Effects of the Consumption of Low to Medium Glycemic Index–based Rice on the Rate of Insulin Initiation in Patients with Gestational Diabetes: A Triple-blind, Randomized, Controlled Trial

Introduction: Medical nutritional therapy is vital in patients with diabetes. A low glycemic index (GI) is generally advised in the management of women with gestational diabetes mellitus (GDM). However, the efficacy of this advice has not been systematically examined. The purpose of this study was to determine whether recommending a low to moderate GI rice (RD43 rice; GI = 56.9) in women with GDM would reduce the number of women requiring insulin, compared with rice of high GI (Thai Hom Mali [THM] rice; GI = 80.1).Methods: Ninety-six participants with GDM were randomly assigned to receive either RD43 rice or THM rice.Results: The mean +/- SD ages in the RD43 and THM groups were 33.1 +/- 13.1 and 33.6 +/- 4.1 years, respectively. The mean gestational ages at the sampling in the RD43 and THM groups were 23.3 +/- 5.9 and 23.5 +/- 5.4 weeks. Both groups had comparable baseline characteristics, including age, gestational age, body mass index prior to pregnancy and at enrollment, baseline postprandial (oral glucose tolerance test)plasma glucose level, and hemoglobin A1c. Of the 48 women assigned to the RD43 group, 3 (6.3%) required insulin; in the THM group, 11 (22.9%) met the criteria for insulin therapy ( P = 0.017). However, 10 of these 11 women were able to avoid insulin use by changing to the low to moderate GI rice.Conclusion: Using a low to moderate GI rice in GDM effectively reduced the number of patients requiring insulin therapy. Thai Clinical Trials Registry ID: TCTR20210524007. (Clin Ther. 2023;45:347- 353.) (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC -ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )