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Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis.

Journal of diabetes research
January 1, 2020
Shixiao Jin et al. (7 authors)
Journal ArticleMeta-AnalysisSystematic ReviewHuman Study
Extracted Claims (14)
InterventionDirectionEndpointPopulationDosageImpactClaim #
omega-3
decrease
FPG, serum insulin, and HOMA-IR
women with GDM
-
were more beneficial for improving
#1
magnesium
decrease
FPG, serum insulin, and HOMA-IR
women with GDM
-
were more beneficial for improving
#2
vitamin D
decrease
FPG, serum insulin, and HOMA-IR
women with GDM
-
were more beneficial for improving
#3
zinc
decrease
FPG, serum insulin, and HOMA-IR
women with GDM
-
were more beneficial for improving
#4
probiotics
decrease
FPG, serum insulin, and HOMA-IR
women with GDM
-
were more beneficial for improving
#5
vitamin D supplementation
decrease
FPG
women with GDM
-3.64 mg/dL
was superior to omega-3
#6
vitamin D supplementation
decrease
FPG
women with GDM
-5.71 mg/dL
was superior to zinc
#7
vitamin D supplementation
decrease
FPG
women with GDM
-6.76 mg/dL
was superior to probiotics
#8
vitamin D supplementation
decrease
FPG
women with GDM
-12.13 mg/dL
was superior to placebo
#9
magnesium supplementation
decrease
serum insulin
women with GDM
-5.10
was more beneficial for decreasing
#10
vitamin D supplementation
decrease
FPG
patients with GDM
-
significantly reduced
#11
vitamin D supplementation
decrease
HOMA-IR
patients with GDM
-
regulated
#12
magnesium supplementation
decrease
serum insulin
patients with GDM
-
was superior in decreasing
#13
Nutrient supplementation
neutral
glucose homeostasis maintenance
patients with GDM
-
seemed to have an effect on
#14
Abstract

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  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.

Medical Subject Headings (MeSH)
Blood GlucoseDiabetes, GestationalDietary SupplementsFemaleHumansInsulinInsulin ResistanceNetwork Meta-AnalysisPregnancyRandomized Controlled Trials as Topic
Study Links
Citation Metrics
Total Citations18
Citations/Year3.6
Relative Citation Ratio1.49
NIH Percentile64.9%
Research Impact Scores
APT Score0.50
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