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Nutrients
Special Issues
Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity
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Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity

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

Deadline for manuscript submissions: 5 July 2024 | Viewed by 6647

Special Issue Editor

Prof. Dr. David Simmons

E-Mail Website
Guest Editor
School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia
Interests: diagnosis and management of GDM; management of diabetes in pregnancy; prevention of GDM and type 2 diabetes; diabetes integrated care; diabetes epidemiology; barriers to diabetes care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hyperglycemia in pregnancy, including gestational diabetes mellitus (GDM) and known pregestational diabetes (type 1 diabetes, type 2 diabetes, and rare forms of diabetes), is associated with a range of pregnancy complications that can often be avoided with glucose and weight management. Diet, exercise, and optimization of gestational weight gain are the cornerstone of management for all forms of diabetes with or without pharmacotherapy and yet often remain a significant challenge for women during pregnancy. Similarly, although nutritional interventions are often promoted for the prevention of GDM, evidence of major effectiveness for reducing GDM incidence is limited. Finally, preventing progression to type 2 diabetes after GDM remains elusive, often due to wider life impacts. Determining how best to implement nutritional interventions and which nutritional interventions to promote are also topics of ongoing investigations.

In this Special Issue, we seek submissions involving all aspects of diet and diet therapy relating to the prevention and management of any form of diabetes and/or obesity in pregnancy, including GDM, and including those relating to breastfeeding. This includes programs for the prevention of progression to type 2 diabetes after GDM involving dietary intervention. Reports on relevant clinical trials and nutrition-related health outcomes are encouraged.

Prof. Dr. David Simmons
Guest Editor

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 mellitus
  • type 1 diabetes in pregnancy
  • type 2 diabetes in pregnancy
  • nutrition
  • diet treatment
  • carbohydrates
  • lifestyle
  • prevention
  • glucose
  • obesity

Published Papers (4 papers)

