The effects of low carbohydrate diet on the outcomes of gestational diabetes: A systematic review

Abstract

Introduction: Gestational diabetes is one of the most common pregnancy complications, which has negative consequences for both mother and fetus. A crucial treatment strategy is modifying the mother's diet. The present study was performed with aim to determine the effects of low carbohydrate (LC) diets on the outcomes of gestational diabetes. Methods: In this systematic review, search was done with the keywords including low carbohydrate diet, carbohydrate restriction, ketogenic diet, gestational diabetes, hyperglycemia, glucose intolerance, insulin resistance, and clinical trials in Persian and English languages in databases of Medline, PubMed, Embase, Science Direct, Magiran, ISD, ISC, and Cochrane until March 2023. Results: This systematic review examined seven studies. Some studies showed that carbohydrate restriction can have beneficial effects on metabolic outcomes, glycemic control, less insulin therapy needs, delivery method, and fetal weight. The LC diet did not lead to ketonemia in pregnant women. However, in other studies, adherence to the LC regimen did not reduce the number of women requiring insulin. There were no significant differences between the groups in terms of insulin dose or time of insulin treatment initiation, and both groups had similar pregnancy outcomes. Conclusion: Adherence to the low carbohydrate diet (about 40%) in pregnant mothers with gestational diabetes could have beneficial effects on some metabolic outcomes, delivery method, weight and health of the fetus. It did not lead to ketonemia in pregnant mothers. However, there are contradictions in the findings of the studies due to the amount and type of carbohydrates. It is recommended to conduct more clinical trials with different percentages of carbohydrates and a higher sample size.

Keywords

• carbohydrate restriction
• gestational diabetes
• hyperglycemia
• insulin resistance
• low carbohydrate diet