BACKGROUND: Dietary management is integral to the effective care of women with gestational diabetes (GDM). This includes regulation of the type, quantity and distribution of carbohydrates in the diet. When provided individually, the most effective form of ‘carbohydrate education’ can be selected for the particular woman, however the best method of carbohydrate education in a group setting is yet to be determined. Education regarding portion sizes can be done in several ways, including (i) ‘household serves’ or (ii) ‘exchanges’. ‘Household serves’ are commonly eaten food portions which have an allocated carbohydrate amount. The exchange method involves quantifying amounts of carbohydrates from a detailed list and requires some calculation.
AIM: To determine the better method of providing information on carbohydrate portions to women with GDM in a group setting.
METHOD: Up to 6 English-speaking women with GDM attended a single education session; these were held weekly. The method of carbohydrate education was alternated between ‘exchanges’ and ‘household serves’. At an individual follow-up appointment, women completed a survey regarding the ease of following carbohydrate counting advice. Questions also included the comprehensiveness of this advice, and whether they were satisfied with dietary quantities. Fifty women from each group completed the survey.
RESULTS: More women (46% vs 38%) found the simpler method, ‘household serves’ ‘very easy’ to follow, although for 6% this limited list did not include any of the carbohydrate foods they consumed and 16% of women in this group didn’t feel they received enough information. More women in the ‘exchange’ group found the portion sizes too small (44% vs 30%), even though the carbohydrate portions were the same.
CONCLUSION: The ease of understanding the concepts and practical aspects of carbohydrate serves did not differ markedly between the two types of instructions; both were satisfactory for the majority of women. Importantly, dietitians found the ‘household serves’ method was more easily understood and thus the preferred method for group education.