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Research

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10 pages, 275 KiB  
Article
Towards Novel Nutritional Strategies in Gestational Diabetes: Eating Behaviour and Obesity in Women with Gestational Diabetes Compared with Non-Pregnant Adults
by Laura C. Kusinski, Patrycja Tobolska, Danielle L. Jones, Nooria Atta, Elizabeth H. Turner, Hannah B. Lewis, Linda M. Oude Griep, Fiona M. Gribble and Claire L. Meek
Nutrients 2023, 15(19), 4141; https://doi.org/10.3390/nu15194141 - 25 Sep 2023
Cited by 1 | Viewed by 1079
Abstract
Background: Gestational diabetes is associated with increased risk of obesity, type 2 diabetes and cardiovascular disease. Effective nutritional strategies are needed to reduce BMI and improve long-term maternal cardiometabolic health, but the relative contribution of maternal eating behaviour, a potential barrier to dietary [...] Read more.
Background: Gestational diabetes is associated with increased risk of obesity, type 2 diabetes and cardiovascular disease. Effective nutritional strategies are needed to reduce BMI and improve long-term maternal cardiometabolic health, but the relative contribution of maternal eating behaviour, a potential barrier to dietary change, has not been explored. We compared eating behaviour in women with gestational diabetes with that of men and non-pregnant women with comparable risk factors, and tested associations between eating behaviour traits and BMI in women with gestational diabetes. We hypothesized that eating behaviour would be unfavourable in gestational diabetes and would be associated with BMI. Methods: Participants (n = 417) including 53 men, 164 non-pregnant women and 200 women with gestational diabetes (singleton pregnancy; 29 weeks’ gestation) were recruited into three prospective studies assessing weight loss interventions, with similar entry criteria. The three-factor eating questionnaire (TFEQ-R18) assessed uncontrolled eating, emotional eating and cognitive restraint at study enrolment. Associations between BMI at study enrolment and TFEQ-R18 (% maximum score) were assessed using linear regression. Results: Women with gestational diabetes had significantly lower uncontrolled eating scores vs. men (53% vs. 65%; p < 0.001) and non-pregnant women (53% vs. 66%; p < 0.001), lower emotional eating scores vs. non-pregnant women (60% vs. 71%; p < 0.001) and higher cognitive restraint (p < 0.001 vs. men and non-pregnant women). In women with gestational diabetes, emotional eating scores were positively associated with BMI at study enrolment (beta coefficient 7.8 (95% CI 3.9 to 11.7), p < 0.001). Conclusions: Women with gestational diabetes have favourable eating behaviour compared with other population groups. Because BMI at study enrolment was associated with emotional eating, nutritional strategies which reduce emotional eating may provide new opportunities to improve long-term maternal health after gestational diabetes. Full article
(This article belongs to the Special Issue Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity)
17 pages, 1769 KiB  
Article
Human Milk Oligosaccharides in Maternal Serum Respond to Oral Glucose Load and Are Associated with Insulin Sensitivity
by Marie-Therese Weiser-Fuchs, Elena Maggauer, Mireille N. M. van Poppel, Bence Csapo, Gernot Desoye, Harald C. Köfeler, Andrea Groselj-Strele, Slave Trajanoski, Herbert Fluhr, Barbara Obermayer-Pietsch and Evelyn Jantscher-Krenn
Nutrients 2023, 15(18), 4042; https://doi.org/10.3390/nu15184042 - 18 Sep 2023
Viewed by 1307
Abstract
(1) Background: Pregnancy presents a challenge to maternal glucose homeostasis; suboptimal adaptations can lead to gestational diabetes mellitus (GDM). Human milk oligosaccharides (HMOs) circulate in maternal blood in pregnancy and are altered with GDM, suggesting influence of glucose homeostasis on HMOs. We thus [...] Read more.
(1) Background: Pregnancy presents a challenge to maternal glucose homeostasis; suboptimal adaptations can lead to gestational diabetes mellitus (GDM). Human milk oligosaccharides (HMOs) circulate in maternal blood in pregnancy and are altered with GDM, suggesting influence of glucose homeostasis on HMOs. We thus assessed the HMO response to glucose load during an oral glucose tolerance test (OGTT) and investigated HMO associations with glucose tolerance/insulin sensitivity in healthy pregnant women. (2) Methods: Serum of 99 women, collected at 0 h, 1 h and 2 h during a 75 g OGTT at 24–28 gestational weeks was analyzed for HMOs (2′FL, 3′SLN, LDFT, 3′SL) by HPLC; plasma glucose, insulin and C-peptide were analyzed by standard biochemistry methods. (3) Results: Serum 3′SL concentrations significantly increased from fasting to 1 h after glucose load, while concentrations of the other HMOs were unaltered. Higher 3′SL at all OGTT time points was associated with a generally more diabetogenic profile, with higher hepatic insulin resistance (HOMA-IR), lower insulin sensitivity (Matsuda index) and higher insulin secretion (C-peptide index 1). (4) Conclusions: Rapid increase in serum 3′SL post-oral glucose load (fasted-fed transition) indicates utilization of plasma glucose, potentially for sialylation of lactose. Associations of sialylated HMOs with a more diabetogenic profile suggest sustained adaptations to impaired glucose homeostasis in pregnancy. Underlying mechanisms or potential consequences of observed HMO changes remain to be elucidated. Full article
(This article belongs to the Special Issue Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity)
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Review

