Dietary intakes and physical activity of women with gestational diabetes are not associated with continuous glucose monitoring metrics; secondary analysis of the DiGest trial

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-08-12 DOI:10.1016/j.clnesp.2025.08.007

Danielle L. Jones , Laura C. Kusinski , Lewis Griffiths , Kirsten L. Rennie , Linda M. Oude Griep , Claire L. Meek

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Abstract

Background

Diet and lifestyle modifications are key to managing gestational diabetes mellitus (GDM), yet current dietary recommendations lack detail. It remains unclear what the dietary intakes or physical activity of pregnant women with GDM are or to what extent these alter glycaemic control.

Aims

To describe dietary intake, diet quality, and PA patterns in women diagnosed with GDM and assess their associations with continuous glucose monitoring (CGM) metrics.

Methods

This secondary, cross-sectional analysis of the Dietary Intervention in Gestational Diabetes (DiGest) trial included 425 pregnant women with GDM (BMI >25 kg/m²) at 28 weeks’ gestation, recruited for an 8–12-week dietary intervention. Baseline dietary intake and PA were assessed through self-reported, validated questionnaires. Diet quality was evaluated using adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (score range: 8–40). A masked Dexcom G6 CGM device was worn for up to 10 days to measure mean glucose (mmol/L), coefficient of variation (%), and the percentage of time spent in, above, and below the target glucose range (3.5–7.8 mmol/L). Associations between dietary intake, DASH score, and physical activity were examined using linear regression.

Results

Across 223 dietary recalls, mean (SD) intakes included energy (1571 (666) kcal); carbohydrates (157 g (86)); fibre; (19 g (10)); protein; (77 g (34)) and fat (75 g (39)). Median physical activity energy expenditure (PAEE) was 18.62 kJ/kg/d. No significant associations were found between dietary intake, diet quality, PA, and CGM metrics.

Conclusions

Women with GDM consumed a diet low in calories, carbohydrates, and fibre but high in saturated fat. PAEE was lower than the background, non-pregnant female population. Diet and PA were not associated with CGM metrics, highlighting the need for optimisation to short-term and long-term metabolic function in women with GDM.

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妊娠期糖尿病妇女的饮食摄入和身体活动与连续血糖监测指标无关；DiGest试验的二次分析。

背景：饮食和生活方式的改变是控制妊娠期糖尿病（GDM）的关键，但目前的饮食建议缺乏细节。目前尚不清楚妊娠糖尿病孕妇的饮食摄入或身体活动是什么，以及它们在多大程度上改变了血糖控制。目的：描述诊断为GDM的女性的饮食摄入、饮食质量和PA模式，并评估其与连续血糖监测（CGM）指标的关系。方法：这项对妊娠期糖尿病饮食干预（DiGest）试验的二次横断面分析纳入了425名妊娠28周的GDM孕妇（体重指数>25 kg/m2），进行了8-12周的饮食干预。基线饮食摄入量和PA通过自我报告的有效问卷进行评估。饮食质量评估采用饮食方法来停止高血压（DASH）饮食（评分范围：8-40）。戴面罩Dexcom G6 CGM装置长达10天，测量平均葡萄糖（mmol/L）、变异系数（%）以及在目标葡萄糖范围（3.5-7.8 mmol/L）以上和以下的时间百分比。饮食摄入、DASH评分和体力活动之间的关系采用线性回归进行检验。结果：在223项饮食回顾中，平均（SD）摄入量包括能量（1571 (666)kcal）；碳水化合物（157克（86））；纤维;(19 g (10));蛋白质;（77克（34））和脂肪（75克（39））。平均体力活动能量消耗（PAEE）为18.62 kJ/kg/d。饮食摄入、饮食质量、PA和CGM指标之间未发现显著关联。结论：患有GDM的女性饮食中卡路里、碳水化合物和纤维含量低，但饱和脂肪含量高。PAEE低于背景、未怀孕女性人群。饮食和PA与CGM指标无关，强调了优化GDM女性短期和长期代谢功能的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.