Effects of Probiotics on Glycemic Control and Metabolic Parameters in Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis.

Enav Yefet, Liron Bar, Ido Izhaki, Rula Iskander, Manal Massalha, Johnny S Younis, Zohar Nachum

Journal: Nutrients 2023;15(7):1633

PMID: 37049473

Plain Language Summary

The prevalence of gestational diabetes is increasing worldwide. Gestational diabetes mellitus (GDM) increases obesity and future development of type 2 diabetes in mother and child. Previous research has looked at the beneficial effects of probiotics in reducing metabolic diseases, however, these specific benefits on women with GDM are not fully understood yet. This systematic review and meta-analysis of fourteen randomised controlled trials assessed the beneficial effects of probiotics on glycemic control and metabolic parameters in women with GDM. This study separately assessed probiotic bacterial strains such as Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus casei to understand their beneficial effects on metabolic parameters. This meta-analysis and systematic review suggest that probiotic supplementation could help improve glycemic control, insulin resistance and lipid levels in women diagnosed with GDM. All probiotic strains showed improvements in metabolic parameters when assessed separately. Further robust studies are required to assess the effect of probiotic supplementation on post- and pre-prandial glycemic control in women with GDM. Healthcare professionals can employ the results of this study to understand the therapeutic benefits of probiotics for improving GDM.

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 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 were used to assess heterogeneity.

RESULTS

Of the 843 papers retrieved, 14 ( = 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.

Address: Department of Obstetrics and Gynecology, Tzafon Medical Center, Poriya 1528001, Israel.; Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel.; Department of Evolutionary and Environmental Biology, University of Haifa, Haifa 3498838, Israel.; Department of Obstetrics and Gynecology, Emek Medical Center, Afula 1834111, Israel.; Rappaport Faculty of Medicine, Technion, Haifa 3200003, Israel.

DOI: 10.3390/nu15071633

Patient Centred Factor

Mediators: Probiotics

Physical Environment

Infectious Agents

Clinical Imbalances

Hormonal Gastro-intestinal

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Diet

Nutrition Evidence Keywords

Insulin resistance Obesity Probiotics Triglycerides Glucose Lactobacillus Gestational diabetes mellitus Total cholesterol Bifidobacterium Fasting serum glucose Lipid profile Glycemic control Very low-density lipoprotein Metabolic parameters Fasting serum insulin Neonatal birth weight

Bioactive Substances

Probiotics

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/diabetesmedicines.html

Miscellaneous:

https://assays.cancer.gov/CPTAC-1496

MeSH Terms: Pregnancy, Infant, Newborn, Female, Humans, Diabetes, Gestational, Birth Weight, Glycemic Control, Blood Glucose, Probiotics, Dietary Supplements, Insulin Resistance, Triglycerides, Insulins