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12 pages, 307 KiB  
Review
Folate Supplementation in Women with Pre-Existing Diabetes
by Nayomi Perera, Victoria L. Rudland, David Simmons and Sarah A. L. Price
Nutrients 2023, 15(8), 1879; https://doi.org/10.3390/nu15081879 - 13 Apr 2023
Cited by 1 | Viewed by 2046
Abstract
Folate supplementation in the periconceptual period is the standard of care for the prevention of neural tube defects. To support dietary folate intake, some countries have introduced mandatory folic acid fortification of food products. Robust evidence supports the additional use of a low-dose [...] Read more.
Folate supplementation in the periconceptual period is the standard of care for the prevention of neural tube defects. To support dietary folate intake, some countries have introduced mandatory folic acid fortification of food products. Robust evidence supports the additional use of a low-dose folic acid supplement (0.4 mg/day) in all women from 2–3 months preconception until the end of the 12th week of gestation. For women with pre-existing diabetes, high-dose folic acid supplementation (5 mg/day) is recommended in some, but not all international guidelines. The recommendation is made based on consensus opinion and reflects the increased risk of neural tube defects in pregnant women with pre-existing diabetes. However, there is limited evidence to clarify the high-risk groups that benefit from high-dose folic acid versus those that do not. There are also some data to suggest that high-dose folic acid may be harmful to mothers and offspring, although this issue remains controversial. This narrative review explores the evidence that supports the recommendation for women with pre-existing diabetes to take high-dose folic acid in the periconceptual period. It explores the potential benefits of high-dose supplemental folate beyond the prevention of neural tube defects, and also the potential adverse impacts of high-dose folate use. These topics are considered with a specific focus on the issues that are pertinent to women with pre-existing diabetes. Based on the available evidence, a pragmatic approach to the use of folic acid supplements in women with pre-existing diabetes during the periconception period is suggested. The need for comprehensive preconception care that optimises glycaemic control and addresses other modifiable risk factors before pregnancy is emphasized. Full article
(This article belongs to the Special Issue Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity)

Other

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14 pages, 588 KiB  
Study Protocol
Preventing Gestational Diabetes with a Healthy Gut Diet: Protocol for a Pilot, Feasibility Randomized Controlled Trial
by Nina Meloncelli, Hannah O’Connor, Shelley A. Wilkinson, Marloes Dekker Nitert, Lauren Kearney and Susan de Jersey
Nutrients 2023, 15(21), 4653; https://doi.org/10.3390/nu15214653 - 02 Nov 2023
Viewed by 1435
Abstract
Around 14% of pregnancies globally are affected by gestational diabetes mellitus (GDM), making it one of the most common disorders experienced by women in pregnancy. While dietary, physical activity and supplement interventions have been implemented to prevent GDM, with varying levels of success, [...] Read more.
Around 14% of pregnancies globally are affected by gestational diabetes mellitus (GDM), making it one of the most common disorders experienced by women in pregnancy. While dietary, physical activity and supplement interventions have been implemented to prevent GDM, with varying levels of success, altering the gut microbiota through diet is a promising strategy for prevention. Several studies have demonstrated that women with GDM likely have a different gut microbiota to pregnant women without GDM, demonstrating that the gut microbiota may play a part in glycemic control and the development of GDM. To date, there have been no randomized controlled trials using diet to alter the gut microbiota in pregnancy with the aim of preventing GDM. Here, we present the study protocol for a single-blind randomized controlled trial which aims to determine the effectiveness of the Healthy Gut Diet on reducing the diagnosis of GDM in pregnant women with one or more risk factors. Consenting women will be randomized into either the Healthy Gut Diet intervention group or the usual care (control) group after 11 weeks gestation. The women in the intervention group will receive three telehealth counseling appointments with an Accredited Practicing Dietitian with the aim of educating and empowering these women to build a healthy gut microbiota through their diet. The intervention was co-designed with women who have lived experience of GDM and incorporates published behavior change techniques. The control group will receive the usual care and will also be shown a brief (3 min) video on general healthy eating in pregnancy. The primary outcome is the diagnosis of GDM at any stage of the pregnancy. Secondary outcomes include changes to gut microbiota composition and diversity; gestational weight gain; maternal and infant outcomes; management of GDM (where relevant); dietary quality and intake; physical activity; and depression scoring. We aim to recruit 120 women over 16 months. Recruitment commenced in January 2023. The trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001285741). Full article
(This article belongs to the Special Issue Nutritional Strategies for Pregnancies Complicated by Diabetes or Obesity)
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