Download PDF
Semin Reprod Med 2020; 38(06): 389-397
DOI: 10.1055/s-0040-1722316
Review Article

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

Nina Meloncelli 
1   Nutrition and Dietetics, Sunshine Coast University Hospital, Birtinya, Australia
2   Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
,
Shelley A. Wilkinson 
3   School of Human Movements and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
4   Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
,
Susan de Jersey 
2   Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
5   Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Gestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

Keywords

gestational diabetes mellitus - medical nutrition therapy - pregnancy - diet


Publication History

Article published online:
11 January 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Farrar D. Hyperglycemia in pregnancy: prevalence, impact, and management challenges. Int J Womens Health 2016; 8: 519-527
    CrossrefPubMedGoogle Scholar
  • 2 Metzger BE, Lowe LP, Dyer AR. et al; HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358 (19) 1991-2002
    CrossrefPubMedGoogle Scholar
  • 3 Song C, Lyu Y, Li C. et al. Long-term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta-analysis with more than 2 million women. Obes Rev 2018; 19 (03) 421-429
    CrossrefPubMedGoogle Scholar
  • 4 Dabelea D. The predisposition to obesity and diabetes in offspring of diabetic mothers. Diabetes Care 2007; 30 (Suppl. 02) S169-S174
    CrossrefPubMedGoogle Scholar
  • 5 Lucovnik M, Steblovnik L, Verdenik I, Premru-Srsen T, Tomazic M, Tul N. Changes in perinatal outcomes after implementation of IADPSG criteria for screening and diagnosis of gestational diabetes mellitus: a national survey. Int J Gynaecol Obstet 2020; 149 (01) 88-92
    CrossrefPubMedGoogle Scholar
  • 6 Meloncelli NJL, Barnett AG, DʼEmden M, De Jersey SJ. Effects of changing diagnostic criteria for gestational diabetes mellitus in Queensland, Australia. Obstet Gynecol 2020; 135 (05) 1215-1221
    CrossrefPubMedGoogle Scholar
  • 7 Agarwal MM. Gestational diabetes mellitus: an update on the current international diagnostic criteria. World J Diabetes 2015; 6 (06) 782-791
    CrossrefPubMedGoogle Scholar
  • 8 Metzger BE, Buchanan TA, Coustan DR. et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 2007; 30 (Suppl. 02) S251-S260
    CrossrefPubMedGoogle Scholar
  • 9 Moreno-Castilla C, Mauricio D, Hernandez M. Role of medical nutrition therapy in the management of gestational diabetes mellitus. Curr Diab Rep 2016; 16 (04) 22
    CrossrefPubMedGoogle Scholar
  • 10 Reader DM. Medical nutrition therapy and lifestyle interventions. Diabetes Care 2007; 30 (Suppl. 02) S188-S193
    CrossrefPubMedGoogle Scholar
  • 11 Tsirou E, Grammatikopoulou MG, Theodoridis X. et al. Guidelines for medical nutrition therapy in gestational diabetes mellitus: systematic review and critical appraisal. J Acad Nutr Diet 2019; 119 (08) 1320-1339
    CrossrefPubMedGoogle Scholar
  • 12 Garduño-Alanis A, Torres-Mejía G, Nava-Díaz P. et al. Association between a medical nutrition therapy program and eating behavior with gestational weight gain in women with diabetes. J Matern Fetal Neonatal Med 2020; 33 (24) 4049-4054
    CrossrefPubMedGoogle Scholar
  • 13 Han S, Crowther CA, Middleton P, Heatley E. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev 2013; (03) CD009275
    PubMedGoogle Scholar
  • 14 Koning SH, Hoogenberg K, Lutgers HL, van den Berg PP, Wolffenbuttel BH. Gestational diabetes mellitus: current knowledge and unmet needs. J Diabetes 2016; 8 (06) 770-781
