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  1. Fulltext Diet and Pre-Intervention Washout Modifies the Effects of Probiotics on Gestational Diabetes Mellitus: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Hasain Z, Che Roos NA, Rahmat F, Mustapa M, Raja Ali RA, Mokhtar NM
    Nutrients, 2021 Aug 30;13(9).
    PMID: 34578921 DOI: 10.3390/nu13093045
    Dynamic interactions among gestational diabetes mellitus (GDM), gut microbiota, inflammation, oxidative stress, and probiotics are increasingly acknowledged. This meta-analysis aimed to summarize the effects of probiotics in GDM, focusing on lifestyle intervention and pre-intervention washout, in addition to metabolic, inflammation, oxidative stress, and pregnancy outcomes. Three electronic databases (i.e., PubMed, Scopus, and CENTRAL) were searched from inception until October 2020. A meta-analysis was performed, and the effect sizes were reported as either mean differences or odds ratios with 95% confidence intervals. Altogether, 10 randomized controlled trials enrolling 594 participants were included. The meta-analysis indicated that probiotics supplementation effectively reduced fasting plasma glucose by 3.10 mg/dL, and subgroup analyses suggested that the duration of intervention, number of species, pre-intervention washout period, and dietary intervention may determine the effects of probiotics. Probiotics also reduced the level of inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and malondialdehyde), incidence of macrosomia, and newborn hospitalization. In conclusion, this meta-analysis suggests that probiotics may have positive effects on metabolic, inflammation, oxidative stress, and neonatal outcomes in women with GDM. Additionally, diet and pre-intervention washout may modify the effects of probiotics. Future studies are warranted on a larger scale to ascertain the clinical significance.
    Matched MeSH terms: Diabetes, Gestational/therapy*
  2. Return for postpartum oral glucose tolerance test following gestational diabetes mellitus
    Mohd Suan MA
    Asia Pac J Public Health, 2015 Sep;27(6):601-9.
    PMID: 26041835 DOI: 10.1177/1010539515588943
    A cross-sectional study was conducted to assess the prevalence and characteristics of women who received a postpartum oral glucose tolerance test and to examine barriers as reported by women who failed to return for the test. Data were collected using a mobile phone-based short messaging service. Only 352 (81.9%) women returned for the test. Women who failed to return for the test were younger (30.1 vs 32.1, P = .003) and did not have a previous history of gestational diabetes (93.6% vs 84.9%, P = .043) compared to women who returned for the test. The commonest reasons given for not returning for the test was "Still waiting for the appointment date for the test" (37.2%), "had family/health problems" (11.5%), and "busy/no time" (10.3%). Flexible time for the test, active involvement from health care staff, and strengthening continuous care system were among the interventions needed to improve the return rate for this screening test.
    Matched MeSH terms: Diabetes, Gestational/therapy*
  3. Fulltext Serum Glucose-Dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) in association with the Risk of Gestational Diabetes: A Prospective Case-Control Study
    Mosavat M, Omar SZ, Jamalpour S, Tan PC
    J Diabetes Res, 2020;2020:9072492.
    PMID: 32090124 DOI: 10.1155/2020/9072492
    Background: Defects in incretin have been shown to be related to the pathogenesis of type 2 diabetes. Whether such a deficiency happens in gestational diabetes mellitus (GDM) remains to be confirmed. We assessed the association of fasting glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) with GDM. We also studied the longitudinal circulation of these peptides during pregnancy and afterwards.

    Methods: 53 women with GDM (30 managed with diet only (GDM-diet) and 23 treated with insulin (GDM-insulin)) and 43 pregnant women with normal glucose tolerance (NGDM) were studied, with GIP and GLP-1 levels measured at 24-28 weeks (E1), prior (E2) and after (E3) delivery, and postpuerperium (E4).

    Results: Basal GIP was shown to be low in GDM groups compared to NGDM in E1, and in E4 for GDM-diet. GLP-1 was low in GDM groups during pregnancy and afterwards. At E1, serum GIP and GLP-1 were inversely associated with GDM and participants with lower levels of GIP (<0.23 ng/mL) and GLP-1 (<0.38 ng/mL) had a 6 (95% CI 2.5-14.5)- and 7.6 (95% CI 3.0-19.1)-fold higher risk of developing GDM compared with the higher level, respectively. In the postpuerperium, when there is a drop in β-cell function, participants with previous GDM (pGDM) presented lower GLP-1 (in both GDM subgroups) and lower GIP in GDM-diet subgroup compared to controls.

    Conclusion: There is an independent, inverse association between fasting incretins and higher risk of GDM. Furthermore, lowered levels of these peptides may play an important role in the abnormality of glucose regulation following pregnancy.

    Matched MeSH terms: Diabetes, Gestational/therapy
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