Abstract

Introduction: Maternal obesity and poor diet choices are often attributed as the cause of gestational diabetes. Maternal eating behaviour during pregnancy and the influence of this on the disease aetiology remains poorly understood. We aimed to compare eating behaviour in women with gestational diabetes to non-pregnant adults to determine which of the eating behaviour traits are associated with BMI as well as glucose metrics. Methods: Participants (total n=448) including men (n=67), non-pregnant women (n=181) and women with gestational diabetes during a singleton pregnancy (n=200; 29 weeks’ gestation; NICE / Covid-19 criteria) were recruited prospectively and completed a three-factor eating questionnaire (TFEQ-R18). Cross-sectional associations between continuous glucose measurement metrics and BMI with uncontrolled eating (UE), emotional eating (EE) and cognitive restraint (CR) were assessed using linear regression. Results: Women with gestational diabetes had significantly lower UE scores compared to men (53% vs 63%; p<0.001) and non-pregnant women (53% vs 65%; p<0.001), and lower EE scores compared to non-pregnant women (60% vs 71%; p<0.001). In women with gestational diabetes, only EE scores were significantly associated with BMI (Coeff 7.8; 95%CI 3.9-11.7; p<0.001), while UE and CR scores have no association. However, EE, UE and CR were not significantly associated with glucose metrics such as average glucose levels, time above range or time below range. Conclusions: Favourable eating behaviour was observed in women with gestational diabetes when compared to men and non-pregnant women. Data showing EE is strongly associated with BMI suggest that interventions which consider this may be more impactful for weight management in women with gestational diabetes and, as such, exploring this avenue may be an important aspect to address when considering new translational approaches. Disclosure L.C.Kusinski: None. P.Tobolska: None. D.Jones: None. N.Atta: None. L.M.Oude griep: None. F.M.Gribble: Other Relationship; Kallyope, Research Support; AstraZeneca, Eli Lilly and Company. C.L.Meek: Research Support; Dexcom, Inc. Funding Diabetes UK (17/0005712)

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