Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis
Background. 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. Objective. We conducted...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/6062478 |
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| author | Shixiao Jin Liyan Sha Jianli Dong Jing Yi Yang Liu Zhongxian Guo Bing Hu |
| author_facet | Shixiao Jin Liyan Sha Jianli Dong Jing Yi Yang Liu Zhongxian Guo Bing Hu |
| author_sort | Shixiao Jin |
| collection | DOAJ |
| description | Background. 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. Objective. We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. Methods. 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). Results. 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 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL; 95% CI-11.95, -3.65). Vitamin D was more effective than probiotics (-0.99, 95% CI: -1.84 to -0.14) and placebo (-1.80, 95% CI: -2.45 to -1.16) for improving HOMA-IR. Conclusion. 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. |
| format | Article |
| id | doaj-art-850438a1b687444bb46cde878bb3d53e |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-850438a1b687444bb46cde878bb3d53e2025-02-03T01:25:17ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/60624786062478Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-AnalysisShixiao Jin0Liyan Sha1Jianli Dong2Jing Yi3Yang Liu4Zhongxian Guo5Bing Hu6Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of International Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaDepartment of Gynaecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, ChinaBackground. 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. Objective. We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. Methods. 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). Results. 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 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL; 95% CI-11.95, -3.65). Vitamin D was more effective than probiotics (-0.99, 95% CI: -1.84 to -0.14) and placebo (-1.80, 95% CI: -2.45 to -1.16) for improving HOMA-IR. Conclusion. 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.http://dx.doi.org/10.1155/2020/6062478 |
| spellingShingle | Shixiao Jin Liyan Sha Jianli Dong Jing Yi Yang Liu Zhongxian Guo Bing Hu Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis Journal of Diabetes Research |
| title | Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis |
| title_full | Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis |
| title_fullStr | Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis |
| title_full_unstemmed | Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis |
| title_short | Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis |
| title_sort | effects of nutritional strategies on glucose homeostasis in gestational diabetes mellitus a systematic review and network meta analysis |
| url | http://dx.doi.org/10.1155/2020/6062478 |
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