Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial

Reduced-energy diets promote weight loss and improve long-term outcomes in type 2 diabetes but are untested in gestational diabetes. We aimed to identify if weight loss in pregnancy improves perinatal outcomes in gestational diabetes. We performed a multicentre parallel, randomized, controlled, double-blind trial of energy restriction in women with singleton pregnancies, gestational diabetes and body mass index ≥25 kg m<sup>-</sup><sup>2</sup>. Participants were randomized to receive a standard-energy control diet (2,000 kcal d<sup>-1</sup>) or reduced-energy intervention diet (1,200 kcal d<sup>-1</sup>) from enrollment (29 weeks) until delivery, provided as weekly diet boxes (40% carbohydrate, 35% fat, 25% protein). The randomization was performed in a 1:1 ratio, stratified by center and blinded to the participants and study team. Primary outcomes were maternal weight change from enrollment to 36 weeks and offspring birth weight. In total, 425 participants were randomized to the control (n = 211) or intervention (n = 214). Outcome data were available for 388 of 425 (90.1%) participants at 36 weeks and 382 of 425 (89.8%) at delivery. There was no evidence of a difference in maternal weight change to 36 weeks between groups (intervention effect -0.20 (95% confidence interval -1.01, 0.61); P > 0.1) and offspring standardized birth weight (intervention effect 0.005 (-0.19, 0.20); P > 0.1). A reduced-energy diet was safe in pregnancy. ISRCTN registration no. 65152174 .

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Publication Details

Journal
Nature Medicine
Published
2025-02-01
DOI
https://doi.org/10.1038/s41591-024-03356-1
Citations
16
Primary Topic
Gestational Diabetes Research and Management
Type
article
Field-Weighted Citation Impact
32.91

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article

Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial

Laura C. Kusinski, Helen Murphy, Suzanne J. Smith, Stephen J. Sharp et al.
16 citations
Nature Medicine
Gestational Diabetes Research and Management
32.91
article

Reduced-energy diet in women with gestational diabetes: the dietary intervention in gestational diabetes DiGest randomized clinical trial

Laura C. Kusinski, Helen Murphy, Suzanne J. Smith, Stephen J. Sharp, Nooria Atta, Linda M. Oude Griep, Claire L. Meek, Vernon T. Farewell, Roy Taylor, Kirsten L. Rennie, Emanuella De Lucia Rolfe, Danielle Jones, Elizabeth L. Turner
article en
16 citations

Abstract

Reduced-energy diets promote weight loss and improve long-term outcomes in type 2 diabetes but are untested in gestational diabetes. We aimed to identify if weight loss in pregnancy improves perinatal outcomes in gestational diabetes. We performed a multicentre parallel, randomized, controlled, double-blind trial of energy restriction in women with singleton pregnancies, gestational diabetes and body mass index ≥25 kg m<sup>-</sup><sup>2</sup>. Participants were randomized to receive a standard-energy control diet (2,000 kcal d<sup>-1</sup>) or reduced-energy intervention diet (1,200 kcal d<sup>-1</sup>) from enrollment (29 weeks) until delivery, provided as weekly diet boxes (40% carbohydrate, 35% fat, 25% protein). The randomization was performed in a 1:1 ratio, stratified by center and blinded to the participants and study team. Primary outcomes were maternal weight change from enrollment to 36 weeks and offspring birth weight. In total, 425 participants were randomized to the control (n = 211) or intervention (n = 214). Outcome data were available for 388 of 425 (90.1%) participants at 36 weeks and 382 of 425 (89.8%) at delivery. There was no evidence of a difference in maternal weight change to 36 weeks between groups (intervention effect -0.20 (95% confidence interval -1.01, 0.61); P > 0.1) and offspring standardized birth weight (intervention effect 0.005 (-0.19, 0.20); P > 0.1). A reduced-energy diet was safe in pregnancy. ISRCTN registration no. 65152174 .

Nature MedicineVol. 31(2)
University of East Anglia (GB), University of Leicester (GB), University of Cambridge (GB), Norfolk and Norwich University Hospitals NHS Foundation Trust (GB), Leicester General Hospital (GB), University Hospitals of Leicester NHS Trust (GB), Cambridge University Hospitals NHS Foundation Trust (GB), Wellcome/MRC Institute of Metabolic Science (GB), MRC Biostatistics Unit (GB), Cambridgeshire and Peterborough NHS Foundation Trust (GB), MRC Epidemiology Unit (GB), NIHR Leicester Biomedical Research Centre (GB), Newcastle University (GB)
Dexcom, National Institute for Health and Care Research, Department of Health and Social Care, Diabetes UK, University of Leicester, European Foundation for the Study of Diabetes, Novo Nordisk, Novo Nordisk Fonden, NIHR Cambridge Biomedical Research Centre, NIHR Leicester Biomedical Research Centre
Good health and well-being
Openalex Percentile: Top 0%
Gestational Diabetes Research and Management
32.91
DOIOpen Access PDFOpenAlex
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