Ingestão proteica associada ao controle glicêmico de mulheres com diabetes mellitus gestacional atendidas em uma maternidade escola.

Abstract

This study investigated the association between protein intake and glycemic control in women with Gestational Diabetes Mellitus (GDM) in Natal, Rio Grande do Norte, Brazil. The objectives included characterizing the pregnant women, evaluating their glycemic profile and protein consumption (animal/vegetal origin), and associating protein intake with glucose levels. The method employed a prospective cohort study with 190 pregnant women diagnosed with GDM. Sociodemographic, clinical, anthropometric, and food consumption data were collected in two trimesters. Glycemic profiles were monitored via home capillary glycemia, OGTT (Oral Glucose Tolerance Test), and HbA1c. Protein intake was classified as low (<15% total energy intake - TEI), adequate (15-20% TEI), and excessive (>20% TEI). Statistical analysis utilized one-way ANOVA. The results showed that most pregnant women presented social vulnerability (80.1% with low education level) and pre-gestational overweight/obesity (86.6%). Approximately 37.6% required insulin therapy. Although routine blood glucose levels remained within limits, the groups with "adequate" and "excessive" protein consumption exhibited higher OGTT and HbA1c values. Interestingly, pregnant women with lower total protein consumption but a higher proportion of vegetable proteins showed more favorable glycemic control. In conclusion, both the quantity and origin of protein intake influence glycemic control in GDM. The predominance of vegetable proteins was associated with better control, while excessive or even "adequate" protein consumption, especially from animal sources, may negatively impact insulin sensitivity. These findings reinforce the need for individualized nutritional assessments to optimize intervention strategies and improve maternal-fetal outcomes.