Gestational Diabetes in Women:Taste &Endocrine Factors

DESCRIPTION(provided by applicant): Gestational Diabetes Mellitus (GDM) is a common complication of pregnancy with serious consequences for maternal and child health. Diet is an integral part of the management of GDM, but current diet strategies for pregnant women with 0DM are poorly defined and often fail. We have shown that GDM increases the preference for sweet taste and dietary intake of sweet foods, which could have important implications for the management of this disease. At the time of diagnosis (-30 30 wk gestational age) pregnant women with GDM showed a higher preference for sweetened dairy drinks compared to pregnant women without GDM. In addition, increased plasma glucose in women with GDM was related to higher preference for the sweet taste of glucose and higher dietary intake of simple sugars as fruit and fruit juices. Because these studies were limited to a single observation point during gestation and excluded women with severe diabetes or those treated with insulin, further studies are needed. The specific aims of this project are: 1) to determine the relationship between hyperglycemia and increased taste preference and dietary intake of sweet foods in GDM, 2) to compare the temporal pattern of taste and dietary changes in women with GDM to those of women without 0DM across pregnancy stages, and 3) to relate these taste changes to alterations in gestational hormone and metabolic profiles. A single prospective study will be conducted. We will measure sweet taste preferences, food cravings, dietary intake of sweet foods and plasma indices of selected hormones and metabolites (including insulin, cortisol and leptin) during early, middle and late gestation and at 6-wk and 26 wk post-delivery. Four groups of pregnant women will be studied; overweight women with GDM; normal weight women with GDM; overweight women without GDM and normal weight women without GDM. Non-pregnant controls will also be studied. The long-term goal of this project is to obtain a better understanding of taste changes in GDM to develop better preventative and therapeutic dietary intervention strategies for this disease.