Dietary Interventions, Lifestyle Changes, and Dietary Supplements in Preventing Gestational Diabetes Mellitus

Abstract

Gestational diabetes mellitus (GDM) is associated with increased rates of fetal morbidity and mortality, both during the pregnancy and in the postnatal life. Current treatment of GDM includes diet with or without medications, but this management is expensive and poorly cost-effective for the health care systems. Strategies to prevent such condition would be preferable with respect to its treatment. The aim of this literature review was to evaluate studies reporting the efficacy of the most used approaches to prevent GDM as well as evidences of efficacy and safety of dietary supplementations. Systematic literature searches were performed in electronic databases, covering the period January 1983 to April 2014. Randomized controlled clinical trials were included. Quality of the articles was evaluated with the Jadad scale. We did not evaluate those articles that were already entered in the most recent systematic reviews, and we completed the research with the trials published thereafter. Of 55 articles identified, 15 randomized controlled trials were eligible. Quality and heterogeneity of the studies cannot allow firm conclusions. Anyway, trials in which only intake or expenditure has been targeted mostly reported negative results. On the contrary, combined lifestyle programs including diet control (orienting food intake, restricting energy intake) associated with moderate but continuous physical activity exhibit better efficacy in reducing GDM prevalence. The results from dietary supplements with myoinositol or probiotics are promising. The actual evidences provide enough arguments for implementing large-scale, high-quality randomized controlled trials looking at the possible benefits of these new approaches for preventing GDM.

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

“…Study findings summarized in systematic reviews and meta-analyses are diverse but suggest a beneficial effect (9,10,13,30). Additional research is needed because of the differences in interventions examined (e.g., diet quality, energy restriction, provision of fortified food products, dietary counseling) as well as the heterogeneous study populations and GDM diagnostic criteria.…”

“…Intervention studies were not included because results from these studies have been systematically reviewed (9,10,13).…”

Zinc supplementation and the effects on metabolic status in gestational diabetes: A randomized, double-blind, placebo-controlled trial

“…Initial treatment of GDM involves dietary modification, lifestyle changes, moderate exercise and dietary supplements (Asemi et al, 2013;Facchinetti et al, 2014). Recently, zinc supplementation has been proposed for decreased insulin resistance and lipid profiles in patients without GDM.…”

An Overview of Herbal Products and Secondary Metabolites Used for Management of Type Two Diabetes

“…Recent studies have also shown the pathological involvement of the immune system in type 2 diabetes, that is, based on the presence of autoantibodies against β cells, self-reactive T cells and evidence of beneficial effect of some anti-inflammatory and immunomodulatory therapy, being viewed as an autoinflammatory disease (Itariu and Stulnig, 2014). Nutritional interventions with food supplements as a form of complementary therapy in patients with diabetes are being used increasingly to counter these effects (Shane-McWhorter, 2005; Campbell, 2010; Ho et al, 2013; Facchinetti et al, 2014). In this review, botanicals that are most frequently promoted to help manage blood glucose levels and can be found marketed as food supplements promoting antidiabetic activity were selected and their mechanism of action described.…”