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Evidence summaries

Different Types of Dietary Advice for Women with Gestational Diabetes Mellitus

One type of dietary advice might possibly not be more effective than another type of advice for women with gestational diabetes mellitus on pregnancy outcomes but the evidence is insufficient. Level of evidence: "D"

The quality of evidence is downgraded by study limitations (unclear allocation concealment in half of the studies, no blinding of outcome assessment, and selective reporting) and by imprecise results (few patients and wide confidence intervals).

Summary

A Cochrane review [Abstract] 1 included 19 studies with a total of 1398 women. All trials had small sample sizes and a total of 11 different types of dietary advice were assessed under six different comparisons.

In the low-moderate glycaemic index (GI) food vs moderate-high GI food comparison, no significant differences were seen for macrosomia (RR 0.45, 95% CI 0.10 to 2.08; 2 trials, 89 babies) or large-for-gestational age (LGA) (RR 0.71, 95% CI 0.22 to 2.34; n=89); or caesarean section (RR 0.66, 95% CI 0.29 to 1.47, 1 trial, n=63).

In the low-GI diet vs high-fibre moderate-GI diet comparison, no significant differences were seen for LGA (RR 2.87, 95% CI 0.61 to 13.50; 1 trial, n=92); or caesarean section (RR 1.91, 95% CI 0.61 to 4.03; 1 trial, n=92).

In the energy-restricted vs unrestricted diet comparison, no significant differences were seen for macrosomia (RR 1.56, 95% CI 0.61 to 3.94; 1 trial, n=122); LGA (RR 1.17, 95% CI 0.65 to 2.12; 1 trial, n=123); or caesarean section (RR 1.12, 95% CI 0.80 to 1.56; 2 trial, n=420).

In the low- vs high-carbohydrate diet comparison ( 45% vs 50% daily total energy intake from carbohydrate), no clear differences were seen for LGA (RR 0.51, 95% CI 0.13 to 1.95; 1 trial, n=149 infants) or caesarean section (RR 1.29, 95% CI 0.84 to 1.99; 2 trials, n=179).

Date of latest search: 2020-05-03

    References

    • Han S, Middleton P, Shepherd E et al. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev 2017;(2):CD009275. [PubMed]

Primary/Secondary Keywords