Further support for the linkages posited by Jenny Brand Miller
between insulin resistance and fecundity comes from this study by my
colleagues here at Univ of Cal, Irvine.  In this case the evidence
is of the effects of a surfeit of CHO, rather than a deficit.  In
two groups of women with gestational diabetes, large gestational age
infants tend to be borne by women who are on higher CHO diets.
Large gestational age infants are difficult children to birth, risky
both to the mother and the child.  Consistent with the
"carnivore-connection" hypothesis, insulin resistant females would
be poor procreators in a CHO abundant environment and would have a
selective advantage were CHO scarce.  (Abstract from PubMed
follows.)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Arthur De Vany
Professor
Institute for Mathematical Behavioral Sciences
3151 Social Science Plaza
Irvine, CA  92697-5100
949-824-5269
[log in to unmask]
http://www.socsci.uci.edu/mbs/personnel/devany/devany.html
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Obstet Gynecol 1998 Apr;91(4):600-604

The effects of carbohydrate restriction in patients with
diet-controlled gestational diabetes.

Major CA, Henry MJ, De Veciana M, Morgan MA

University of California, Irvine Medical Center, Department of
Obstetrics and Gynecology, Orange 92686, USA.

OBJECTIVE: To determine the effect of carbohydrate restriction on
perinatal outcome in patients with diet-controlled gestational
diabetes mellitus (GDM). METHODS: Women with diet-controlled GDM
were divided non-randomly into two groups based on their dietary
carbohydrate content: those with low dietary carbohydrate content
(below 42%) and those with high dietary carbohydrate content
(exceeding 45%). Subjects kept dietary accounts and were followed
with daily fasting and postprandial glucose assessments. Subjects
also were tested daily for urinary ketones. Glycosylated hemoglobin,
mean fasting and postprandial glucose values, incidence of
macrosomia and large for gestational age (LGA) infants, cesarean
deliveries for cephalopelvic disproportion and macrosomia, and need
for insulin therapy were compared between the groups. RESULTS: The
two groups were identical in terms of demographic characteristics.
Significant reductions in the postprandial glucose values were seen
among subjects in the low-carbohydrate group (P < .04). Fewer
subjects in the low-carbohydrate group required the addition of
insulin for glucose control (P < .047; relative risk [RR] 0.14; 95%
confidence interval [CI] 0.02, 1.00). The incidence of LGA infants
was significantly lower in the low-carbohydrate group (P < .035; RR
0.22; 95% CI 0.05, 0.91). Subjects in the low carbohydrate group
also had a lower rate of cesarean deliveries for cephalopelvic
disproportion and macrosomia (P < .037; RR 0.15; 95% CI 0.04, 0.94).
CONCLUSION: Carbohydrate restriction in patients with
diet-controlled GDM results in improved glycemic control, less need
for insulin therapy, a decrease in the incidence LGA infants, and a
decrease in cesarean deliveries for cephalopelvic disproportion and
macrosomia.