Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant women with type 1 diabetes; insights from the Diabetes and Pre‐eclampsia Intervention Trial (DAPIT)

A.J. Hill, C. Patterson, I.S. Young, V.A. Holmes, D.R. McCance

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The present study aimed to explore the relationships between carbohydrate intake, body mass index (BMI) and glycaemic control (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM). Methods: Secondary analysis of data was undertaken to assess dietary intake in a cohort of women who participated in a randomised controlled trial (RCT) of antioxidant supplementation to prevent preeclampsia (DAPIT 10). Study-specific peripheral venous blood samples were obtained for HbA1c at 26 and 34 weeks. Diet was collected using a validated semiquantitative food frequency questionnaire at 26–28 weeks of gestation which assessed dietary intake over 2 weeks. Mean daily average nutrient intakes were analysed using Q Builder nutritional software and SPSS, version 25. Results: Dietary data were available for 547 pregnant women (72% of cohort) aged 29 years (95% confidence interval [CI] = 28.9–29.9) with average diabetes duration 11.8 years (95% confidence interval = 11.1–12.6). Average body mass index (BMI) (<16 weeks of gestation) was 26.7 kg/m 2 (95% CI = 26.3 −27, range 18.8–45.6 kg/m 2); 43% (n = 234) were overweight (BMI = 25.0−29.9 kg/m 2) and 20% (n = 112) were obese (BMI ≥ 30 kg/m 2). Differences in HbA1c and carbohydrate quantity and quality were found when adjusted for age and insulin dose. No differences between BMI group were observed for total carbohydrate and glycaemic control; however, differences were noted in fibre and glycaemic index. Conclusions: Average quantity of dietary carbohydrate influenced HbA1c when adjusted for insulin dose however, BMI had less impact. More research is required on the relationship between carbohydrate consumption and glycaemic control in pregnancy.

Original languageEnglish
Number of pages9
JournalJournal of Human Nutrition and Dietetics
Early online date25 May 2022
DOIs
Publication statusE-pub ahead of print - 25 May 2022

Bibliographical note

Funding Information:
We thank the patients who took part in the DAPIT study; the DAPIT research midwives who collected the data; and the collaborators at each centre. AH has received speaker honoraria. DRM/ISY has received speaker honoraria and has participated in advisory boards. The DAPIT study was funded by Grant Nos 067028/Z/02/Z and 083145/Z/07/Z from The Wellcome Trust (registered charity number 210183).

Publisher Copyright:
© 2022 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Keywords

  • body weight
  • Type 1 diabetes
  • pregnancy
  • dietary assessment
  • carbohydrate

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