    CrossrefPubMedGoogle Scholar
  • 15 Martis R, Crowther CA, Shepherd E, Alsweiler J, Downie MR, Brown J. Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev 2018; 8: CD012327
    PubMedGoogle Scholar
  • 16 Morisset AS, Côté JA, Michaud A. et al. Dietary intakes in the nutritional management of gestational diabetes mellitus. Can J Diet Pract Res 2014; 75 (02) 64-71
    CrossrefPubMedGoogle Scholar
  • 17 Mustad VA, Huynh DTT, López-Pedrosa JM, Campoy C, Rueda R. The role of dietary carbohydrates in gestational diabetes. Nutrients 2020; 12 (02) 12
    CrossrefPubMedGoogle Scholar
  • 18 Thomaz de Lima H, Lopes Rosado E, Ribeiro Neves PA, Corrêa Monteiro Machado R, Mello de Oliveira L, Saunders C. Systematic review; nutritional therapy in gestational diabetes mellitus. Nutr Hosp 2013; 28 (06) 1806-1814
    PubMedGoogle Scholar
  • 19 Moreno-Castilla C, Hernandez M, Bergua M. et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus: a randomized controlled trial. Diabetes Care 2013; 36 (08) 2233-2238
    CrossrefPubMedGoogle Scholar
  • 20 Rasmussen L, Christensen ML, Poulsen CW. et al. Effect of high versus low carbohydrate intake in the morning on glycemic variability and glycemic control measured by continuous blood glucose monitoring in women with gestational diabetes mellitus—a randomized crossover study. Nutrients 2020; 12 (02) 12
    CrossrefPubMedGoogle Scholar
  • 21 Hernandez TL, Van Pelt RE, Anderson MA. et al. Women with gestational diabetes mellitus randomized to a higher-complex carbohydrate/low-fat diet manifest lower adipose tissue insulin resistance, inflammation, glucose, and free fatty acids: a pilot study. Diabetes Care 2016; 39 (01) 39-42
    CrossrefPubMedGoogle Scholar
  • 22 Hernandez TL, Van Pelt RE, Anderson MA. et al. A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diabetes Care 2014; 37 (05) 1254-1262
    CrossrefPubMedGoogle Scholar
  • 23 Louie JC, Brand-Miller JC, Moses RG. Carbohydrates, glycemic index, and pregnancy outcomes in gestational diabetes. Curr Diab Rep 2013; 13 (01) 6-11
    CrossrefPubMedGoogle Scholar
  • 24 Louie JC, Markovic TP, Perera N. et al. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care 2011; 34 (11) 2341-2346
    CrossrefPubMedGoogle Scholar
  • 25 Louie JC, Markovic TP, Ross GP, Foote D, Brand-Miller JC. Higher glycemic load diet is associated with poorer nutrient intake in women with gestational diabetes mellitus. Nutr Res 2013; 33 (04) 259-265
    CrossrefPubMedGoogle Scholar
  • 26 Moses RG, Barker M, Winter M, Petocz P, Brand-Miller JC. Can a low-glycemic index diet reduce the need for insulin in gestational diabetes mellitus? A randomized trial. Diabetes Care 2009; 32 (06) 996-1000
    CrossrefPubMedGoogle Scholar
  • 27 Perichart-Perera O, Balas-Nakash M, Rodríguez-Cano A, Legorreta-Legorreta J, Parra-Covarrubias A, Vadillo-Ortega F. Low glycemic index carbohydrates versus all types of carbohydrates for treating diabetes in pregnancy: a randomized clinical trial to evaluate the effect of glycemic control. Int J Endocrinol 2012; 2012: 296017
    CrossrefPubMedGoogle Scholar
  • 28 Shyam S, Arshad F, Abdul Ghani R. et al. Low glycaemic index diets improve glucose tolerance and body weight in women with previous history of gestational diabetes: a six months randomized trial. Nutr J 2013; 12: 68
    CrossrefPubMedGoogle Scholar
  • 29 Augustin LSA, Kendall CWC, Jenkins DJA. et al. Glycemic index, glycemic load and glycemic response: an International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015; 25 (09) 795-815
