The influence of carbohydrate consumption on glycemic control in pregnant women with type 1 diabetes

Aims: To study the influence of the quantity and the quality of carbohydrate consumption on glycemic control in early pregnancy among women with type 1 diabetes. Methods: A retrospective study of 107 women with type 1 diabetes who completed 1-3 days of diet recording before first antenatal visit, as a part of routine care. The total daily carbohydrate consumption from the major sources (e.g. bread, potatoes, rice, pasta, dairy products, fruits, candy) was calculated. A dietician estimated the overall glycemic index score (scale 0-7). Results: At least two days of diet recording were available in 75% of the 107 women at mean 64 (SD +/- 14) gestational days. The quantity of carbohydrate consumption from major sources was 180 (+/- 51) g/day. HbA1c was positively associated with the quantity of carbohydrate consumption (beta = 0.41; 95% CI 0.13-0.70, P = 0.005), corresponding to an increase of 0.4% in HbA1c per 100 g carbohydrates consumed daily, when adjusted for insulin dose/-bodyweight and use of insulin pump treatment. The median (IQR) glycemic index score was 2 (0-3). An adjusted association between HbA1c and glycemic index score was not demonstrated. The women using carbohydrate counting daily (45%) had lower HbA1c compared to the remaining women (6.4 (+/- 0.5) vs. 6.8 (+/- 0.9)% (47 +/- 6 vs. 51 +/- 10 mmol/mol), P = 0.01). Conclusions: HbA1c in early pregnancy was positively associated with the quantity of carbohydrate consumption regardless of insulin treatment. Carbohydrate counting is probably important for glycemic control in pregnant women with type 1 diabetes. (C) 2017 Elsevier B.V. All rights reserved.