The effect of fruit consumption time on glucose regulation in pregnancy with gestational diabetes

Authors

Keywords:

Diabetes, gestational, Fructose, Fruit, Glycemic index

Abstract

Objective
This study aims to determine the effect of fruit consumption time on blood glucose regulation in pregnant women with gestational diabetes.
Methods
The study was carried out with 64 volunteer participants diagnosed with gestational diabetes. Participants who were directed to the Department of Nutrition and Dietetics were divided into two groups according to the order of application; Group 1 was included in the nutrition treatment program for a week, consuming fruit for the main meal and Group 2 for the snack. During this process, the participants were applied a personalized nutrition plan that was adjusted equally for macronutrients of all meals containing isocaloric 3 main and 4 snacks. In this process, blood glucose values were measured six times a day by the participants and the blood glucose results of both groups before starting the nutrition therapy and on the seventh day after starting the medical nutrition therapy were compared.
Results
The mean age of the women participating in the study was 33.50±4.95 years and 32.28±5.18 years for the 1st and 2nd groups, respectively, and the groups were similar in terms of anthropometric measurements. The post-diet average of postprandial blood glucose levels in the morning within each group dropped from 180mg/d to 115mg/dL (p<0,001) for Group 1 and from 185mg/dL to 110mg/dL (p<0,001) for Group 2. There was a decrease in the fasting plasma glucose and postprandial blood glucose levels measured in the morning, noon and evening before and after the medical nutrition therapy of the groups, but no statistically significant difference was found between the groups (p>0.05). All participants on the gestational diabetes diet had normal blood sugar levels without the need for insulin. A statistically significant decrease was observed in the postprandial blood glucose-fasting plasma glucose difference levels of the pregnant women in the group that consumed fruit for snacks (Group 2) on the seventh day of the study (p<0,001). There was no significant difference in the pre-diet and post-diet morning fasting plasma glucose values of both groups (p>0,05).
Conclusion
This study found that medical nutrition therapy in pregnant women with gestational diabetes led to a decrease in blood glucose levels, but consuming fruits as a snack or at the main meal did not make a significant difference on fasting plasma glucose and postprandial blood glucose. It was concluded that the type and amount of carbohydrates consumed daily in gestational diabetes are determinative on blood glucose level.

References

Goyal A, Gupta Y, Singla R, Kalra S, Tandon N. American Diabetes Association “Standarts of Medical Care-2020 for Gestational Diabetes Mellitus”: A Critical Appraisal”. Diabetes Ther. 2020;11(8):1639-44. https://doi.org.10.1007/s13300-020-00865-3

Krejci H, Simjak P, Anderlova K, Benakova H, Parizek A, et al. The incidence of gestational diabetes mellitus before and after the introduction of HAPO Diagnostic Criteria. Ceska Gynekol. 2019;84(6):404-11.

Vasile FC, Preda A, Ștefan AG, Vladu ML, Forțofoiu MC, Clenciu D, et al. An update of medical nutrition therapy in gestational diabetes mellitus. J Diabetes Res. 2021; 2021: 5266919. https://doi.org.10.1155/2021/5266919

Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu, Diyabette Tibbı Beslenme Tedavisi. Ankara: TEMD; 2020.

Sun C, Liu Y, Zhan L, Rayat G, Xiao J, Jiang H, et al. Anti-Diabetic effects of natural antioxidants from fruits. Trends Food Sci Technol. 2021;117:3-14.

Rocha D, Caldas A, Silva B, Hermsdorff H, Alfenas R. Effects of Blueberry and cranberry consumption on type 2 diabetes glycemic control: a systematic review. Crit Rev Food Sci Nutr. 2019;59:1816-28.

Klein AV, Kiat H. The mechanisms underlying fructose-induced hypertension: a review. J Hypertens. 2015;33:912-20.

Wu F, Tian FJ , Lin Y. Oxidative stress in placenta: health and diseases. Biomed Res Int. 2015;2015:293271. https://doi.org.10.1155/2015/293271

Jain S, Maheshwari A, Sunil K. Maternal nutrition and fetal/ınfant development. Clin Perinatol. 2022;49(2):313-30.

Marshall NE, Abrams B , Barbour LA, Catalano P, Christian P, Friedman JE , et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol. 2022;226(5),607-32. https://doi.org.10.1016/j.ajog.2021.12.035

Salinas-Roca B, Rubió-Piqué R, Montull-López A. Polyphenol ıntake in pregnant women on gestational diabetes risk and neurodevelopmental disorders in offspring: a systematic review. Nutrients. 2022;14(18):3753.

