Dietary fiber intakes and insulin requirements in pregnant women with type 1 diabetes

J Am Diet Assoc. 2001 Mar;101(3):305-10. doi: 10.1016/s0002-8223(01)00080-3.

Abstract

Objective: To determine whether higher dietary fiber intake (water soluble and insoluble) is associated with lower insulin requirements and better glycemic control in pregnant women with type 1 diabetes consuming a self-selected diet.

Design: A longitudinal, observational study.

Subjects: Pregnant women (n=141) with type 1 diabetes participating in an interdisciplinary program examining the effects of glycemic control on pregnancy outcome (Diabetes and Pregnancy Program, University of Cincinnati Medical Center).

Measurements: We determined total, water soluble and insoluble fiber intakes from 3-day food records kept each trimester during pregnancy. Outcome measures were insulin dose, pre-meal blood glucose, and glycated hemoglobin concentrations.

Statistical analyses: Correlation coefficients, multiple regression, mixed-model analysis of variance.

Results: Mean intakes (g/day) of total, water soluble fiber, and insoluble fiber were 14.0 (range, 1.8-33.1), 4.8 (range, 0.6-10.5) and 9.0 (range, 1.1-24.0), respectively. In the second and third trimesters of pregnancy, insulin requirements were inversely associated with total, water soluble, and insoluble fiber intakes; the correlation coefficients ranged from -0.22 to -0.17 (P=.02 to .08). Insulin requirements associated with a higher fiber intake (20.5 g/day) were 16% to 18% lower than for a lower fiber intake (8.1 g/day). These relations remained after adjustment for body weight, disease severity and duration, insulin type, and study year in the second (P=.03 to .10) but not in the third trimester. Pre-meal blood glucose and glycated hemoglobin concentrations were not associated with fiber intake.

Conclusions: Among pregnant women with type 1 diabetes, higher fiber intake is associated with lower daily insulin requirements. Dietary fiber intake should be considered when counseling patients about the management of blood glucose concentrations.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diet Records
  • Dietary Fiber / administration & dosage*
  • Dietary Fiber / metabolism
  • Dietary Fiber / pharmacology
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin / administration & dosage*
  • Insulin / blood
  • Longitudinal Studies
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Pregnancy in Diabetics / metabolism*
  • Regression Analysis

Substances

  • Blood Glucose
  • Dietary Fiber
  • Glycated Hemoglobin A
  • Insulin