    CrossrefPubMedGoogle Scholar
  • 30 Zeevi D, Korem T, Zmora N. et al. Personalized nutrition by prediction of glycemic responses. Cell 2015; 163 (05) 1079-1094
    CrossrefPubMedGoogle Scholar
  • 31 Dallanora S, Medeiros de Souza Y, Deon RG. et al. Do probiotics effectively ameliorate glycemic control during gestational diabetes? A systematic review. Arch Gynecol Obstet 2018; 298 (03) 477-485
    CrossrefPubMedGoogle Scholar
  • 32 Jafarnejad S, Saremi S, Jafarnejad F, Arab A. Effects of a multispecies probiotic mixture on glycemic control and inflammatory status in women with gestational diabetes: a randomized controlled clinical trial. J Nutr Metab 2016; 2016: 5190846
    CrossrefPubMedGoogle Scholar
  • 33 Bassols J, Serino M, Carreras-Badosa G. et al. Gestational diabetes is associated with changes in placental microbiota and microbiome. Pediatr Res 2016; 80 (06) 777-784
    CrossrefPubMedGoogle Scholar
  • 34 Crusell MKW, Hansen TH, Nielsen T. et al. Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum. Microbiome 2018; 6 (01) 89
    CrossrefPubMedGoogle Scholar
  • 35 Ferrocino I, Ponzo V, Gambino R. et al. Changes in the gut microbiota composition during pregnancy in patients with gestational diabetes mellitus (GDM). Sci Rep 2018; 8 (01) 12216
    CrossrefPubMedGoogle Scholar
  • 36 Ponzo V, Fedele D, Goitre I. et al. Diet-gut microbiota interactions and gestational diabetes mellitus (GDM). Nutrients 2019; 11 (02) 11
    CrossrefPubMedGoogle Scholar
  • 37 García-Patterson A, Balsells M, Yamamoto JM. et al. Usual dietary treatment of gestational diabetes mellitus assessed after control diet in randomized controlled trials: subanalysis of a systematic review and meta-analysis. Acta Diabetol 2019; 56 (02) 237-240
    CrossrefPubMedGoogle Scholar
  • 38 Falavigna M, Schmidt MI, Trujillo J. et al. Effectiveness of gestational diabetes treatment: a systematic review with quality of evidence assessment. Diabetes Res Clin Pract 2012; 98 (03) 396-405
    CrossrefPubMedGoogle Scholar
  • 39 Heindel JJ, Vandenberg LN. Developmental origins of health and disease: a paradigm for understanding disease cause and prevention. Curr Opin Pediatr 2015; 27 (02) 248-253
    CrossrefPubMedGoogle Scholar
  • 40 Fleming TP, Watkins AJ, Velazquez MA. et al. Origins of lifetime health around the time of conception: causes and consequences. Lancet 2018; 391 (10132): 1842-1852
    CrossrefPubMedGoogle Scholar
  • 41 World Health Organization. Promoting Optimal Fetal Development. 2006
    PubMedGoogle Scholar
  • 42 Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 2006; 184 (02) 56-59
    CrossrefPubMedGoogle Scholar
  • 43 Goldstein RF, Abell SK, Ranasinha S. et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA 2017; 317 (21) 2207-2225
    CrossrefPubMedGoogle Scholar
  • 44 Darnton-Hill I, Nishida C, James WP. A life course approach to diet, nutrition and the prevention of chronic diseases. Public Health Nutr 2004; 7 (1A): 101-121
    CrossrefPubMedGoogle Scholar
  • 45 U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th ed.. Accessed October 2020 at: https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/
    Google Scholar
  • 46 National Health and Medical Research Council Healthy eating during your pregnancy. Accessed October 2020 at: www.eatforhealth.gov.au
    PubMedGoogle Scholar
  • 47 British Dietetic Association. Pregnancy and diet. 2016 . Accessed October 2020 at: https://www.bda.uk.com/resource/pregnancy-diet.html
    PubMedGoogle Scholar
