| J Am Diet Assoc 2001 Mar;101(3):305-10
fiber intakes and insulin requirements in pregnant women with
type 1 diabetes.
Kalkwarf HJ, Bell RC, Khoury JC, Gouge AL, Miodovnik M.
Division of General and Community Pediatrics, Children's Hospital
Medical Center, Cincinnati, Ohio 45229-3039, USA. firstname.lastname@example.org
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.