{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:17:18Z","timestamp":1788182238797,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015334","name":"Endocrine Fellows Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1F32DK126343\u201001A1"],"award-info":[{"award-number":["1F32DK126343\u201001A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1UL1TR002541\u201001"],"award-info":[{"award-number":["1UL1TR002541\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The first\u2010line treatment for gestational diabetes mellitus (GDM) is dietary modification, but there is little evidence on the impact of fat and protein on glycemia in pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the effect of fat and protein on postprandial glycemia in individuals with GDM and to determine if this response differed in GDM characterized by insulin resistance versus insulin deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a double\u2010blind randomized crossover pilot study using test meals with similar caloric (390\u2013411\u00a0kcal) and carbohydrate content (45%), but with either high\u2010fat (41%) or high\u2010protein (35%) content in diet\u2010controlled GDM (\n                      <jats:italic>N\u00a0=<\/jats:italic>\n                      \u00a016). We used fasting glucose and insulin levels to classify participants as insulin\u2010resistant or insulin\u2010deficient GDM. The primary outcome was peak postprandial glucose within 3\u00a0h following the test meals measured by a continuous glucose monitor (CGM). Secondary outcomes included glucose area under the curve (AUC) and glycemic excursion (peak postprandial glucose minus pre\u2010meal glucose). We used\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests to evaluate the relationship between meal type and outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The high\u2010fat meal resulted in a higher mean (standard deviation [SD]) peak postprandial glucose (146.4 [19.7] mg\/dL) than the high\u2010protein meal (137.2 [21.1] mg\/dL,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.03) (mean difference, 9.2 [15.9] mg\/dL; 95% confidence interval [CI], 0.78, 148.4). The glucose AUC (high fat: 26,236 [3220] mg\/dL*min, high protein: 24,788 [3567] mg\/dL*min,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.03) (mean difference, 1448 [2462] mg\/dL*min; 95% CI, 136.0, 2760) and the glycemic excursion (high fat: 68.3 [23.3] mg\/dL, high protein: 59.7 [22.3] mg\/dL,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.03) (mean difference, 8.6 [14.9] mg\/dL; 95% CI, 0.7, 16.5) were higher after the high\u2010fat meal. There was no differential peak postprandial glucose response to high\u2010fat versus high\u2010protein in insulin\u2010deficient versus insulin\u2010resistant GDM (mean difference, \u22120.25\u00a0mg\/dL; 95% CI, \u221224.1, 23.5,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      =\u00a00.98).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In GDM, a high\u2010protein meal leads to lower CGM\u2010measured postprandial glucose compared to a high\u2010fat meal, when calories and carbohydrate content are held constant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT04187521<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70182","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:54:36Z","timestamp":1765608876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of fat and protein on postprandial glycemia in gestational diabetes: A randomized pilot crossover trial"],"prefix":"10.1002","volume":"2","author":[{"given":"Emily A.","family":"Rosenberg","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolic Diseases Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Endocrinology, Diabetes and Hypertension Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0613-4176","authenticated-orcid":false,"given":"Tanayott","family":"Thaweethai","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Biostatistics Center Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana C.","family":"Soria\u2010Contreras","sequence":"additional","affiliation":[{"name":"Diabetes Unit Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"James","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Obstetrics and Gynecology Massachusetts General Hospital  Boston Massachusetts 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hsu","sequence":"additional","affiliation":[{"name":"Clinical and Translational Epidemiology Unit Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Broad Institute  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie Lynn","family":"Garry","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Centers Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen W.","family":"Seely","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Endocrinology, Diabetes and Hypertension Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7060-7778","authenticated-orcid":false,"given":"Camille E.","family":"Powe","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Diabetes Unit Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Obstetrics and Gynecology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Broad Institute  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","first-page":"1","article-title":"Trends and Characteristics in Gestational Diabetes: United States, 2016\u20102020","volume":"71","author":"Gregory E. 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