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[Influence of an individualized diet to control gestational diabetes mellitus]
Rebeca Monroy Torres1, Claudia Citlaly Reeves Aguirre, Jaime Naves Sánchez
1Facultad de Medicina de la Universidad de Guanajuato, Area de Nutrición, Léon, México. rmonroy79@yahoo.com.mx
Background:
Dietetic control is part of an integral therapy to gestational diabetes mellitus.
Objective:
To evaluate the effect of an individualized diet with 52% of complex carbohydrates of low and moderate glycemic index to control gestational diabetes mellitus.
Material And Methods:
Analytic and longitudinal study in 31 patients with gestational diabetes mellitus in a third level hospital in Leon, Guanajuato, from August 2005 to December 2006. During 4 months, starting on 24 to 26 weeks of pregnancy, patients followed a 1,700 to 2,000 kcal/day diet, with 52% of complex carbohydrates of low and moderate glycemic index, 30% of fat and 18% of proteins. Total diet intake, weight gain, percentage of weight for gestational age, and glucose were measured monthly; glycosylated hemoglobin was measured at the beginning and at the end of the study. The weight of the newborn was registered.
Results:
Overall, 76% of patients were obese and 24% had overweight. Final weight gain at the end of third trimester was 3 kg. There were significant differences in month-to-month and final comparisons of glucose (146 +/- 37 vs 90 +/- 5 mg/dL), caloric intake (2,800 +/- 1,030 vs 1,740 +/- 109 kcal/day) and macronutrients, as well as in glycosylated hemoglobin (7.1 +/- 1.2 vs 5.3 +/- 0.5%). At the end of the study diet of 65% of patients was recommendable, in comparison with 14% at the beginning. Adherence to diet plan improved in final months. Average newborn weight was 3,347 +/- 385 g.
Conclusion:
An individualized diet here prescribed leads to control of gestational diabetes and to the birth of normal size babies. There were significant differences in the month-to-month comparisons of glucose, weight, caloric intake and macronutrients, as well as in the initial and final glycosylated hemoglobin (7.1 +/- 1.2 and 5.0 +/- 0.7%). Our results suggest that an individual diet of 52% of complex carbohydrates allowed a satisfactory control of gestational diabetes mellitus, with normal levels of glucose, glycosylated hemoglobin, and weight gain.
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