scholarly journals Dietary Intakes and Dietary Quality during Pregnancy in Women with and without Gestational Diabetes Mellitus—A Norwegian Longitudinal Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1811 ◽  
Author(s):  
Trude Elvebakk ◽  
Ingrid L. Mostad ◽  
Siv Mørkved ◽  
Kjell Å. Salvesen ◽  
Signe N. Stafne

Gestational diabetes mellitus (GDM) is associated with maternal diet, however, findings are inconsistent. The aims of the present study were to assess whether intakes of foods and beverages during pregnancy differed between women who developed GDM and non-GDM women, and to compare dietary intakes with dietary recommendations of pregnancy. This is a nested case-control study within a randomized controlled trial. Women with complete measurements of a 75 g oral glucose tolerance test (OGTT) at 18–22 and 32–36 weeks gestation were included in the cohort (n = 702). Women were diagnosed for GDM according to the simplified International Association of Diabetes and Pregnancy Study Group criteria at 32–36 weeks (GDM women: n = 40; non-GDM women: n = 662). Dietary data (food frequency questionnaire) was collected at both time points and compared between GDM and non-GDM women. Variability in OGTT values was assessed in a general linear model. Marginal differences between GDM and non-GDM women in intakes of food groups were found. No associations were found between dietary variables and OGTT values. Not all dietary recommendations were followed in the cohort, with frequently reported alcohol consumption giving largest cause for concern. This study did not find dietary differences that could help explain why 40 women developed GDM.

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e055314
Author(s):  
Ibrahim Ibrahim ◽  
Hala Abdullahi ◽  
Yassin Fagier ◽  
Osman Ortashi ◽  
Annalisa Terrangera ◽  
...  

IntroductionGestational diabetes mellitus (GDM) affects 23.6% of Qatari women and is associated with maternal and perinatal morbidity and long-term risk of developing type 2 diabetes. A number of challenges exist with current interventions, including non-compliance with dietary advice, the reluctance of mothers to ingest metformin tablets or use insulin injections. These challenges highlight the importance of pursuing evidence-based prevention strategies. Myo-inositol is readily available as an US Food and Drug Administration-approved food supplement with emerging but limited evidence suggesting it may be beneficial in reducing the incidence of GDM. Further studies, such as this one, from different ethnic contexts and with differing risk factors, are urgently needed to assess myo-inositol effects on maternal and neonatal outcomes.Methods and analysisThis study is a prospective, randomised, double-blinded, placebo controlled clinical trial to either myo-inositol supplementation or placebo.We plan to enrol 640 pregnant women attending antenatal care at Sidra Medicine, Doha, Qatar, 320 in each arm. All participants will complete at least 12 weeks of supplementation prior to undertaking the Oral Glucose Tolerance Test at 24–28 weeks. The daily use of the trial supplementation will continue until the end of pregnancy. All outcome measures will be collected from the electronic medical records.Ethics and disseminationEthical approval for the study was obtained on 12 April 2021 from Sidra Medicine (IRB number 1538656). Results of the primary trial outcome and secondary endpoints will be submitted for publication in a peer-reviewed journal.Trial registration numberProspectively registered on 26 May 2021. Registration number ISRCTN16448440 (ISRCTN registry).


2017 ◽  
Vol 117 (6) ◽  
pp. 804-813 ◽  
Author(s):  
Kristin L. Wickens ◽  
Christine A. Barthow ◽  
Rinki Murphy ◽  
Peter R. Abels ◽  
Robyn M. Maude ◽  
...  

AbstractThe study aims to assess whether supplementation with the probiotic Lactobacillus rhamnosus HN001 (HN001) can reduce the prevalence of gestational diabetes mellitus (GDM). A double-blind, randomised, placebo-controlled parallel trial was conducted in New Zealand (NZ) (Wellington and Auckland). Pregnant women with a personal or partner history of atopic disease were randomised at 14–16 weeks’ gestation to receive HN001 (6×109 colony-forming units) (n 212) or placebo (n 211) daily. GDM at 24–30 weeks was assessed using the definition of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (fasting plasma glucose ≥5·1 mmol/l, or 1 h post 75 g glucose level at ≥10 mmol/l or at 2 h ≥8·5 mmol/l) and NZ definition (fasting plasma glucose ≥5·5 mmol/l or 2 h post 75 g glucose at ≥9 mmol/l). All analyses were intention-to-treat. A total of 184 (87 %) women took HN001 and 189 (90 %) women took placebo. There was a trend towards lower relative rates (RR) of GDM (IADPSG definition) in the HN001 group, 0·59 (95 % CI 0·32, 1·08) (P=0·08). HN001 was associated with lower rates of GDM in women aged ≥35 years (RR 0·31; 95 % CI 0·12, 0·81, P=0·009) and women with a history of GDM (RR 0·00; 95 % CI 0·00, 0·66, P=0·004). These rates did not differ significantly from those of women without these characteristics. Using the NZ definition, GDM prevalence was significantly lower in the HN001 group, 2·1 % (95 % CI 0·6, 5·2), v. 6·5 % (95 % CI 3·5, 10·9) in the placebo group (P=0·03). HN001 supplementation from 14 to 16 weeks’ gestation may reduce GDM prevalence, particularly among older women and those with previous GDM.