  • 48 Government of Canada. Canada's Food Guides: Healthy Eating When Pregnant and Breastfeeding. 2020 . Accessed October 2020 at: https://food-guide.canada.ca/en/tips-for-healthy-eating/pregnant-breastfeeding/
    PubMedGoogle Scholar
  • 49 National Health and Medical Research Council Australian Dietary Guidelines - Providing the scientific evidence for healthier Australian Diets. . Accessed October 2020 at: https://www.nhmrc.gov.au/about-us/publications/australian-dietary-guidelines
    PubMedGoogle Scholar
  • 50 Agriculture USDoHaHSaUSDo. The science behind healthy eating patterns. 2015 . Accessed October 2020 at: https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/chapter-1/the-science-behind-healthy-eating-patterns/
    PubMedGoogle Scholar
  • 51 Butte NF, Wong WW, Treuth MS, Ellis KJ, O'Brian Smith E. Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr 2004; 79 (06) 1078-1087
    CrossrefPubMedGoogle Scholar
  • 52 Institute of Medicine, National Research Council Committee to Reexamine IOMPWG. The National Academies Collection: reports funded by National Institutes of Health. In: Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; 2009
    Google Scholar
  • 53 Duarte-Gardea MO, Gonzales-Pacheco DM, Reader DM. et al. Academy of Nutrition and Dietetics Gestational Diabetes Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2018; 118 (09) 1719-1742
    CrossrefPubMedGoogle Scholar
  • 54 Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol 2010; 115 (03) 597-604
    CrossrefPubMedGoogle Scholar
  • 55 Lewandowska M, Więckowska B, Sajdak S. Pre-pregnancy obesity, excessive gestational weight gain, and the risk of pregnancy-induced hypertension and gestational diabetes mellitus. J Clin Med 2020; 9 (06) 1980
    CrossrefPubMedGoogle Scholar
  • 56 Kennelly MA, McAuliffe FM. Prediction and prevention of gestational diabetes: an update of recent literature. Eur J Obstet Gynecol Reprod Biol 2016; 202: 92-98
    CrossrefPubMedGoogle Scholar
  • 57 Barnes RA, Wong T, Ross GP. et al. Excessive weight gain before and during gestational diabetes mellitus management: What is the impact?. Diabetes Care 2020; 43 (01) 74-81
    CrossrefPubMedGoogle Scholar
  • 58 Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol 2008; 112 (05) 1015-1022
    CrossrefPubMedGoogle Scholar
  • 59 Barnes RA, Wong T, Ross GP. et al. A novel validated model for the prediction of insulin therapy initiation and adverse perinatal outcomes in women with gestational diabetes mellitus. Diabetologia 2016; 59 (11) 2331-2338
    CrossrefPubMedGoogle Scholar
  • 60 Meloncelli N, Barnett A, Pelly F, de Jersey S. Diagnosis and management practices for gestational diabetes mellitus in Australia: cross-sectional survey of the multidisciplinary team. Aust N Z J Obstet Gynaecol 2019; 59 (02) 208-214
    CrossrefPubMedGoogle Scholar
  • 61 Kevat DAS, Sinha AK, McLean AG. Lower treatment targets for gestational diabetes: is lower really better?. Med J Aust 2014; 201 (04) 204-207
    CrossrefPubMedGoogle Scholar
  • 62 Landon MB, Spong CY, Thom E. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361 (14) 1339-1348
    CrossrefPubMedGoogle Scholar
  • 63 Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352 (24) 2477-2486
    CrossrefPubMedGoogle Scholar
  • 64 Cade TJ, Polyakov A, Brennecke SP. Implications of the introduction of new criteria for the diagnosis of gestational diabetes: a health outcome and cost of care analysis. BMJ Open 2019; 9 (01) e023293
    CrossrefPubMedGoogle Scholar
  • 65 Abell SK, Boyle JA, Earnest A. et al. Impact of different glycaemic treatment targets on pregnancy outcomes in gestational diabetes. Diabet Med 2019; 36 (02) 177-183
