Carbohydrate Intake and Oral Glucose Tolerance Test Results in the Postpartum Period

Abstract Context The American Diabetes Association (ADA) recommends a 3-day preparatory diet prior to a diagnostic oral glucose tolerance test (OGTT), a test often recommended in postpartum individuals with a history of gestational diabetes (GDM). Objective Evaluate the relationship between carbohyd...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2023-09, Vol.108 (10), p.e1007-e1012
Main Authors: Rosenberg, Emily A, Seely, Ellen W, James, Kaitlyn, Soffer, Marti D, Nelson, Stacey, Nicklas, Jacinda M, Powe, Camille E
Format: Article
Language:English
Subjects:
Blood Glucose - analysis
Breast feeding
Carbohydrates
Clinical
Diabetes
Diabetes mellitus
Diabetes, Gestational - diagnosis
Diabetes, Gestational - epidemiology
Dietary intake
Female
Glucose
Glucose tolerance
Glucose Tolerance Test
Humans
Population studies
Postpartum
Postpartum Period
Pregnancy
Pregnancy complications
Prospective Studies
Risk factors
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Summary:Abstract Context The American Diabetes Association (ADA) recommends a 3-day preparatory diet prior to a diagnostic oral glucose tolerance test (OGTT), a test often recommended in postpartum individuals with a history of gestational diabetes (GDM). Objective Evaluate the relationship between carbohydrate intake and OGTT glucose in 2 cohorts of postpartum individuals. Methods We performed analyses of postpartum individuals from 2 prospective studies with recent GDM (Balance after Baby Intervention, BABI, n = 177) or risk factors for GDM (Study of Pregnancy Regulation of INsulin and Glucose, SPRING, n = 104) .We measured carbohydrate intake using 24-hour dietary recalls (SPRING) or Food Frequency Questionnaire (BABI) and performed 2-hour 75-g OGTTs. The main outcome measure was 120-minute post-OGTT glucose. Results There was no relationship between carbohydrate intake and 120-minute post-OGTT glucose level in either study population (SPRING: β = 0.03, [−5.5, 5.5] mg/dL, P = .99; BABI: β = −3.1, [−9.5, 3.4] mg/dL, P = .35). Adding breastfeeding status to the model did not change results (SPRING β = −0.14, [−5.7, 5.5] mg/dL, P = .95; BABI β = −3.9, [−10.4, 2.7] mg/dL, P = .25). There was, however, an inverse relationship between glycemic index and 120-minute post OGTT glucose (BABI: β = −1.1, [−2.2, −0.03] mg/dL, P = .04). Conclusion Carbohydrate intake is not associated with post-OGTT glucose levels among postpartum individuals. Dietary preparation prior to the OGTT may not be necessary in this population.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgad234