Can a Low–Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus?

OBJECTIVE — A low–glycemic index diet is effective as a treatment for individuals with diabetes and has been shown to improve pregnancy outcomes when used from the first trimester. A low–glycemic index diet is commonly advised as treatment for women with gestational diabetes mellitus (GDM). However, the efficacy of this advice and associated pregnancy out-comes have not been systematically examined. The purpose of this study was to determine whether prescribing a low–glycemic index diet for women with GDM could reduce the number of women requiring insulin without compromise of pregnancy outcomes. RESEARCHDESIGNANDMETHODS — All women with GDM seen over a 12-month period were considered for inclusion in the study. Women (n 63) were randomly assigned to receive either a low–glycemic index diet or a conventional high-fiber (and higher glycemic index) diet. RESULTS — Of the 31 women randomly assigned to a low–glycemic index diet, 9 (29%) required insulin. Of the women randomly assigned to a higher–glycemic index diet, a signifi-cantly higher proportion, 19 of 32 (59%), met the criteria to commence insulin treatment (P 0.023). However, 9 of these 19 women were able to avoid insulin use by changing to a low