    CrossrefPubMedGoogle Scholar
  • 66 Hernandez TL, Friedman JE, Van Pelt RE, Barbour LA. Patterns of glycemia in normal pregnancy: should the current therapeutic targets be challenged?. Diabetes Care 2011; 34 (07) 1660-1668
    CrossrefPubMedGoogle Scholar
  • 67 Institute of Medicine. Dietary Reference Intakes: Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: National Academy Press; 2005
    Google Scholar
  • 68 Mahajan A, Donovan LE, Vallee R, Yamamoto JM. Evidenced-based nutrition for gestational diabetes mellitus. Curr Diab Rep 2019; 19 (10) 94
    CrossrefPubMedGoogle Scholar
  • 69 Romon M, Nuttens M-C, Vambergue A. et al. Higher carbohydrate intake is associated with decreased incidence of newborn macrosomia in women with gestational diabetes. J Am Diet Assoc 2001; 101 (08) 897-902
    CrossrefPubMedGoogle Scholar
  • 70 Hui AL, Sevenhuysen G, Harvey D, Salamon E. Food choice decision-making by women with gestational diabetes. Can J Diabetes 2014; 38 (01) 26-31
    CrossrefPubMedGoogle Scholar
  • 71 Hui AL, Sevenhuysen G, Harvey D, Salamon E. Stress and anxiety in women with gestational diabetes during dietary management. Diabetes Educ 2014; 40 (05) 668-677
    CrossrefPubMedGoogle Scholar
  • 72 Lawson EJ, Rajaram S. A transformed pregnancy: the psychosocial consequences of gestational diabetes. Sociol Health Illn 1994; 16: 536-562
    CrossrefPubMedGoogle Scholar
  • 73 Barrett HL, Dekker Nitert M, McIntyre HD, Callaway LK. Normalizing metabolism in diabetic pregnancy: is it time to target lipids?. Diabetes Care 2014; 37 (05) 1484-1493
    CrossrefPubMedGoogle Scholar
  • 74 Hernandez TL. Carbohydrate content in the GDM diet: two views: view 1: Nutrition therapy in gestational diabetes: the case for complex carbohydrates. Diabetes Spectr 2016; 29 (02) 82-88
    CrossrefPubMedGoogle Scholar
  • 75 Bowman SA, Spence JT. A comparison of low-carbohydrate vs. high-carbohydrate diets: energy restriction, nutrient quality and correlation to body mass index. J Am Coll Nutr 2002; 21 (03) 268-274
    CrossrefPubMedGoogle Scholar
  • 76 Elidottir AS, Halldorsson TI, Gunnarsdottir I, Ramel A. Dietary intake and cardiovascular risk factors in Icelanders following voluntarily a low carbohydrate diet. PLoS One 2016; 11 (08) e0156655
    CrossrefPubMedGoogle Scholar
  • 77 Calton JB. Prevalence of micronutrient deficiency in popular diet plans. J Int Soc Sports Nutr 2010; 7: 24
    CrossrefPubMedGoogle Scholar
  • 78 Asemi Z, Samimi M, Tabassi Z, Sabihi SS, Esmaillzadeh A. A randomized controlled clinical trial investigating the effect of DASH diet on insulin resistance, inflammation, and oxidative stress in gestational diabetes. Nutrition 2013; 29 (04) 619-624
    CrossrefPubMedGoogle Scholar
  • 79 Barbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care 2007; 30 (Suppl. 02) S112-S119
    CrossrefPubMedGoogle Scholar
  • 80 Hernandez TL, Brand-Miller JC. Nutrition therapy in gestational diabetes mellitus: time to move forward. Diabetes Care 2018; 41 (07) 1343-1345
    CrossrefPubMedGoogle Scholar
  • 81 Farhanah AS, Barakatun Nisak MY, Zalilah MS. et al. Low-glycaemic index diet to improve dietary intake among women with gestational diabetes mellitus. Pertanika J Sci Technol 2017; 25: 31-42
    PubMedGoogle Scholar
  • 82 Wei J, Heng W, Gao J. Effects of low glycemic index diets on gestational diabetes mellitus: a meta-analysis of randomized controlled clinical trials. Medicine (Baltimore) 2016; 95 (22) e3792
    CrossrefPubMedGoogle Scholar
