The influence of fasting insulin level in post-gestational diabetes mellitus women receiving low-glycaemic-index diets

R A Ghani; S Shyam; F Arshad; N A Wahab; K Chinna; N S Safii; M Y B Nisak; N A Kamaruddin

doi:10.1038/nutd.2014.5

The influence of fasting insulin level in post-gestational diabetes mellitus women receiving low-glycaemic-index diets

Nutr Diabetes. 2014 Feb 17;4(2):e107. doi: 10.1038/nutd.2014.5.

Authors

R A Ghani¹, S Shyam², F Arshad³, N A Wahab¹, K Chinna⁴, N S Safii⁵, M Y B Nisak⁶, N A Kamaruddin¹

Affiliations

¹ Endocrine Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (National University of Malaysia), Kuala Lumpur, Malaysia.
² School of Post Graduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia.
³ Department of Nutrition and Dietetics, International Medical University, Kuala Lumpur, Malaysia.
⁴ Epidemiology and Biostatistics Unit, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵ Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
⁶ Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.

Abstract

Post-gestational diabetes mellitus (GDM) women are recommended weight loss to manage increased cardio-metabolic risks. We investigated the effects of lowering diet glycaemic index (GI) on fasting blood glucose (FBG), serum lipids, body weight and composition of post-GDM women with varying fasting insulin levels (INS). Seventy-seven Asian, non-diabetic women with previous GDM (aged 20-40 years, mean BMI: 26.4±4.6 kg m(-2)) were recruited. At baseline, 20 subjects with INS <2 μIU ml(-1) and 18 with INS 2 μIU ml(-1) received conventional dietary recommendations (CHDR) only. CHDR emphasised energy and fat intake restriction and encouraged increase in dietary fibre intakes. Twenty-four subjects with INS <2 μIU ml(-1) and 15 with INS 2 μIU ml(-1), in addition to CHDR, received low-GI education (LGI). Changes in FBG, serum lipids, body weight and body composition were evaluated. Subjects with INS <2 μIU ml(-1) had similar outcomes with both diets. After 1 year, subjects with INS 2 μIU ml(-1) who received LGI education had reductions in FBG and triglycerides. Subjects who received CHDR observed increase in both FBG and triglycerides (P<0.05). Among all subjects, diet GI was lower and dietary fibre intakes were higher in LGI compared with CHDR subjects (all P<0.05). Thus, in Asian post-GDM women with normal/higher INS, adding low-GI education to CHDR improved management of FBG and triglycerides.