The caloric cost and sources of energy in diabetic pregnancy
Emerson, K.; Saxena, B.N.; Varma, S.K.; Poindexter, E.L.
Obstetrics and Gynecology 43(3): 354-362
1974
ISSN/ISBN: 0029-7844 PMID: 4814453 Document Number: 75807
Six diabetic pregnant women selected before the 20th week of pregnancy had a diet containing 217 g carbohydrate, 65 g fat, 97 g protein and 1837 kcal/daily. The average intake of non-diabetic controls was 202 g carbohydrate, 77 g fat, 86 g protein and 1844 kcal/day. Of the diabetics, 2 were in class A receiving no insulin and 4 received insulin treatment. Only 2 diabetics had normal deliveries, 3 had Caesarean sections and 1 an emergency induction. The 2 class A diabetics gained weight more slowly than controls, reaching a peak at 35 to 36 weeks. Those treated with insulin had a more rapid initial weight gain than controls reaching a maximum at 28 weeks. Diabetic subjects reached a higher maximum oxygen consumption than normal controls and those given insulin did so at 32 to 35 weeks instead of at 40 weeks. In diabetic subjects, oxygen consumption tended to rise faster than bodyweight after week 28. The mean non-protein respiratory quotient was higher for diabetics than for controls from week 20 to week 35. Controls showed a gradual rise from 30 to 42% in the proportion of carbohydrate burned in the daily metabolic mixture while diabetics reduced this proportion from 54 to 43%. The average increment in daily energy expenditure increased from 19 to 22 kcal in normal subjects from week 20 to week 36; in class A diabetics the value increased from 66 to 268 and in those given insulin from 60 to 435 kcal daily.