Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China.
Department of International Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China.
J Diabetes Res. 2020 Feb 23;2020:6062478. doi: 10.1155/2020/6062478. eCollection 2020.
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and nutritional therapy is the basis of GDM treatment. However, the effects of different forms of nutritional supplementation on improving gestational diabetes are uncertain.
We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM.
We conducted a literature search using PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the differences between different nutritional strategies in women with GDM. The Cochrane tool was used to assess the risk of bias. Pairwise meta-analysis and network meta-analysis were used to compare and rank the effects of nutritional strategies for the improvement of fasting plasma glucose (FPG), serum insulin, and homeostasis model assessment-insulin resistance (HOMA-IR).
We included thirteen RCTs with a total of 754 participants. Compared with placebo, omega-3, magnesium, vitamin D, zinc, and probiotics were more beneficial for improving FPG, serum insulin, and HOMA-IR. Network analysis showed that vitamin D supplementation was superior to omega-3 (-3.64 mg/dL, 95% CI: -5.77 to -1.51), zinc (-5.71 mg/dL, 95% CI: -10.19 to -1.23), probiotics (-6.76 mg/dL, 95% CI: -10.02 to -3.50), and placebo (-12.13 mg/dL, 95% CI: -14.55 to -9.70) for improving FPG. Magnesium supplementation was more beneficial for decreasing serum insulin compared with probiotics (-5.10 IU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 IU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 .
Vitamin D supplementation significantly reduced FPG and regulated HOMA-IR. Magnesium supplementation was superior in decreasing serum insulin than supplementation with other nutrients. Nutrient supplementation seemed to have an effect on glucose homeostasis maintenance in patients with GDM and may be considered an adjunctive therapy.
妊娠糖尿病（GDM）是妊娠最常见的并发症之一，营养治疗是 GDM 治疗的基础。然而，不同形式的营养补充对改善妊娠糖尿病的效果尚不确定。
我们进行了一项网状荟萃分析，以评估不同营养素补充对 GDM 妇女葡萄糖代谢的影响。
我们使用 PubMed、EMBASE 和 Cochrane 图书馆进行文献检索，以确定比较 GDM 妇女中不同营养策略差异的随机对照试验（RCT）。使用 Cochrane 工具评估偏倚风险。采用成对荟萃分析和网状荟萃分析比较和排名营养策略对改善空腹血糖（FPG）、血清胰岛素和稳态模型评估-胰岛素抵抗（HOMA-IR）的效果。
我们纳入了 13 项 RCT，共 754 名参与者。与安慰剂相比，ω-3、镁、维生素 D、锌和益生菌更有利于改善 FPG、血清胰岛素和 HOMA-IR。网络分析显示，维生素 D 补充优于 ω-3（-3.64mg/dL，95%CI：-5.77 至-1.51）、锌（-5.71mg/dL，95%CI：-10.19 至-1.23）、益生菌（-6.76mg/dL，95%CI：-10.02 至-3.50）和安慰剂（-12.13mg/dL，95%CI：-14.55 至-9.70）改善 FPG。与益生菌（-5.10IU/mL，95%CI：-9.32 至-0.88）和安慰剂（-7.80IU/mL，95%CI：-9.32 至-0.88）相比，镁补充更有利于降低血清胰岛素。
维生素 D 补充可显著降低 FPG 并调节 HOMA-IR。镁补充在降低血清胰岛素方面优于其他营养素补充。营养补充似乎对 GDM 患者的血糖稳态维持有一定作用，可考虑作为辅助治疗。