2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.


2019 ◽  
Vol 89 (1-2) ◽  
pp. 37-44 ◽  
Author(s):  
Parvin Mirmiran ◽  
Somayeh Hosseinpour-Niazi ◽  
Lida Moghaddam-Banaem ◽  
Minoor Lamyian ◽  
Azita Goshtasebi ◽  
...  

Abstract. Background: The aim of this study was to investigate the association of intakes of fruit, vegetable and dairy with gestational diabetes mellitus (GDM). Methods: This prospective study was conducted over a 17 month period, on a random sample of pregnant women (n = 1026), aged 18–45 y, in their first half of pregnancy, attending prenatal clinics in five hospitals’ affiliated to universities of medical sciences in different districts of Tehran, Iran. Dietary intakes were assessed during gestational age ≤ 6 weeks using a 168-item validated semi-quantitative food frequency questionnaire. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3-h oral glucose tolerance test. Diagnosis of GDM was based on criteria set by the American Diabetes Association. Results: Of 1026 study participants, 71 had GDM, with a mean age and pre-pregnancy BMI of 26.7 ± 4.3 y and 25.4 ± 4.5 Kg/m2, respectively. High fruit and vegetable intakes were negatively associated with GDM risk. Compared with women who consumed < 2.1 servings/day, odds ratio (ORs) for those who consumed ≥ 4.9 servings/day was 0.44 (95% CI: 0.20–0.93), after adjustment for confounding factors. Fruit and vegetable intakes were significantly and inversely associated with the GDM; ORs (95% CIs) for GDM among participants with the highest, compared to the lowest quartiles were 0.48 (0.18–0.89) for fruit and 0.46 (0.22–0.99) for vegetables intake. No association was found between dairy products and GDM. Conclusions: Fruit and vegetable consumption in women of reproductive age have beneficial effects in the prevention of GDM.


Author(s):  
Sheema Yousuf

Background: Gestational Diabetes Mellitus (GDM) has now become one of the most common and important complication of pregnancy worldwide. There are conflicting results of various studies regarding the role of exercise in reducing the risk of GDM. Therefore, the aim of this study was to determine the effectiveness of exercise on prevention of gestational diabetes. Methods: It is a randomized controlled study directed in the obstetrics and gynecology outpatient clinic of Pakistan Institute of Medical Sciences (PIMS) hospital Islamabad beginning from 6 June 2016 to 5 December 2016 including 170 pregnant women satisfying the inclusion criteria. Group A received routine antenatal care while Group B included the pregnant women that were advised brisk walk for 30 minutes three days per week. At 24-28 week of pregnancy, 75gm oral glucose tolerance test (OGTT) was performed and International association for Diabetes in Pregnancy Study Group (IADPSG) and Hyperglycemia and adverse pregnancy outcome (HAPO) standards, determined GDM. Chi Square was applied for comparing GDM frequency and p value ≤0.05 was considered as significant. Results: The mean age of the patients was 28.08 ± 4.15 years and mean gestation of pregnancy was 17.18 ± 0.78 weeks. Gestational diabetes was seen in 08 (9.41%) patients of non-exercising group while in exercise group only 01 (1.18%) patient had GDM (p-value 0.016). Conclusion: Moderate exercise during pregnancy decreases the risk of gestational diabetes mellitus and is safe for the mother and the baby. However, more studies are needed to establish recommendations.


2019 ◽  
Vol 39 (8) ◽  
Author(s):  
Lihui Si ◽  
Ruixin Lin ◽  
Yan Jia ◽  
Wenwen Jian ◽  
Qing Yu ◽  
...  

