A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes

A randomised controlled trial was designed to determine the effect of moder ate 30% maternal dietary energy restriction on the requirement for maternal insulin therapy and the incidence of macrosomia in gestational diabetes. A lthough the control group restricted their intake to a level similar to tha t of the intervention group (6845 kiloJoules (kJ) versus 6579 kJ), the resu lting cohort could not identify any adverse effect of energy restriction in pregnancy. Energy restriction did not alter the frequency of insulin thera py (17.5% in the intervention group and 16.9% in the control group). Mean b irthweight (3461 g in the intervention group and 3267 g in the control grou p) was not affected. There was a trend in the intervention group towards la ter gestational age at commencement of insulin therapy (33 weeks versus 31 weeks) and lower maximum daily insulin dose (23 units versus GO units) whic h did not reach statistical significance. Energy restriction did not cause an increase in ketonemia.