{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:15:00Z","timestamp":1784265300207,"version":"3.55.0"},"reference-count":42,"publisher":"BMJ","issue":"1","funder":[{"name":"Instituto de Salud Carlos III of Spain","award":["PI14\/01563"],"award-info":[{"award-number":["PI14\/01563"]}]},{"name":"Fundaci\u00f3n para Estudios Endocrinometabolicos, IdISSC Hospital Cl\u00ednico San Carlos"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2018,8,13]]},"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess whether Mediterranean Diet (MedDiet)-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes mellitus (GDMw) and observe the effects on adverse pregnancy outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>This is a secondary analysis of the St Carlos GDM Prevention Study, conducted between January and December 2015 in Hospital Cl\u00ednico San Carlos (Madrid, Spain). One thousand consecutive women with normoglycemia were included before 12 gestational weeks (GWs), with 874 included in the final analysis. Of these, 177 women were diagnosed with gestational diabetes mellitus (GDM) and 697 had normal glucose tolerance. All GDMw received MedDiet-based medical nutrition therapy with a recommended daily extra virgin olive oil intake \u226540 mL and a daily handful of nuts. The primary goal was comparison of hemoglobin A1c (HbA<jats:sub>1c<\/jats:sub>) levels at 36\u201338 GWs in GDMw and women with normal glucose tolerance (NGTw).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>GDMw as compared with NGTw had higher HbA<jats:sub>1c<\/jats:sub> levels at 24\u201328 GWs (5.1%\u00b10.3% (32\u00b10.9 mmol\/mol) vs 4.9%\u00b10.3% (30\u00b10.9 mmol\/mol), p=0.001). At 36\u201338 GWs values were similar between the groups. Similarly, fasting serum insulin and homeostatic model assessment insulin resitance (HOMA-IR) were higher in GDMw at 24\u201328 GWs (p=0.001) but became similar at 36\u201338 GWs. 26.6% of GDMw required insulin for glycemic control. GDMw compared with NGTw had higher rates of insufficient weight gain (39.5% vs 22.0%, p=0.001), small for gestational age (6.8% vs 2.6%, p=0.009), and neonatal intensive care unit admission (5.6% vs 1.7%, p=0.006). The rates of macrosomia, large for gestational age, pregnancy-induced hypertensive disorders, prematurity and cesarean sections were comparable with NGTw.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Using a MedDiet-based medical nutrition therapy as part of GDM management is associated with achievement of near-normoglycemia, subsequently making most pregnancy outcomes similar to those of NGTw.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2018-000550","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T12:54:24Z","timestamp":1539348864000},"page":"e000550","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"isrctn84389045","registry":"10.18810\/isrctn"}],"author":[{"given":"Carla","family":"Assaf-Balut","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Garcia de la Torre","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Cl\u00ednico San Carlos and Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, 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