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Context The American Diabetes Association (ADA) recommends a 3-day preparatory diet prior to a diagnostic oral glucose tolerance test (OGTT), a test often recommended in postpartum individuals with a history of gestational diabetes (GDM). Objective Evaluate the relationship between carbohydrate intake and OGTT glucose in 2 cohorts of postpartum individuals. Methods We performed analyses of postpartum individuals from 2 prospective studies with recent GDM (Balance after Baby Intervention, BABI, n = 177) or risk factors for GDM (Study of Pregnancy Regulation of INsulin and Glucose, SPRING, n = 104) .We measured carbohydrate intake using 24-hour dietary recalls (SPRING) or Food Frequency Questionnaire (BABI) and performed 2-hour 75-g OGTTs. The main outcome measure was 120-minute post-OGTT glucose. Results There was no relationship between carbohydrate intake and 120-minute post-OGTT glucose level in either study population (SPRING: β = 0.03, [−5.5, 5.5] mg/dL, P = .99; BABI: β = −3.1, [−9.5, 3.4] mg/dL, P = .35). Adding breastfeeding status to the model did not change results (SPRING β = −0.14, [−5.7, 5.5] mg/dL, P = .95; BABI β = −3.9, [−10.4, 2.7] mg/dL, P = .25). There was, however, an inverse relationship between glycemic index and 120-minute post OGTT glucose (BABI: β = −1.1, [−2.2, −0.03] mg/dL, P = .04). Conclusion Carbohydrate intake is not associated with post-OGTT glucose levels among postpartum individuals. Dietary preparation prior to the OGTT may not be necessary in this population.

Background: Dietary modification in gestational diabetes (GDM) has focused on restricting carbohydrates. Some research suggests that increased dietary fat intake, which often occurs with carbohydrate restriction, may worsen insulin resistance in women with GDM. We tested for a relationship between dietary fat intake and insulin sensitivity in pregnant women. Methods: Pregnant women in the late 2nd trimester, (median [IQR] =26 [25-27] weeks’ gestation) completed a 75 g oral glucose tolerance test (OGTT) and a validated self-administered 24-hr dietary recall. We tested for an association between fat intake the day before the OGTT and insulin sensitivity (inverse of insulin resistance, measured using Matsuda index) using linear regression, adjusting for age, race, education, parity, BMI, gestational age, carbohydrate intake, and caloric intake. We also tested for associations with insulin secretion (measured using Stumvoll 1st phase estimate, with adjustment for insulin sensitivity) , and fasting, 1-hr and 2-hr OGTT glucose (mg/dl) . Results: Pregnant women (N=120, age 34 [31-36]) consumed 82 g of fat [62-101], 235 g of carbohydrate [195-298] and 78 g of protein [61-100] during a 24-hr period. Carbohydrate and fat intake were inversely related after adjusting for total caloric intake (0.3 fewer g of carbohydrate per additional g of fat, P Conclusion: Our results suggest that dietary fat intake does not increase insulin resistance in pregnant women. This may have implications for dietary recommendations in women with GDM. Disclosure E.A.Rosenberg: None. E.W.Seely: None. T.Thaweethai: None. K.James: None. C.Yu: None. M.J.Callahan: None. S.Nelson: None. C.E.Powe: None. Funding National Institutes of Health (1F32DK126343-01A1) ,Nation Institutes of Health (K23DK113218) , and the Robert Wood Johnson Foundation’s Harold Amos Medical Faculty Development Program

AIMS/HYPOTHESIS: Despite recommendations to screen women with diabetes risk factors for hyperglycaemia in the first trimester, criteria for normal glucose values in early pregnancy have not been firmly established. We aimed to compare glucose levels in early pregnancy with those later in gestation and outside of pregnancy in women with diabetes risk factors. METHODS: In pregnant women (N=123) followed longitudinally through the postpartum period, and a separate cohort of non-pregnant women (N=65), we performed 75 g oral glucose tolerance tests. All participants had one or more risk factors for diabetes. Using linear regression, we tested for differences in glucose levels between non-pregnant and pregnant women at early (7–15 weeks) and mid-late (24–32 weeks) gestation as well as postpartum, with adjustment for maternal age, parity, marital status and BMI. In a longitudinal analysis using mixed-effects models, we tested for differences in glucose levels across early and mid-late pregnancy compared with postpartum. Differences are expressed as β (95% CI). RESULTS: Fasting glucose was lower in pregnant compared with non-pregnant women by 0.34 (0.18, 0.51) mmol/l (p

Background: In pregnant and postpartum (PP) women, an oral glucose tolerance test (OGTT) is the diagnostic test of choice for glucose intolerance. Consistent with classic studies outside of pregnancy, we recently found that lower carbohydrate intake on the day before an OGTT in pregnancy was associated with higher post-load OGTT glucose. Here, we test for a relationship between carbohydrate intake and OGTT glucose in PP women. Methods: PP women (N=84, median [IQR] = 9 [8-14] weeks PP) completed a 75 g OGTT and a validated self-administered 24-hr dietary recall. We tested for an association between carbohydrate intake in the day before the OGTT and 1-hr OGTT glucose using linear regression, with adjustment for age, race, BMI, time postpartum, and caloric intake. We also tested for associations with 30 minute and 2-hr OGTT glucose and glucose area under the curve (AUC). A subset of women (N=72) had completed the same protocol during pregnancy (median=26 weeks gestation). Results: PP women with lower carbohydrate intake ( Conclusion: While carbohydrate intake in the day prior to an OGTT may alter gestational diabetes diagnosis, we found no relationship between carbohydrate intake and OGTT glucose among PP women. Metabolic factors that differentiate the pregnant and postpartum state may account for our findings. Disclosure E. A. Rosenberg: None. E. W. Seely: None. K. James: None. M. J. Callahan: None. S. Nelson: None. C. E. Powe: None. Funding National Institutes of Health (K23DK113218); Robert Wood Johnson Foundation (T32DK007028); Massachusetts General Hospital