Evidence map›Paper›PMID 34444759›Full record

ReviewNutrients2021

The Carbohydrate Threshold in Pregnancy and Gestational Diabetes: How Low Can We Go?

Arianne Sweeting, Jovana Mijatovic, Grant D Brinkworth, Tania P Markovic, Glynis P Ross, Jennie Brand-Miller, Teri L Hernandez

Registry-linked trialOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Nutrients, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06355154 (Effects of Moderate Carbohydrate Consumption on Metabolic and Obstetric Outcomes in Pregnant Women With Insulin-treated Diabetes- A Randomized Controlled Trial), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 2 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06355154 narecruitingnot on this mapstarted 2024, after this paper: background citation

Effects of Moderate Carbohydrate Consumption on Metabolic and Obstetric Outcomes in Pregnant Women With Insulin-treated Diabetes- A Randomized Controlled Trial

TypeinterventionalSponsorHadassah Medical OrganizationRan2024 to 2028Enrolled120ConditionsDiabetes in PregnancyArmsNutritional intervention
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Review
  14. Article
  15. Observational
  16. Review
  17. Article
  18. Does a Ketogenic Diet Have a Place Within Diabetes Clinical Practice? Review of Current Evidence and Controversies.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Arianne SweetingSydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia.ORCID 0000-0001-6843-6247
Jovana MijatovicCharles Perkins Centre, Boden Initiative, University of Sydney, NSW 2006, Australia.ORCID 0000-0003-3810-561X
Grant D BrinkworthCommonwealth Scientific and Industrial Research Organisation-Health and Biosecurity, Sydney, NSW 2113, Australia.
Tania P MarkovicSydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia.
Glynis P RossSydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia.
Jennie Brand-MillerSchool of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.ORCID 0000-0002-6797-8754
Teri L HernandezCollege of Nursing, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA.ORCID 0000-0002-7024-5017
The University of Sydney · AUChildren's Hospital Colorado · USCommonwealth Scientific and Industrial Research Organisation · AU

Funding

Randomized Trial of Diet in GDM: Metabolic Consequences to Mother and OffspringR01DK101659 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI HERNANDEZ, TERI L · 2014 to 2018
$3.1M
National Health and Medical Research Council GNT1148952NIDDK NIH HHS R01 DK101659NIH HHS R01DK101659
6 · The paper itself

Abstract

The original nutrition approach for the treatment of gestational diabetes mellitus (GDM) was to reduce total carbohydrate intake to 33-40% of total energy (EI) to decrease fetal overgrowth. Conversely, accumulating evidence suggests that higher carbohydrate intakes (60-70% EI, higher quality carbohydrates with low glycemic index/low added sugars) can control maternal glycemia. The Institute of Medicine (IOM) recommends ≥175 g/d of carbohydrate intake during pregnancy; however, many women are consuming lower carbohydrate (LC) diets (<175 g/d of carbohydrate or <40% of EI) within pregnancy and the periconceptual period aiming to improve glycemic control and pregnancy outcomes. This report systematically evaluates recent data (2018-2020) to identify the LC threshold in pregnancy in relation to safety considerations. Evidence from 11 reports suggests an optimal carbohydrate range of 47-70% EI supports normal fetal growth; higher than the conventionally recognized LC threshold. However, inadequate total maternal EI, which independently slows fetal growth was a frequent confounder across studies. Effects of a carbohydrate intake <175 g/d on maternal ketonemia and plasma triglyceride/free fatty acid concentrations remain unclear. A recent randomized controlled trial (RCT) suggests a higher risk for micronutrient deficiency with carbohydrate intake ≤165 g/d in GDM. Well-controlled prospective RCTs comparing LC (<165 g/d) and higher carbohydrate energy-balanced diets in pregnant women are clearly overdue.

Indexed as

Birth WeightBlood GlucoseDatabases, FactualDiabetes, GestationalDietary CarbohydratesDiet, Carbohydrate-RestrictedEatingEnergy IntakeFemaleFetal MacrosomiaGlycemic IndexHumansKetonesLipidsMicronutrientsPregnancyBlood GlucoseDietary CarbohydratesKetonesLipidsMicronutrientsbirth weightketoneslipidslow carbohydratemicronutrientspregnancy

Identifiers

PMID34444759
PMCPMC8398846
OpenAlexW3186589164

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.