A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes

Authors

  • Anne Rae,

    Corresponding author
    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
      PO Box 134 Subiaco Western Australia 6008. Australia
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  • Dianne Bond,

    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
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  • Sharon Evans,

    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
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  • Felicity North,

    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
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  • Brian Roberman,

    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
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  • Barry Walters

    1. Diabetes Service, King Edward Memorial Hospital for Women and University Department of Obstetrics and Gynaecology, University of Western Australia, Western Australia, Australia
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PO Box 134 Subiaco Western Australia 6008. Australia

Abstract

Summary: A randomised controlled trial was designed to determine the effect of moderate 30% maternal dietary energy restriction on the requirement for maternal insulin therapy and the incidence of macrosomia in gestational diabetes. Although the control group restricted their intake to a level similar to that of the intervention group (6845 kiloJoules (kJ) versus 6579 kJ), the resulting cohort could not identify any adverse effect of energy restriction in pregnancy. Energy restriction did not alter the frequency of insulin therapy (17.5% in the intervention group and 16.9% in the control group). Mean birth weight (3461 g in the intervention group and 3267 g in the control group) was not affected. There was a trend in the intervention group towards later gestational age at commencement of insulin therapy (33 weeks versus 31 weeks) and lower maximum daily insulin dose (23 units versus 60 units) which did not reach statistical significance. Energy restriction did not cause an increase in ketonemia.

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