Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial

Lindsay, Karen L.; Brennan, Lorraine; Kennelly, Maria A.; Maguire, Orla; Smith, Thomas P.; Curran, Sinéad; Coffey, Mary; Foley, Michael; Hatunic, Mensud; Shanahan, Fergus; McAuliffe, Fionnuala M.

doi:10.1016/j.ajog.2015.02.008

Cited by 109 publications

(159 citation statements)

References 38 publications

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“…After removal of duplicate publications and exclusion of irrelevant articles, four articles [33,34,35,36] reporting on four randomized controlled trials involving 288 participants were ultimately included (Figure 1). Characteristics of the included studies are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies investigated the effect of probiotic supplementation on FBG levels in pregnant women with GDM [32,33,34,35]. Two [33,35] of the four studies reported statistically significant reductions in FBG levels in the groups receiving probiotics in comparison to the groups receiving the placebo.…”

Section: Resultsmentioning

confidence: 99%

“…Two [33,35] of the four studies reported statistically significant reductions in FBG levels in the groups receiving probiotics in comparison to the groups receiving the placebo. However, a meta-analysis of all four trials ( n = 288) indicated no significant reduction in FBG following probiotic supplementation (Mean Difference = −0.13; 95% CI −0.32, 0.06, p = 0.18) (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Four trials estimated insulin resistance in study participants by calculating HOMA-IR from fasting glucose and insulin values [33,34,35,36]. While one study found no change in insulin resistance between intervention and control groups following probiotic supplementation [33], three studies reported significant reductions in insulin resistance in the women receiving probiotics [34,35,36].…”

Section: Resultsmentioning

confidence: 99%

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Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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The metabolic effects of probiotic administration in women with gestational diabetes mellitus (GDM) is unknown. The objective of this review was to investigate the effect of probiotics on fasting plasma glucose (FPG), insulin resistance (HOMA-IR) and LDL-cholesterol levels in pregnant women diagnosed with GDM. Seven electronic databases were searched for RCTs published in English between 2001 and 2017 investigating the metabolic effects of a 6–8 week dietary probiotic intervention in pregnant women following diagnosis with GDM. Eligible studies were assessed for risk of bias and subjected to qualitative and quantitative synthesis using a random effects model meta-analyses. Four high quality RCTs involving 288 participants were included in the review. Probiotic supplementation was not effective in decreasing FBG (Mean Difference = −0.13; 95% CI −0.32, 0.06, p = 0.18) or LDL-cholesterol (−0.16; 95% CI −0.45, 0.13, p = 0.67) in women with GDM. However, a significant reduction in HOMA-IR was observed following probiotic supplementation (−0.69; 95% CI −1.24, −0.14, p = 0.01). There were no significant differences in gestational weight gain, delivery method or neonatal outcomes between experimental and control groups, and no adverse effects of the probiotics were reported. Probiotic supplementation for 6–8 weeks resulted in a significant reduction in insulin resistance in pregnant women diagnosed with GDM. The use of probiotic supplementation is promising as a potential therapy to assist in the metabolic management of GDM. Further high quality studies of longer duration are required to determine the safety, optimal dose and ideal bacterial composition of probiotics before their routine use can be recommended in this patient group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2017

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“…Several clinical trials have shown the effect of probiotics on the reduction of glucose, insulin, HbA 1c and other glycemic factors for type 2 diabetes mellitus (T2DM) [10][11][12][13][14][15][16][17][18][19] and other diabetes or metabolic syndrome (defined as MS) [9,[20][21][22][23][24][25][26]. However, their dosages, bacterial strains and time of therapy were short of homogeneity.…”

Section: Introductionmentioning

confidence: 99%

Multiple effects of probiotics on different types of diabetes: a systematic review and meta-analysis of randomized, placebo-controlled trials

Wang

Juan

et al. 2017

Journal of Pediatric Endocrinology and Metabolism

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Background: A systematic review and meta-analysis was designed to evaluate the effect of probiotics on diabetes and its associated risk factors. Methods: We systematically searched the Cochrane Library, PubMed, EMBASE and Web of Science to June 2016. We also hand-searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Our primary outcome variables included glucose, glycated hemoglobin (HbA 1c ) and insulin. The pooled standardized mean difference was used to compare the effect between the probiotics and controlled groups, and the pooled standardized mean difference effect size with a 95% confidence interval (CI) was estimated using a random-effect model. Heterogeneity was assessed with Cochran's Q and Higgins I 2 tests. Two reviewers assessed trial quality and extracted data independently. The analysis and bias for each included study was performed and assessed using Review Manager 5.2. Results: Eighteen randomized, placebo-controlled studies (n = 1056 participants, 527 consuming probiotics, 529 not consuming probiotics) were included for analysis. Comparing the probiotics groups with the control groups, there were statistically significant pooled standardized

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Different types of dietary advice for women with gestational diabetes mellitus

Han

Middleton

Shepherd

et al. 2017

Cochrane Database of Systematic Reviews

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BackgroundDietary advice is the main strategy for managing gestational diabetes mellitus (GDM). It remains unclear what type of advice is best. ObjectivesTo assess the effects of different types of dietary advice for women with GDM for improving health outcomes for women and babies. Search methodsWe searched Cochrane Pregnancy and Childbirth's Trials Register (8 March 2016), PSANZ's Trials Registry (22 March 2016) and reference lists of retrieved studies. Selection criteriaRandomised controlled trials comparing the effects of different types of dietary advice for women with GDM. Data collection and analysisTwo authors independently assessed study eligibility, risk of bias, and extracted data. Evidence quality for two comparisons was assessed using GRADE, for primary outcomes for the mother: hypertensive disorders of pregnancy; caesarean section; type 2 diabetes mellitus; and child: large-for-gestational age; perinatal mortality; neonatal mortality or morbidity composite; neurosensory disability; secondary outcomes for the mother: induction of labour; perineal trauma; postnatal depression; postnatal weight retention or return to prepregnancy weight; and child: hypoglycaemia; childhood/adulthood adiposity; childhood/adulthood type 2 diabetes mellitus. Main resultsIn this update, we included 19 trials randomising 1398 women with GDM, at an overall unclear to moderate risk of bias (10 comparisons). For outcomes assessed using GRADE, downgrading was based on study limitations, imprecision and inconsistency. Where no findings are reported below for primary outcomes or pre-specified GRADE outcomes, no data were provided by included trials.

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Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial

Cited by 109 publications

References 38 publications

Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Probiotics on Metabolic Outcomes in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Multiple effects of probiotics on different types of diabetes: a systematic review and meta-analysis of randomized, placebo-controlled trials

Different types of dietary advice for women with gestational diabetes mellitus

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