Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
Department of Nutrition, Nanjing Maternal and Child Health Hospital, Nanjing 210009, China.
Nutrients. 2022 Nov 2;14(21):4626. doi: 10.3390/nu14214626.
The efficacy of different types and doses of dietary fiber supplementation in the treatment of gestational diabetes (GDM) remains controversial. The purpose of this study is to investigate the effect of dietary fiber on blood glucose control in pregnant women with gestational diabetes mellitus, and further observe the effect on their blood lipids and pregnancy outcomes. We searched on Web of Science, PubMed, Embase, Scopus, and Cochrane, and included several articles on additional fortification with dietary fiber for gestational diabetes interventions. This meta-analysis included 8 trials. We found that additional dietary fiber supplements significantly reduced fasting glucose (Hedges’g = −0.3; 95% CI [−0.49, −0.1]), two-hour postprandial glucose (Hedges’g = −0.69; 95% CI [−0.88, −0.51]), glycated hemoglobin (Hedges’g = −0.5; 95% CI [−0.68, −0.31]), TC (Hedges’g = −0.44; 95% CI [−0.69, −0.19]), TG (Hedges’g = −0.3; 95% CI [−0.4, −0.2]) and LDL-C (Hedges’g = −0.48; 95% CI [−0.63, −0.33]). It also significantly reduced preterm delivery (Hedges’g = 0.4, 95% CI [0.190.84]), cesarean delivery (Hedges’g = 0.6; 95% CI [0.370.97]), fetal distress (Hedges’g = 0.51; 95% CI [0.221.19]), and neonatal weight (Hedges’g = −0.17; 95% CI [−0.27−0.07]). In a subgroup analysis comparing dietary fiber type and dose, insoluble dietary fiber was more effective than soluble dietary fiber in reducing fasting glucose (Hedges’g = −0.44; 95% CI [−0.52, −0.35]). ≥12 g fiber per day may be more effective in improving glycemic lipid and pregnancy outcomes than <12 g/day, but the difference was not statistically significant. In conclusion, our meta-analysis showed that dietary fiber supplementation significantly improved glycolipid metabolism and pregnancy outcomes in gestational diabetes. Dietary fiber may be considered adjunctive therapy for gestational diabetes, and an additional supplement with insoluble dietary fiber is more recommended for those with poor fasting glucose. However, more high-quality studies are needed on the further effect of fiber type and the dose-effect relationship.
膳食纤维补充剂的类型和剂量对治疗妊娠期糖尿病（GDM）的疗效仍存在争议。本研究旨在探讨膳食纤维对妊娠期糖尿病患者血糖控制的影响，并进一步观察其对血脂和妊娠结局的影响。我们在 Web of Science、PubMed、Embase、Scopus 和 Cochrane 上进行了检索，并纳入了一些关于膳食纤维额外强化治疗妊娠期糖尿病的干预措施的文章。这项荟萃分析包括 8 项试验。我们发现，额外的膳食纤维补充剂可显著降低空腹血糖（Hedges'g = －0.3；95％CI [－0.49，－0.1]）、餐后 2 小时血糖（Hedges'g = －0.69；95％CI [－0.88，－0.51]）、糖化血红蛋白（Hedges'g = －0.5；95％CI [－0.68，－0.31]）、TC（Hedges'g = －0.44；95％CI [－0.69，－0.19]）、TG（Hedges'g = －0.3；95％CI [－0.4，－0.2]）和 LDL-C（Hedges'g = －0.48；95％CI [－0.63，－0.33]）。它还显著降低了早产（Hedges'g = 0.4，95％CI [0.190.84]）、剖宫产（Hedges'g = 0.6；95％CI [0.370.97]）、胎儿窘迫（Hedges'g = 0.51；95％CI [0.221.19]）和新生儿体重（Hedges'g = －0.17；95％CI [－0.27－0.07]）。在比较膳食纤维类型和剂量的亚组分析中，不溶性膳食纤维在降低空腹血糖方面比可溶性膳食纤维更有效（Hedges'g = －0.44；95％CI [－0.52，－0.35]）。每天摄入≥12 g 膳食纤维可能比每天摄入＜12 g 更有利于改善血糖、血脂和妊娠结局，但差异无统计学意义。总之，本荟萃分析表明，膳食纤维补充剂可显著改善妊娠期糖尿病患者的糖脂代谢和妊娠结局。膳食纤维可作为妊娠期糖尿病的辅助治疗方法，对于空腹血糖不佳的患者，建议额外补充不溶性膳食纤维。然而，还需要更多高质量的研究来进一步探讨纤维类型的影响和剂量-效应关系。