AbstractObjectives: Lactobacillus bulgaricus may improve antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus (GDM).Methods: Black garlic was prepared with or without L. bulgaricus. Volatile and polysaccharides were analyzed by using LC-MS, Fourier Transform infrared (FTIR) and 13C nuclear magnetic resonance (NMR). The study design was parallel randomized controlled trial and 226 GDM patients were randomly assigned into BG (black garlic and L. bulgaricus) and CG (black garlic) groups, and allocation ratio was 1:1. The treatment duration was 40 weeks. Fasting blood glucose (FBG) and 1- and 2-h blood glucose (1hBG and 2hBG) after oral glucose tolerance test (OGTT) were detected. Antioxidant function of black garlic was determined by measuring plasma malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and total antioxidant capacity (T-AOC) in GDM patients. The comparison between two groups was made using two independent samples t test.Results: The intake of nutrients was similar between two groups (P>0.05). L. bulgaricus promoted the transformation of the glucopyranoside to glucofuranoside. L. bulgaricus increased the abilities of black garlic for scavenging hydroxyl radicals, 2,2′-azino-bis (3-ethylbenzenthiazoline-6-sulfonic) acid (ABTS) and DPPH free radicals. L. bulgaricus reduced the levels of FBG, 1hBG and 2hBG, and incidence of perinatal complications (P<0.01). Plasma MDA level in the BG group was lower than in the CG group, whereas the levels of SOD, GSH-PX and T-AOC in the BG group were higher than in the CG group (P<0.01).Conclusions: L. bulgaricus improves antioxidant capacity of black garlic in the prevention of GDM.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 574-574
Author(s):  
Huanzhuo Wang ◽  
Li Huang ◽  
Chunrong Zhong ◽  
Renjuan Chen ◽  
Xuezhen Zhou ◽  
...  

Abstract Objectives The overall plant-based diet index (PDI) has been demonstrated to be protective against type 2 diabetes (T2D) in the general population. Whether the PDI was linked to gestational diabetes mellitus (GDM) is unclear. We aimed to assess the association of the PDI with GDM incidence in Chinese pregnant women. Methods A total of 2099 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) were included in the present study. Dietary data were collected at 13–28 wks of pregnancy by using a validated semi-quantitative food frequency questionnaire (FFQ). Food groups including cereals, fruits, vegetables, nuts, beans, vegetable oil, dairy, eggs, meat, and fish, were ranked into quintiles and given positive (1–5 for plant food groups) or reverse (5–1 for animal food groups) scores. The PDI was obtained by summing the 10 food group scores, with a theoretical range of 10 to 50. GDM was diagnosed by the 75-g 2-h oral glucose tolerance test at 24–28 wks. Cubic-restricted spline function and logistic regression analyses were used to examine the association between the PDI during pregnancy and GDM. Results GDM was reported by 8.1% of the 2099 pregnancies. The PDI score ranged from 17 to 43 (theoretical range: 10–50), the mean (SD) was 30.2 (4.4). After adjusting for maternal age, ethnicity, education, income, parity, gravidity, family history of diabetes, total energy intake per day, and other pre-pregnancy information such as body mass index (BMI), smoking status, drinking status, exercise, and sleep quality, a linear association between the PDI and GDM risk was demonstrated by the restricted cubic splines (P for overall association = 0.024, P for nonlinearity = 0.370). Compared to the lowest quartile 1 of PDI, ORs (95% CI) were 0.91 (0.59, 1.42) for quartile 2, 0.91 (0.58, 1.41) for quartile 3, and 0.52 (0.30, 0.89) for quartiles 4 (P for trend = 0.040) in the adjusted model. Conclusions Our study suggests that higher PDI is associated with a substantially lower risk of developing GDM, which indicates that adopt plant-based diets during pregnancy could be an easy avenue to reduce GDM risk. Funding Sources Funding was received from the National Program on Basic Research Project of China (NO.2013FY114200) and the Fundamental Research Funds for the Central Universities (HUST2016YXZD040) for Nianhong Yang.


2017 ◽  
Vol 20 (1) ◽  
pp. 85-92
Author(s):  
Polina Viktorovna Popova ◽  
Aleksandra Sergeevna Tkachuk ◽  
Yana Alexeevna Bolotko ◽  
Andrey Sergeevich Gerasimov ◽  
Ksenia Alexandrovna Demidova ◽  
...  

