0.03) and free fatty acids (P = 0.06) decreased on CHOICE, whereas fasting glucose increased on LC/CONV (P = 0.03). Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV (56 vs. 31%, P = 0.005), consistent with improved IR. AT expression of multiple proinflammatory genes was lower on CHOICE (P < 0.01). Infant adiposity trended lower with CHOICE (10.1 ± 1.4 vs. 12.6 ± 2%, respectively). CONCLUSIONS A CHOICE diet may improve maternal IR and infant adiposity, challenging recommendations for a LC/CONV diet. |
| Databáze: | OpenAIRE |
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