Illawarra Shoalhaven Local Health District Wollongong

Shoalhaven, Australia

Illawarra Shoalhaven Local Health District Wollongong

Shoalhaven, Australia
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Moses R.G.,Illawarra Shoalhaven Local Health District Wollongong | Casey S.A.,Illawarra Shoalhaven Local Health District Wollongong | Quinn E.G.,Illawarra Shoalhaven Local Health District Wollongong | Cleary J.M.,Illawarra Shoalhaven Local Health District Wollongong | And 4 more authors.
American Journal of Clinical Nutrition | Year: 2014

Background: Eating carbohydrate foods with a high glycemic index (GI) has been postulated to result in fetoplacental overgrowth and higher infant body fat. A diet with a low glycemic index (LGI) has been shown to reduce birth percentiles and the ponderal index (PI). Objectives: We investigated whether offering LGI dietary advice at the first antenatal visit would result in a lower fetal birth weight, birth percentile, and PI than providing healthy eating (HE) advice. This advice had to be presented within the resources of routine antenatal care. Design: The Pregnancy and Glycemic Index Outcomes study was a 2-arm, parallel-design, randomized, controlled trial that compared the effects of LGI dietary advice with HE advice on pregnancy outcomes. Eligible volunteers who attended for routine antenatal care at <20 wk of gestation were randomly assigned to either group. Results: A total of 691 women were enrolled, and 576 women had final data considered. In the LGI group, the GI was reduced from a mean (±SEM) of 56 ± 0.3 at enrollment to 52 ± 0.3 (P < 0.001) at the final assessment. There were no significant differences in primary outcomes of fetal birth weight, birth percentile, or PI. In a multivariate regression analysis, the glycemic load was the only significant dietary predictor (P = 0.046) of primary outcomes but explained < 1% of all variation. Conclusion: A low-intensity dietary intervention with an LGI diet compared with an HE diet in pregnancy did not result in any significant differences in birth weight, fetal percentile, or PI. This trial was registered at https://www.anzctr.org.au as ACTRN12610000174088. © 2014 American Society for Nutrition.


Moses R.G.,Illawarra Shoalhaven Local Health District Wollongong | Round E.,Merck And Co. | Shentu Y.,Merck And Co. | Golm G.T.,Merck And Co. | And 5 more authors.
Journal of Diabetes | Year: 2016

Background: Type 2 diabetes mellitus (T2DM) treatment generally requires multiple antihyperglycemic agents. When diet, exercise, and treatment with sulfonylurea and metformin do not achieve glycemic goals, several options are available. The present study evaluated the efficacy and tolerability of sitagliptin 100mg/day added to therapy with sulfonylurea and metformin. Methods: Patients with HbA1c ≥7.5% and ≤10.5% while on a sulfonylurea and metformin were randomized 1:1 to sitagliptin 100mg/day or placebo for 24weeks. At Week 24, patients in the placebo group switched to pioglitazone 30mg/day and both groups continued treatment for another 30weeks. Results: Of 427 patients randomized, 339 (79.4%) completed the study. At Week 24, significantly greater (P< 0.001) mean reductions from baseline were seen in the sitagliptin versus placebo group for HbA1c (-0.84% vs -0.16%, respectively), 2-h post-meal glucose (-2.0 vs -0.2mmol/L, respectively) and fasting plasma glucose (-0.7 vs 0.3mmol/L, respectively). At Week 54, improvements in glycemic control continued. At Week 24, the incidence of adverse events (AEs) was numerically greater with sitagliptin than placebo, primarily because of a higher incidence of hypoglycemia. At Week 54, the incidence of AEs was similar in both groups, primarily because of a higher incidence of hypoglycemia and edema in the placebo/pioglitazone group after Week 24. The only meaningful change in body weight was an increase in the placebo/pioglitazone group at Week 54. Conclusions: In this study, sitagliptin 100mg/day was generally well tolerated and provided improvement in glycemic control when added to the combination of sulfonylurea and metformin in patients with T2DM. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd 2015 10.1111/1753-0407.12351 Original Article Original Articles © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.


Goletzke J.,University of Bonn | Goletzke J.,University of Sydney | Buyken A.E.,University of Bonn | Louie J.C.Y.,University of Sydney | And 3 more authors.
American Journal of Clinical Nutrition | Year: 2015

Background: Despite normal gestational weight gain, dietary studies in pregnant women show intakes below the recommendations for energy and micronutrients. Objective: This study compared changes in dietary intake from the second to third trimester with emphasis on energy intake and carbohydrate quality. Design: These post hoc analyses were based on 566 women participating in the Pregnancy and Glycemic Index Outcomes study, a randomized controlled trial comparing the effect of low-glycemic index (GI) dietary advice with healthy eating advice on selected pregnancy outcomes. With the use of multilevel mixed-regression analysis, changes in total energy intake, starch, sugar, fiber intake, GI, and glycemic load (GL) were correlated with intake of different micronutrients. Results: Energy intake decreased in the third trimester, and most women did not meet the national recommended amounts for iron, folate, and dietary fiber from food sources alone. After adjustment for age, ethnicity, prepregnancy body mass index, and intervention group, change in energy intake was positively related to change in intake of all micronutrients (P , 0.001). GI, GL, and starch intake were inversely related to micronutrient intake (P , 0.001), whereas higher total sugars predicted higher intake (P , 0.001). Associations with dietary fiber were inconsistent. Conclusions: Normal pregnancy can be associated with a decline in energy and micronutrient intake from diet. Low dietary GI and GL were the best predictors of a favorable micronutrient profile. © 2015 American Society for Nutrition.

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