Background. Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It can cause significant problems for the mother and offspring, such as caesarean delivery, birth trauma and the development of type 2 diabetes mellitus (T2DM) in the future. The identification and correction of modifiable risk factors for GDM will provide a possibility to prevent these complications. Aim. This study aimed to identify the most significant lifestyle parameters affecting the risk of developing GDM. Methods. The study included 680 pregnant women who underwent oral glucose tolerance test at 2432 weeks of pregnancy and responded to a questionnaire comprising the following sections stratified in a semi-quantitative manner: the consumption of major food groups and drinks and the amount of physical activity and smoking before and during pregnancy. A logistic regression analysis was performed to identify lifestyle parameters that influence GDM development. GDM was diagnosed according to the IADPSG criteria. Results. GDM was diagnosed in 266 women; the other 414 women formed the control group. The most significant dietary risk factor for developing GDM was the consumption of sausage(s), dried fruits and fresh fruits. Eating sausage(s) more than thrice a week during pregnancy increased the risk of developing GDM by 2.4 times [95% confidence interval (CI), 1.53.8; p 0.001] and so did the consumption of dried fruits more than thrice a week during pregnancy [odds ratio (OR), 6.5; 95% CI, 2.516.8; p 0.001)] compared with the risk of GDM by less consumption of these food groups. A regular consumption of fresh fruits more than 12 times a week during pregnancy reduced the risk of GDM (OR, 0.5; 95% CI, 0.30.8; p = 0.015). The habit of climbing at least four floors per day during pregnancy also reduced the risk of GDM (OR, 0.7; 95% CI, 0.51.0; p = 0.069). Conclusions. The recommendations for GDM prevention should include limiting the consumption of sausage(s) and dried fruits, increasing the consumption of fresh fruits and introducing regular physical activities, such as climbing stairs.


2019 ◽  
Vol 17 (01) ◽  
pp. 103-108 ◽  
Author(s):  
Kamana K.C. ◽  
Hua Zhang ◽  
Anju Vaidya

Background: Currently, most of the countries across the globe follow the International Association of the Diabetes and Pregnancy Study Groups criteria in the diagnosis of gestational diabetes mellitus, which is based on the analysis of Hyperglycemia and Adverse Pregnancy Outcome study. The International Association of the Diabetes and Pregnancy Study Groups criterion comes with its benefits and doubts. Although it has been adopted worldwide, diagnosis of gestational diabetes mellitus with single test and only one positive value has always been debated and is often criticized. This study aimed to assess if the participant with lesser degree of glucose intolerance increases the incidence of false positive diagnosis of gestational diabetes mellitus with 75gm Oral Glucose Tolerance Test based on International Association of the Diabetes and Pregnancy Study Groups criteria.Methods: This prospective, interventional study was conducted in outpatient department of a tertiary hospital of China over a period of 12 months. 48 patients who were diagnosed with gestational diabetes mellitus in 24-31 weeks of pregnancy by 75mg Oral Glucose Tolerance Test were selected via conventional sampling technique based on lesser degree (less severe, not in need of immediate medical attention) of glucose intolerance. These patients underwent second Oral Glucose Tolerance Test within 2-3 weeks of first test. Patients with normal 2nd Oral Glucose Tolerance Test were observed closely throughout their gestational period and compared with the control group.Results: The mean values of data of control and case group were compared and 37.5% of the patients failed to reproduce the same result with the second test and all of them having normal maternal and fetal outcome without any treatment of gestational diabetes mellitus (t-test, p=0.05).Conclusions: With International Association of the Diabetes and Pregnancy Study criteria, more patients with lesser degree of glucose intolerance have been falsely diagnosed and treated as gestational diabetes mellitus.Keywords: Gestational diabetes mellitus; international association of the diabetes and pregnancy study groups; Oral glucose tolerance test .


2021 ◽  
pp. 1-10
Author(s):  
Huanzhuo Wang ◽  
Li Huang ◽  
Lixia Lin ◽  
Xi Chen ◽  
Chunrong Zhong ◽  
...  

Abstract The high overall plant-based diet index (PDI) is considered to protect against type 2 diabetes in the general population. However, whether the PDI affects gestational diabetes mellitus (GDM) risk among pregnant women is still unclear. We evaluated the association between PDI and GDM risk based on a Chinese large prospective cohort – the Tongji Maternal and Child Health Cohort. Dietary data were collected at 13–28 weeks of pregnancy by a validated semi-quantitative FFQ. The PDI was obtained by assigning plant food groups positive scores while assigning animal food groups reverse scores. GDM was diagnosed by a 75 g 2-h oral glucose tolerance test at 24–28 weeks of gestation. Logistic regression models were fitted to estimate OR of GDM, with associated 95 % CI, comparing women in different PDI quartiles. Among the total 2099 participants, 169 (8·1 %) were diagnosed with GDM. The PDI ranged from 21·0 to 52·0 with a median of 36·0 (interquartile range (IQR) 33·0–39·0). After adjusting for social-demographic characteristics and lifestyle factors etc., the participants with the highest quartile of PDI were associated with 57 % reduced odds of GDM compared with women in the lowest quartile of PDI (adjusted OR 0·43; 95 % CI 0·24, 0·77; Pfor trend = 0·005). An IQR increment in PDI was associated with 29 % decreased odds of GDM (adjusted OR 0·71; 95 % CI 0·56, 0·90). Findings suggest that adopting a plant-based diet during pregnancy could reduce GDM risk among Chinese women, which may be valuable for dietary counselling during pregnancy.


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