Timing of peak blood glucose after breakfast meals of different glycemic index in women with gestational diabetes

Jimmy Chun Yu Louie, Tania P Markovic, Glynis P Ross, Deborah Foote, Jennie C Brand-Miller, Jimmy Chun Yu Louie, Tania P Markovic, Glynis P Ross, Deborah Foote, Jennie C Brand-Miller

Abstract

This study aims to determine the peak timing of postprandial blood glucose level (PBGL) of two breakfasts with different glycemic index (GI) in gestational diabetes mellitus (GDM). Ten women with diet-controlled GDM who were between 30 and 32 weeks of gestation were enrolled in the study. They consumed two carbohydrate controlled, macronutrient matched bread-based breakfasts with different GI (low vs. high) on two separate occasions in a random order after an overnight fast. PBGLs were assessed using a portable blood analyser. Subjects were asked to indicate their satiety rating at each blood sample collection. Overall the consumption of a high GI breakfast resulted in a greater rise in PBGL (mean ± SEM peak PBGL: low GI 6.7 ± 0.3 mmol/L vs. high GI 8.6 ± 0.3 mmol/L; p < 0.001) and an earlier peak PBGL time (16.9 ± 4.9 min earlier; p = 0.015), with high variability in PBGL time between subjects. There was no significant difference in subjective satiety throughout the test period. In conclusion, the low GI breakfast produced lower postprandial glycemia, and the peak PBGL occurred closer to the time recommended for PBGL monitoring (i.e., 1 h postprandial) in GDM than a macronutrient matched high GI breakfast.

Figures

Figure 1
Figure 1
Mean ± SEM postprandial blood glucose level of the 10 subjects. NS: non-significant.
Figure 2
Figure 2
Postprandial glycemic responses of the subjects after the consumption of a low or high glycemic index breakfast. Peak blood glucose levels were circled. Subjects #2 and #8 withdrew after the first test session and hence their individual data were not presented.
Figure 3
Figure 3
Subjective satiety after a low or high GI breakfast. NS: non-significant.

References

    1. Scholl T.O., Chen X., Khoo C.S., Lenders C. The dietary glycemic index during pregnancy: Influence on infant birth weight, fetal growth, and biomarkers of carbohydrate metabolism. Am. J. Epidemiol. 2004;159:467–474. doi: 10.1093/aje/kwh068.
    1. Metzger B.E., Lowe L.P., Dyer A.R., Trimble E.R., Sheridan B., Hod M., Chen R., Yogev Y., Cousta D.R., Catalano P.M., et al. Hyperglycemia and adverse pregnancy outcome (hapo) study: Associations with neonatal anthropometrics. Diabetes. 2009;58:453–459.
    1. Ben-Haroush A., Yogev Y., Chen R., Rosenn B., Hod M., Langer O. The postprandial glucose profile in the diabetic pregnancy. Am. J. Obstet. Gynecol. 2004;191:576–581. doi: 10.1016/j.ajog.2004.01.055.
    1. Leguizamon G., von Stecher F. Third trimester glycemic profiles and fetal growth. Curr. Diab. Rep. 2003;3:323–326. doi: 10.1007/s11892-003-0025-x.
    1. Jovanovic-Peterson L., Peterson C.M., Reed G.F., Metzger B.E., Mills J.L., Knopp R.H., Aarons J.H. Maternal postprandial glucose levels and infant birth weight: The diabetes in early pregnancy study. The national institute of child health and human development—Diabetes in early pregnancy study. Am. J. Obstet. Gynecol. 1991;164:103–111.
    1. Jovanovic L. Point: Yes, it is necessary to rely entirely on glycemic values for the insulin treatment of all gestational diabetic women. Diabetes Care. 2003;26:946–947. doi: 10.2337/diacare.26.3.946.
    1. Jovanovic L. Using meal-based self-monitoring of blood glucose as a tool to improve outcomes in pregnancy complicated by diabetes. Endocr. Pract. 2008;14:239–247.
    1. Wolever T.M. The glycemic index. World Rev. Nutr. Diet. 1990;62:120–185.
    1. Lock D.R., Bar-Eyal A., Voet H., Madar Z. Glycemic indices of various foods given to pregnant diabetic subjects. Obstet. Gynecol. 1988;71:180–183.
    1. Moses R.G., Barker M., Winter M., Petocz P., Brand-Miller J.C. Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? A randomized trial. Diabetes Care. 2009;32:996–1000. doi: 10.2337/dc09-0007.
    1. Louie J.C., Markovic T.P., Perera N., Foote D., Petocz P., Ross G.P., Brand-Miller J.C. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care. 2011;34:2341–2346. doi: 10.2337/dc11-0985.
    1. Brand-Miller J.C., Stockmann K., Atkinson F., Petocz P., Denyer G. Glycemic index, postprandial glycemia, and the shape of the curve in healthy subjects: Analysis of a database of more than 1000 foods. Am. J. Clin. Nutr. 2009;89:97–105.
    1. Wald A., van Thiel D.H., Hoechstetter L., Gavaler J.S., Egler K.M., Verm R., Scott L., Lester R. Effect of pregnancy on gastrointestinal transit. Dig. Dis. Sci. 1982;27:1015–1018. doi: 10.1007/BF01391748.
    1. Butte N.F. Carbohydrate and lipid metabolism in pregnancy: Normal compared with gestational diabetes mellitus. Am. J. Clin. Nutr. 2000;71:1256S–1261S.
    1. AUSNUT 2007. [(accessed on 30 September 2012)]. Available online:
    1. Grant S.M., Wolever T.M.S., O’Connor D.L., Nisenbaum R., Josse R.G. Effect of a low glycaemic index diet on blood glucose in women with gestational hyperglycaemia. Diabetes Res. Clin. Pract. 2011;91:15–22. doi: 10.1016/j.diabres.2010.09.002.
    1. Peterson C.M., Jovanovic-Peterson L. Percentage of carbohydrate and glycemic response to breakfast, lunch, and dinner in women with gestational diabetes. Diabetes. 1991;40:172–174.
    1. Bühling K.J., Winkel T., Wolf C., Kurzidim B., Mahmoudi M., Wohlfarth K., Wäscher C., Schink T., Dudenhausen J.W. Optimal timing for postprandial glucose measurement in pregnant women with diabetes and a non-diabetic pregnant population evaluated by the Continuous Glucose Monitoring System (CGMS) J. Perinat. Med. 2005;33:125–131.
    1. Wolever T.M., Chiasson J.L., Csima A., Hunt J.A., Palmason C., Ross S.A., Ryan E.A. Variation of postprandial plasma glucose, palatability, and symptoms associated with a standardized mixed test meal versus 75 g oral glucose. Diabetes Care. 1998;21:336–340. doi: 10.2337/diacare.21.3.336.
    1. Ellison J.M., Stegmann J.M., Colner S.L., Michael R.H., Sharma M.K., Ervin K.R., Horwitz D.L. Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites. Diabetes Care. 2002;25:961–964. doi: 10.2337/diacare.25.6.961.
    1. Stout P.J., Peled N., Erickson B.J., Hilgers M.E., Racchini J.R., Hoegh T.B. Comparison of glucose levels in dermal interstitial fluid and finger capillary blood. Diabetes Technol. Ther. 2001;3:81–90. doi: 10.1089/152091501750220046.
    1. Cengiz E., Tamborlane W.V. A tale of two compartments: Interstitial versus blood glucose monitoring. Diabetes Technol. Ther. 2009;11:S11–S16. doi: 10.1089/dia.2008.0041.

Source: PubMed

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