Gestational diabetes, affecting over one in six births globally, is a growing public health concern. Characterised by high blood glucose, it increases the risk of pregnancy complications and raises the mother's long-term risk of type 2 diabetes. Managing high fasting glucose, which reflects elevated overnight levels, is a key challenge. Night-time snacking-more common in women with gestational diabetes-is linked to higher fasting glucose, but the impact of snack quality is unclear. Almonds have been shown to improve glucose control in non-pregnant adults. This study will test whether almonds, as a night-time snack, can improve overnight glucose levels in pregnant women with gestational diabetes. Findings could support a simple, effective dietary strategy to improve outcomes for mothers and babies worldwide.
Age over 16 years
Singleton pregnancy
25 to 31+6 weeks' gestation diagnosed with GDM using a standard clinical 75g oral glucose tolerance test (OGTT), as per the guidelines of the National Institute of Health and Care Excellence (NICE), and had their first post-diagnosis consultation (approx. 7-10 days later). The NICE criteria state that the diagnosis of GDM will be made with one or more glucose concentrations during the OGTT of >5.6 mmol/l in the fasting state; >7.8 mmol/l 2 hours after 75g glucose
Planned antenatal care at the same centre
Age under 16 years or over 55 years
Multiple pregnancy
Non-snack consumers
Smokers
Parallel
Almond Snack Intervention for Gestational Diabetes
Other interventionThis intervention involves daily consumption of 43 g of whole almonds, split into two portions (afternoon and evening), for 28 days in pregnant women diagnosed with gestational diabetes who habitually consume evening snacks.
Control (placebo) group
Other interventionThis control involves the daily consumption of a nut-free snack (2 portions) that reflects a 'typical snack' choice among pregnant women with gestational diabetes. It serves as a comparison to assess the specific impact of almond-based evening snacking on overnight glucose regulation.
Mean nocturnal blood glucose (22.00-07.00h)
Mean daytime glucose 07.00-22.00h
Recommended glucose control target 3.5-7.8mmol/L, AUC \<6.7mmol/L, AUC \<7.8mmol/L
Postprandial blood glucose
Mean postprandial blood glucose for 1, 2 \& 4 hours after dinner.
Glucose variability
Glucose SD, glucose CV
Blood glucose indices
High and low blood glucose indices (HBGI \& LBGI)
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Guy's and St Thomas' NHS Foundation Trust
Lead sponsor
King's College London
Collaborator
Almond Board of California
Collaborator
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