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Gestational Diabetes Mellitus and Diet: A Systematic Review and Meta-analysis of Randomized Controlled Trials Examining the Impact of Modified Dietary Interventions on Maternal Glucose Control and Neonatal Birth Weight.
Yamamoto, Jennifer M; Kellett, Joanne E; Balsells, Montserrat; García-Patterson, Apolonia; Hadar, Eran; Solà, Ivan; Gich, Ignasi; van der Beek, Eline M; Castañeda-Gutiérrez, Eurídice; Heinonen, Seppo; Hod, Moshe; Laitinen, Kirsi; Olsen, Sjurdur F; Poston, Lucilla; Rueda, Ricardo; Rust, Petra; van Lieshout, Lilou; Schelkle, Bettina; Murphy, Helen R; Corcoy, Rosa.
Afiliação
  • Yamamoto JM; Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Canada.
  • Kellett JE; Norfolk and Norwich University Hospitals, Norfolk, U.K.
  • Balsells M; Department of Endocrinology and Nutrition, Hospital Mútua de Terrassa, Terrassa, Spain.
  • García-Patterson A; Institute of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • Hadar E; Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel.
  • Solà I; Institute of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • Gich I; Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • van der Beek EM; CIBER Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.
  • Castañeda-Gutiérrez E; CIBER Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.
  • Heinonen S; Department of Epidemiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • Hod M; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra, Spain.
  • Laitinen K; Nutricia Research, Utrecht, the Netherlands.
  • Olsen SF; Department of Pediatrics, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
  • Poston L; Nestlé Research Center, Lausanne, Switzerland.
  • Rueda R; Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.
  • Rust P; Helsinki University Hospital, Helsinki, Finland.
  • van Lieshout L; Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel.
  • Schelkle B; Institute of Biomedicine, University of Turku, Turku, Finland.
  • Murphy HR; Turku University Hospital, Turku, Finland.
  • Corcoy R; Statens Serum Institut, Copenhagen, Denmark.
Diabetes Care ; 41(7): 1346-1361, 2018 07.
Article em En | MEDLINE | ID: mdl-29934478
OBJECTIVE: Medical nutrition therapy is a mainstay of gestational diabetes mellitus (GDM) treatment. However, data are limited regarding the optimal diet for achieving euglycemia and improved perinatal outcomes. This study aims to investigate whether modified dietary interventions are associated with improved glycemia and/or improved birth weight outcomes in women with GDM when compared with control dietary interventions. RESEARCH DESIGN AND METHODS: Data from published randomized controlled trials that reported on dietary components, maternal glycemia, and birth weight were gathered from 12 databases. Data were extracted in duplicate using prespecified forms. RESULTS: From 2,269 records screened, 18 randomized controlled trials involving 1,151 women were included. Pooled analysis demonstrated that for modified dietary interventions when compared with control subjects, there was a larger decrease in fasting and postprandial glucose (-4.07 mg/dL [95% CI -7.58, -0.57]; P = 0.02 and -7.78 mg/dL [95% CI -12.27, -3.29]; P = 0.0007, respectively) and a lower need for medication treatment (relative risk 0.65 [95% CI 0.47, 0.88]; P = 0.006). For neonatal outcomes, analysis of 16 randomized controlled trials including 841 participants showed that modified dietary interventions were associated with lower infant birth weight (-170.62 g [95% CI -333.64, -7.60]; P = 0.04) and less macrosomia (relative risk 0.49 [95% CI 0.27, 0.88]; P = 0.02). The quality of evidence for these outcomes was low to very low. Baseline differences between groups in postprandial glucose may have influenced glucose-related outcomes. As well, relatively small numbers of study participants limit between-diet comparison. CONCLUSIONS: Modified dietary interventions favorably influenced outcomes related to maternal glycemia and birth weight. This indicates that there is room for improvement in usual dietary advice for women with GDM.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peso ao Nascer / Glicemia / Macrossomia Fetal / Ensaios Clínicos Controlados Aleatórios como Assunto / Diabetes Gestacional Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Limite: Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peso ao Nascer / Glicemia / Macrossomia Fetal / Ensaios Clínicos Controlados Aleatórios como Assunto / Diabetes Gestacional Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Limite: Female / Humans / Newborn / Pregnancy Idioma: En Ano de publicação: 2018 Tipo de documento: Article