The Gut Microbiota in Women Suffering from Gestational Diabetes Mellitus with the Failure of Glycemic Control by Lifestyle Modification

Abstract

Gestational diabetes mellitus (GDM) is prevalent worldwide, leading to a high risk of significant morbidity for both the mother and offspring with complications. Increasing evidences suggest that gut microbiota plays a role in the pathogenesis of GDM. Lifestyle modification is the cornerstones of GDM treatment. However, a number of patients whose blood glucose is not controlled by lifestyle modification still require exogenous insulin to control blood glucose. No observational study is available about the relationship between the gut microbiota in GDM patients and lifestyle modifications. Thus, we investigated the differences in gut microbiota between GDM patients with successful glycemic control (GDM1) and failure of glycemic control (GDM2) by lifestyle modifications. We sequenced the V3-V4 regions of 16S ribosomal ribonucleic acid (rRNA) gene from stool samples of 52 singleton pregnant women with 24–28 weeks of gestation. Our results showed that Blautia, Eubacterium_hallii_group, and Faecalibacterium in the gut microbiota showed significant differences among the normoglycemic mother, GDM1, and GDM2 groups, respectively. The combined diagnostic performance of Blautia, Eubacterium_hallii_group, and Faecalibacterium in differentiating GDM2 from GDM was considered as the most reasonable identification indicator. Gut bacteria may participate in the pathological development of GDM2 through the peroxisome proliferator-activated receptor (PPAR) signaling pathway. These results indicated that Blautia, Eubacterium_hallii_group, and Faecalibacterium had important characteristic changes in the gut microbiota of women with GDM2.

High levels of fucosylation and sialylation of milk N‐glycans from mothers with gestational diabetes mellitus alter the offspring gut microbiome and immune balance in mice

“…For example, previous studies have shown that newborns of mothers with GDM have gut microbiomes containing decreased abundance of bacterial genera such as Lactobacillus and Bifidobacterium spp. 43,44 In the present study, Lactobacillus spp. were also found to be relatively less abundant in the gut microbiome of offspring fed by GDM mice.…”

Alterations in Gut Microbiota of Gestational Diabetes Patients During the First Trimester of Pregnancy

“…Specific differences in gut microbiota between GDM patients and normoglycemic pregnant women were reported by several recent studies (Kuang et al, 2017;Mokkala et al, 2017;Cortez et al, 2018;Crusell et al, 2018;Wang et al, 2018a;Ye and Zhang, 2019). Increased abundance of Klebsiella variicola (Kuang et al, 2017), Ruminococcus, Prevotella (Cortez et al, 2018), Desulfovibrio, Rothia (Crusell et al, 2018), Fusobacterium (Wang et al, 2018a), Blautia, Eubacterium hallii group (Ye and Zhang, 2019), and reduced richness of Bifidobacterium spp., Eubacterium spp. (Kuang et al, 2017), Bacteroides, Parabacteroides, Dialister, Akkermansia (Cortez et al, 2018), Marvinbryantia, Anaerosporobacter (Crusell et al, 2018), and Faecalibacterium (Wang et al, 2018a;Ye and Zhang, 2019) in the gut were reported in GDM patients compared to normoglycemic controls.…”

“…Gut microbiota changes significantly during gestation (Koren et al, 2012) and may contribute to metabolic dysfunction during pregnancy, like GDM (Lv et al, 2018). Specific differences in gut microbiota between GDM patients and normoglycemic pregnant women were reported by several recent studies (Kuang et al, 2017;Mokkala et al, 2017;Cortez et al, 2018;Crusell et al, 2018;Wang et al, 2018a;Ye and Zhang, 2019). Increased abundance of Klebsiella variicola (Kuang et al, 2017), Ruminococcus, Prevotella (Cortez et al, 2018), Desulfovibrio, Rothia (Crusell et al, 2018), Fusobacterium (Wang et al, 2018a), Blautia, Eubacterium hallii group (Ye and Zhang, 2019), and reduced richness of Bifidobacterium spp., Eubacterium spp.…”

“…Increased abundance of Klebsiella variicola (Kuang et al, 2017), Ruminococcus, Prevotella (Cortez et al, 2018), Desulfovibrio, Rothia (Crusell et al, 2018), Fusobacterium (Wang et al, 2018a), Blautia, Eubacterium hallii group (Ye and Zhang, 2019), and reduced richness of Bifidobacterium spp., Eubacterium spp. (Kuang et al, 2017), Bacteroides, Parabacteroides, Dialister, Akkermansia (Cortez et al, 2018), Marvinbryantia, Anaerosporobacter (Crusell et al, 2018), and Faecalibacterium (Wang et al, 2018a;Ye and Zhang, 2019) in the gut were reported in GDM patients compared to normoglycemic controls. The only study that focused on changes in gut microbiota preceding diagnosis of GDM (15 of the total 75 overweight/obese women developed GDM) demonstrated that increased proliferation of the Ruminococcaceae family in the gut was associated with a higher potential of developing GDM (Mokkala et al, 2017).…”

Gut Microbiota and Gestational Diabetes Mellitus: A Review of Host-Gut Microbiota Interactions and Their Therapeutic Potential

“…For instance, Faecalibacterium was inversely associated with fasting blood sugar (FBS), while OTUs assigned to Akkermansia were associated with lower insulin sensitivity. In addition, Bacteroides and Sutterella were associated with hs-CRP and CRP levels, respectively (Crusell et al, 2018;Ferrocino et al, 2018;Ye et al, 2019). Nonetheless, the association between gut microbiota and inflammation, as well as the risk for GDM, is scarce.…”