Children's Hospital Los Angeles, 4641 Sunset Blvd, Los Angeles, CA, 90027, USA.
Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand.
Curr Diab Rep. 2019 Aug 1;19(9):73. doi: 10.1007/s11892-019-1199-1.
Gestational diabetes mellitus (GDM) is a common pregnancy complication that has short- and long-term health implications for both the mother and child. While lifestyle modifications, insulin therapy, and oral agents such as metformin are effective, they can be difficult to adhere to, and there remain concerns over long-term effects of oral agents on the infant. Further, GDM has no proven preventive strategies, which could be more effective than treatment postdiagnosis. Nutritional supplements are an appealing, potentially safer, and better tolerated alternative to pharmaceuticals to treat and/or prevent GDM. Here, we review the existing evidence for nutritional supplementation for treatment and prevention of GDM.
There is limited evidence that myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics might be beneficial for the prevention or treatment of GDM. There are very few studies for each nutrient, and the existing studies tend to have few participants. Where multiple studies of a nutrient exist, often those studies were conducted within the same country, limiting the generalizability of the findings, or alternatively there was no consensus across findings. There is limited evidence that nutritional supplementation of myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics could improve glycemic control or prevent GDM. Our understanding is constrained by the small number of studies, small sample sizes in most studies, and by lack of consistency across findings. Further large, high-quality, randomized controlled trials are required to determine the efficacy of nutritional supplements to treat or prevent GDM.
妊娠期糖尿病(GDM)是一种常见的妊娠并发症,对母亲和儿童的短期和长期健康都有影响。虽然生活方式的改变、胰岛素治疗和二甲双胍等口服药物是有效的,但它们很难被遵守,而且人们仍然担心口服药物对婴儿的长期影响。此外,GDM 没有经过验证的预防策略,这可能比诊断后治疗更有效。营养补充剂是一种有吸引力的、潜在更安全、更能被患者耐受的替代药物,可以用于治疗和/或预防 GDM。在这里,我们回顾了营养补充剂治疗和预防 GDM 的现有证据。
有有限的证据表明肌醇、维生素 D 和 B6、镁、硒、锌、脂肪酸和益生菌可能对预防或治疗 GDM 有益。每种营养素的研究都很少,现有的研究往往参与者也很少。对于一种营养素的多项研究,这些研究通常是在同一个国家进行的,限制了研究结果的普遍性,或者研究结果之间没有共识。有有限的证据表明,营养补充肌醇、维生素 D 和 B6、镁、硒、锌、脂肪酸和益生菌可以改善血糖控制或预防 GDM。由于研究数量少、大多数研究的样本量小,以及研究结果缺乏一致性,我们对这些问题的理解受到限制。需要进一步开展大型、高质量、随机对照试验,以确定营养补充剂治疗或预防 GDM 的疗效。