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Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their...
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Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Diabetes".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 9874

Special Issue Editors

Dr. Zohar Nachum

E-Mail Website
Guest Editor
1. Department of Obstetrics and Gynecology, Emek Medical Center, Afula 1834111, Israel
2. Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa 3200003, Israel
Interests: maternal; fetal; medicine; diabetes in pregnancy; microbiome
Special Issues, Collections and Topics in MDPI journals
Dr. Enav Yefet

E-Mail Website
Guest Editor
1. Department of Obstetrics & Gynecology, Baruch Padeh Medical Center Poriya, Tiberias 1410000, Israel
2. Azrieli Faculty of Medicine, Bar Ilan University, Safed 1310000, Israel
Interests: maternal; fetal medicine; diabetes; microbiome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gestational diabetes mellitus (GDM) complicates 4–12% of pregnancies. It is considered one of the most prevalent pregnancy complications. Adequate glycemic control is highly important during pregnancy, since uncontrolled GDM is associated with severe short- and long-term maternal and neonatal morbidities.

In recent years, the effect of dietary changes and lifestyle modifications on glycemic control has gained attention, especially since pharmacological therapies to lower blood glucose are associated with adverse effects as well as unclear long-term effects on offspring health. Probiotic supplements have been shown to improve glucose metabolism by increasing host insulin sensitivity, cholesterol metabolism, and beneficial effects on the immune system. Moderate exercise has also improved glycemic control and insulin sensitivity. Another important issue is the growing prevalence of obesity that has led to an increased prevalence of GDM. Treating both conditions simultaneously is challenging due to the risk of ketosis in low-carbohydrate diet on one hand and gaining weight and insulin resistance on the other. The growing fetus is more susceptible to dietary and lifestyle modifications, and neonatal outcomes should be evaluated in appropriate clinical trials.

The aim of this Special Issue is to provide a collection of articles that showcase the current issues in research on “Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health”. As the Guest Editors of this Special Issue, we invite you to submit research articles, review articles, and short communications related to this topic.

Dr. Zohar Nachum
Dr. Enav Yefet
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gestational diabetes
  • glycemic control
  • obstetric complications
  • pregnancy
  • maternal and offspring health

Published Papers (4 papers)

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Research

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15 pages, 2054 KiB  
Article
Effects of Probiotics on Glycemic Control and Metabolic Parameters in Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis
by Enav Yefet, Liron Bar, Ido Izhaki, Rula Iskander, Manal Massalha, Johnny S. Younis and Zohar Nachum
Nutrients 2023, 15(7), 1633; https://doi.org/10.3390/nu15071633 - 28 Mar 2023
Cited by 11 | Viewed by 3297
Abstract
Objectives: To assess the effects of probiotic supplements on glycemic control and metabolic parameters in women with gestational diabetes mellitus (GDM) by performing a systematic review and meta-analysis of randomized controlled trials. The primary outcome was glycemic control, i.e., serum glucose and insulin [...] Read more.
Objectives: To assess the effects of probiotic supplements on glycemic control and metabolic parameters in women with gestational diabetes mellitus (GDM) by performing a systematic review and meta-analysis of randomized controlled trials. The primary outcome was glycemic control, i.e., serum glucose and insulin levels. Secondary outcomes were maternal weight gain, neonatal birth weight, and lipid parameters. Weighted mean difference (WMD) was used. Cochrane’s Q test of heterogeneity and I2 were used to assess heterogeneity. Results: Of the 843 papers retrieved, 14 (n = 854 women) met the inclusion criteria and were analyzed. When compared with placebo, women receiving probiotic supplements had significantly lower mean fasting serum glucose, fasting serum insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides, total cholesterol, and VLDL levels. Decreased neonatal birth weight was witnessed in supplements containing Lactobacillus acidophilus. Conclusion: Probiotic supplements may improve glycemic control and lipid profile and reduce neonatal birth weight in women with GDM. Full article
(This article belongs to the Special Issue Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health)
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13 pages, 443 KiB  
Article
Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey
by Angelo Sabag, Lauren Houston, Elizabeth P. Neale, Hannah E. Christie, Lauren A. Roach, Joanna Russell, Colin H. Cortie, Marijka Batterham, Barbara J. Meyer and Monique E. Francois
Nutrients 2023, 15(3), 487; https://doi.org/10.3390/nu15030487 - 17 Jan 2023
Cited by 5 | Viewed by 2913
Abstract
Background: Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers [...] Read more.
Background: Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation. Methods: An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions. Results: A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with “low-carbohydrate” diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were “lack of time” (71.4%) and “childcare” commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%). Conclusion: Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation. Full article
(This article belongs to the Special Issue Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health)
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Review

