Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
Nutr Diet. 2019 Apr;76(2):211-232. doi: 10.1111/1747-0080.12524. Epub 2019 Apr 1.
Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM.
The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta-analysis and assessment of quality of evidence.
Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre-enriched diets were associated with a reduction in fasting plasma glucose, 2-hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk.
In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre-enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies.
国际上，华裔女性是妊娠糖尿病（GDM）高危人群之一。本系统评价旨在确定哪些饮食干预策略对改善 GDM 华裔女性的血糖控制和妊娠结局有效。
本研究方案已在 PROSPERO（CRD42016043585）注册。检索了 8 个英文数据库和 4 个中文数据库，纳入了针对 GDM 华裔女性的饮食干预的随机对照试验和队列研究。使用 Review Manager 5.3 和 GRADE 标准进行荟萃分析和证据质量评估。
纳入的 29 项研究共纳入 3944 名女性。与标准治疗相比，低升糖指数（GI）饮食、低升糖负荷（GL）饮食和富含纤维的饮食与空腹血糖、2 小时血糖和 HbA1c 的降低以及新生儿结局的改善相关。低 GL 饮食与剖宫产风险降低相关。
对于 GDM 的华裔女性，低 GI 饮食、低 GL 饮食和富含纤维的饮食与血糖控制和妊娠结局的改善相关。鉴于这三种饮食之间缺乏直接比较，未来需要进行直接比较试验来确定最佳的饮食干预策略。
