Introduction and Objective: GDM dietary therapy targets maternal glycemia in gestation but fails to address postpartum metabolic disease risk. In an RCT, pregnant women on a higher-complex CHO diet showed an improved OGTT response at 36 wks’. We studied the diets’ sustained effect 2 mos postpartum (PP).Methods: At diagnosis, women with diet-managed GDM were randomized to a conventional lower CHO (LC/CONV; 40% CHO/45% fat) or a higher-complex CHO diet (CHOICE; 60% CHO/25% fat) with all food provided. A 2-hr 75g OGTT (Matsuda protocol) was given at 30-31, 36-37 wks’, & 2 mos PP. We compared glucose (gluc) and insulin (ins) areas-under-the-curve (AUC) between groups using a Bayesian parallel process model, which accounts for assay measurement error.Results: Women (n=44) were 60±5 d PP and had similar BMI (30±5 kg/m2), weight loss, oral disposition index (oDI), and HOMA-IR. Gluc AUC was 6.1% lower for CHOICE (p<.05; Diff: -1005 mg/dL*min; 95% CI: [-1558, -467]; Fig. 1). For CHOICE, fasting, 1h, and 2h gluc were (mean±SD) 87±7, 147±33, and 116 ±24 mg/dl vs 84±9, 160±42, and 123±29 mg/dl for LC/CONV. Ins AUC did not differ.Conclusion: Women with GDM randomized to CHOICE demonstrated a lower OGTT AUC gluc with no difference in insulin 2 mos PP. PP dietary intake data are pending. This suggests diet-driven antepartum improvements in OGTT gluc may persist at 2 mos PP. Further diet-related metabolic mechanisms for the gluc response remain under investigation.
S. Hagen-Lillevik: None. M.R. Waldman: None. G.N. Bosma: None. N. Hirsch: None. E.G. Dunn: None. J. Friedman: None. L. Barbour: None. T.L. Hernandez: None.
NIH: NIDDK R01DK101659, NIH:T32DK007658-35
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