The purpose of this study is to determine whether glycemic index is effective in the treatment of maternal glycemia and pregnancy outcomes in women with Gestational Diabetes Mellitus.
1\. This research is divided into 2, that are study I and study II 1. Study I, is to determine the long-term effects of intervention (low GI and SNT) on maternal glycemia, pregnancy outcomes and postprandial metabolic markers in women with GDM * A total of 110 women with confirmed diagnosis of GDM will be recruited * They will be randomized either to receive low GI (n=55) or Standard Nutrition Therapy (SNT; n=55) * The intervention will be started as soon as the women being diagnosed with GDM and they will be followed-up every month until delivery and up to the 3-month postpartum. * The primary outcome measures include glycemic control parameters as assessed by fasting and postprandial glycemia, fructosamine, HbA1c, insulin level and requirement for insulin treatment. * Secondary outcomes include lipid profile, weight gain, measures of postprandial metabolic response (free fatty acid and triglyceride), pregnancy outcomes, and overall improvement in postpartum metabolic parameters. 2. Study II, a sub-Mixed-meal Tolerant Test (MTT) study will be conducted to determine postprandial glycemic and metabolic responses before and after 4-weeks of intensive intervention * During the 4-weeks of intensive intervention, the subjects will receive individualise counseling and daily food supply regarding the allocated study group. * A minimum of 19 subjects from a pool of 110 subjects who is participated in the intervention study will be recruited. * The MTT procedure is similar to the oral glucose tolerant test (OGTT) but the subject will be asked to consume the real mixed meals representing low and high GI foods rather than oral glucose solution. * Subject will be asked to consume the test meal (either low or high GI foods) and the blood will be sampled before and after consuming the test meal in two different occasions with 1-week wash-out period. * After one month of intensive intervention, 19 subjects from each arm will undergo the final HGI meal tolerant test (MTT3) and the same procedure of MTT 1 and 2 * Approximately 32μl of capillary blood by finger-prick will be obtained 7 times per MTT session, which is every 30 minutes thereafter to complete 3-h postprandial meal for each set of meal tests.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
40
Subjects will be advised on standard diet appropriate for the management of Gestational Diabetes Mellitus (GDM) designed to be high in fiber and have moderate to high dietary glycemic index
Subjects will be advised to eat low glycemic index foods
Universiti Kebangsaan Malaysia Medical Centre
Cheras, Kuala Lumpur, Malaysia
Post meal blood glucose level
Average blood glucose profiles after breakfast, lunch and dinner measured using capillary blood glucose at home
Time frame: 12 weeks
Level of Triglycerides
Changes in Fasting Triglycerides
Time frame: 12 weeks
Level of glycemic control
Changes in Fructosamine
Time frame: 4 weeks
Maternal weight gain
Changes in total weight gain based on Institute of Medicine (IOM) recommendations
Time frame: 12 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.