Relationship between Glycemic Control Evaluated Using Continuous Glucose Monitoring and Carbohydrate Intake in Patients with Gestational Diabetes Mellitus

Abstract

Factors affecting the blood glucose and urinary ketone levels were investigated in 44 patients with gestational diabetes mellitus (GDM) using continuous glucose monitoring (CGM). The patients received nutritional guidance to eat three small- to moderate-sized meals and one or more snacks each day before the CGM assessment. The amount of nutrient intake was calculated based on the subjects' food records. The ratio of ingested/suggested calories was 88±17 %. The proportion of ingested carbohydrates among total calories was 46±10 %, while that of ingested protein and lipids was 37±9 % and 17±3 %, respectively. A total of 13 patients (30 %) exhibited a ratio of ingested carbohydrates of more than 60 %. Meanwhile, hyperglycemia was observed in 14 subjects (32 %) and was significantly more frequent in the patients with an excessive intake of carbohydrates (64 %) than in those without (13 %). The ingested/suggested calorie ratios were significantly lower in six patients with ketonuria (69±10 %) than in those without (91±17 %). It is therefore important to pay attention to the intake of carbohydrates, not simply the number of ingested calories, in patients with GDM.