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22 pages, 805 KiB  
Review
The Role of Gut Microbiota in Gestational Diabetes Mellitus Affecting Intergenerational Glucose Metabolism: Possible Mechanisms and Interventions
by Yaolin Ren, Yuan Zeng, Yifan Wu, Jie Yu, Qian Zhang and Xinhua Xiao
Nutrients 2023, 15(21), 4551; https://doi.org/10.3390/nu15214551 - 27 Oct 2023
Cited by 1 | Viewed by 1555
Abstract
The incidence of type 2 diabetes is increasing every year and has become a serious public health problem. In addition to genetic factors, environmental factors in early life development are risk factors for diabetes. There is growing evidence that the gut microbiota plays [...] Read more.
The incidence of type 2 diabetes is increasing every year and has become a serious public health problem. In addition to genetic factors, environmental factors in early life development are risk factors for diabetes. There is growing evidence that the gut microbiota plays an important role in glucose metabolism, and the gut microbiota of pregnant women with gestational diabetes mellitus (GDM) differs significantly from that of healthy pregnant women. This article reviews the role of maternal gut microbiota in offspring glucose metabolism. To explore the potential mechanisms by which the gut microbiota affects glucose metabolism in offspring, we summarize clinical studies and experimental animal models that support the hypothesis that the gut microbiota affects glucose metabolism in offspring from dams with GDM and discuss interventions that could improve glucose metabolism in offspring. Given that adverse pregnancy outcomes severely impact the quality of survival, reversing the deleterious effects of abnormal glucose metabolism in offspring through early intervention is important for both mothers and their offspring. Full article
(This article belongs to the Special Issue Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health)
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Other

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18 pages, 2108 KiB  
Systematic Review
The Influence of Maternal Folate Status on Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis
by Ruhan Xu, Shenhao Liu, Zhiqi Zhong, Yifei Guo, Tianqi Xia, Yanyan Chen and Lingling Ding
Nutrients 2023, 15(12), 2766; https://doi.org/10.3390/nu15122766 - 16 Jun 2023
Cited by 2 | Viewed by 1490
Abstract
Maternal folate has been shown to relate to the risk of gestational diabetes mellitus (GDM). However, the existing studies have yielded inconsistent conclusions. The purpose of this study was to systematically review the association between maternal folate status and the risk of GDM. [...] Read more.
Maternal folate has been shown to relate to the risk of gestational diabetes mellitus (GDM). However, the existing studies have yielded inconsistent conclusions. The purpose of this study was to systematically review the association between maternal folate status and the risk of GDM. Observational studies up to 31 October 2022 were included. Study characteristics, the means and standard deviations (SDs) of folate levels (serum/red blood cell (RBC)), the odds ratios (ORs) with 95% confidence intervals (CIs) and the time for folate measurement were extracted. Compared with the non-GDM group, serum and RBC folate levels in women with GDM were significantly higher. Our subgroup analysis demonstrated that serum folate levels in the GDM group were significantly higher than in the non-GDM group only in the second trimester. RBC folate levels in the GDM group were significantly higher than in the non-GDM group in the first and second trimesters. Taking serum/RBC folate levels as continuous variables, the adjusted odds ratios of GDM risk showed that increased serum folate concentration rather than RBC folate elevated the risk of GDM. In the descriptive analysis, five studies reported high serum folate levels increased GDM risk, whereas the other five showed no association between serum folate levels and GDM risk. Moreover, the rest three studies pointed out high RBC folate levels increased GDM risk. Altogether we found that the risk of GDM is associated with high serum/plasma and RBC folate levels. Future studies should determine the recommended folic acid cutoff balancing the risk for GDM and fetal malformations. Full article
(This article belongs to the Special Issue Dietary Therapies and Lifestyle Modifications for Gestational Diabetes and Their Implications for Maternal and Offspring Health)
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