Mohammed SG, Qoronfleh MW. Fruits. Adv Neurobiol. 2020;24:279-376. https://doi.org.10.1007/978-3- 030-30402-7_9

Hunt KF, Whitelaw BC, Gayle C. Gestational diabetes. Obstet Gynaecol Reprod Med, 2014;(8);238-44.

Abdul Hakim B, Yahya H, Shahar S, Abdul Manaf Z, Damanhuri H. Effect of sequence of fruit ıntake in a meal on satiety. Int J Environ Res Public Health. 2019;122:4464. https://doi.org.10.3390/ijerph16224464

Kheriji N, Boukhalfa W, Mahjoub F, Hechmi M, Dakhlaoui T, Mrad M, et al. The role of dietary ıntake in type 2 diabetes mellitus: ımportance of macro and micronutrients in glucose homeostasis. Nutrients. 2022;14(10):2132. https://doi.org.10.3390/nu14102132

Köseler E, Kızıltan G. The Effect of Different Amounts of Fructose Consumption on Some Anthropometric Measurements and Biochemical Parameters. J Hum Nutr Diet, 2019;1:14-23.

Onat T, Inandiklioglu N. Circulating Myonectin and Irisin Levels in Gestational Diabetes Mellitus. Z Geburtshilfe Neonatol. 2021;225(4):320-6. https://doi.org.10.1055/a-1404-4323

Duarte-Gardea MO, Gonzales-Pacheco DM, Reader DM, Thomas AM, Wang SR, Gregory RP. Gestational diabetes evidence-based nutrition practice guideline. J Acad Nutr Diet. 2018;118:1719-42. https://doi.org.10.1016/j.jand.2018.03.014

Marangoni F , Martini D , Scaglioni S , Sculati M , Donini L , Leonardi F, et al . Snacking in nutrition and health. Int J Food Sci Nutr. 2019;70(8):909-23. https://doi.org.10.1080/09637486.2019

Festa C , Fresa R , Visalli N , Bitterman O , Giuliani C , Surac Ci , et al. Insulin requirements and carbohydrate to ınsulin ratio in normal weight, overweight, and obese women with type 1 diabetes under pump treatment during pregnancy: a lesson from old technologies. Front Endocrinol. 2021;25(12):610877. https://doi.org.10.3389/fendo.2021.610877

Walsh P, Roberts R, Schwarts F. New Criteria for Assessing the Accuracy of Blood Glucose Monitors Meeting. J Diabetes Sci Technol. 2012;6(2):226-485. https://doi.org/10.1177/193229681200600236

Chiavaroli l , Lee D , Ahmed A , Cheung A , Khan T , Blanco S, et al. Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials. BMJ. 2021;4(374):1651. https://doi.org.10.1136/bmj.n1651

Vlachos D, Malisova S, Lindberg F, Karaniki G. Glycemic Index (GI) or Glycemic Load (GL) and dietary ınterventions for optimizing postprandial hyperglycemia in patients with T2 diabetes. Nutrients. 2020;12(6):1561. https://doi.org.10.3390/nu12061561

Rasmussen L, Christensen M, Poulsen CW, Rud C , Christensen AS, Andersen JR, et al. Effect of high versus low carbohydrate ıntake in the morning on glycemic variability and glycemic control measured by continuous blood glucose monitoring in women with gestational diabetes mellitus: a randomized crossover study. Nutrients. 2020;12(2):475. https://doi.org.10.3390/nu12020475

Sweeting A , Mijatovic J, Brinkworth GD, Markovic TP, Ross G , Brand-Miller J, et al. The Carbohydrate threshold in pregnancy and gestational diabetes: how low can we go? Nutrients. 2021;13(8):2599. https://doi.org.10.3390/nu13082599

Almeida R, Marot L, Latorraca C, Oliveira R, Crispim C. Is evening carbohydrate ıntake in healthy ındividuals associated with higher postprandial glycemia and ınsulinemia when compared to morning ıntake? a systematic review and meta-analysis of randomized crossover studies. J Am Nutr Assoc. 2022;1:1-12. https://doi.org.10.1080/07315724.2022.2043199

Reyhanoglu G, Rehman A. Somogyi Phenomenon. Treasure Island: StatPearls Publishing; 2023.

Published

2023-10-27

How to Cite

NAS, S., & YILMAZ, H. Öngün. (2023). The effect of fruit consumption time on glucose regulation in pregnancy with gestational diabetes. Brazilian Journal of Nutrition, 36. Retrieved from https://periodicos.puc-campinas.edu.br/nutricao/article/view/10197

Issue

Section

ORIGINAL ARTICLE