  • 83 Asemi Z, Samimi M, Tabassi Z, Esmaillzadeh A. The effect of DASH diet on pregnancy outcomes in gestational diabetes: a randomized controlled clinical trial. Eur J Clin Nutr 2014; 68 (04) 490-495
    CrossrefPubMedGoogle Scholar
  • 84 Hu ZG, Tan RS, Jin D, Li W, Zhou XY. A low glycemic index staple diet reduces postprandial glucose values in Asian women with gestational diabetes mellitus. J Investig Med 2014; 62 (08) 975-979
    CrossrefPubMedGoogle Scholar
  • 85 Ma WJ, Huang ZH, Huang BX. et al. Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: a randomized control trial. Public Health Nutr 2015; 18 (08) 1506-1513
    CrossrefPubMedGoogle Scholar
  • 86 Yamamoto JM, Kellett JE, Balsells M. et al. 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. Diabetes Care 2018; 41 (07) 1346-1361
    CrossrefPubMedGoogle Scholar
  • 87 Tieu J, Shepherd E, Middleton P, Crowther CA. Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 2017; 1: CD006674
    Google Scholar
  • 88 Wan CS, Nankervis A, Teede H, Aroni R. Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis. Nutr Diet 2019; 76 (02) 211-232
    CrossrefPubMedGoogle Scholar
  • 89 Babadi M, Khorshidi A, Aghadavood E. et al. The effects of probiotic supplementation on genetic and metabolic profiles in patients with gestational diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Probiotics Antimicrob Proteins 2019; 11 (04) 1227-1235
    CrossrefPubMedGoogle Scholar
  • 90 Karamali M, Dadkhah F, Sadrkhanlou M. et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016; 42 (04) 234-241
    CrossrefPubMedGoogle Scholar
  • 91 Ye G, Zhang L, Wang M. et al. The gut microbiota in women suffering from gestational diabetes mellitus with the failure of glycemic control by lifestyle modification. J Diabetes Res 2019; 2019: 6081248
    PubMedGoogle Scholar
  • 92 Assaf-Balut C, Garcia de la Torre N, Durán A. et al. Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study. BMJ Open Diabetes Res Care 2018; 6 (01) e000550
    CrossrefPubMedGoogle Scholar
  • 93 Grant SM, Wolever TMS, O'Connor DL, Nisenbaum R, Josse RG. Effect of a low glycaemic index diet on blood glucose in women with gestational hyperglycaemia. Diabetes Res Clin Pract 2011; 91 (01) 15-22
    CrossrefPubMedGoogle Scholar
  • 94 Assaf-Balut C, García de la Torre N, Durán A. et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): a randomized controlled trial: the St. Carlos GDM prevention study. PLoS One 2017; 12 (10) e0185873
    CrossrefPubMedGoogle Scholar
  • 95 Barbour LA, Hernandez TL. Maternal non-glycemic contributors to fetal growth in obesity and gestational diabetes: spotlight on lipids. Curr Diab Rep 2018; 18 (06) 37
    CrossrefPubMedGoogle Scholar
  • 96 Bomba-Opon D, Wielgos M, Szymanska M, Bablok L. Effects of free fatty acids on the course of gestational diabetes mellitus. Neuroendocrinol Lett 2006; 27 (1-2): 277-280
    PubMedGoogle Scholar
  • 97 Wang H, Jiang H, Yang L, Zhang M. Impacts of dietary fat changes on pregnant women with gestational diabetes mellitus: a randomized controlled study. Asia Pac J Clin Nutr 2015; 24 (01) 58-64
    PubMedGoogle Scholar
  • 98 Nolan CJ. Improved glucose tolerance in gestational diabetic women on a low fat, high unrefined carbohydrate diet. Aust N Z J Obstet Gynaecol 1984; 24 (03) 174-177
    CrossrefPubMedGoogle Scholar
  • 99 Asemi Z, Tabassi Z, Samimi M, Fahiminejad T, Esmaillzadeh A. Favourable effects of the dietary approaches to stop hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial. Br J Nutr 2013; 109 (11) 2024-2030
    CrossrefPubMedGoogle Scholar
  • 100 Lauszus FF, Rasmussen OW, Henriksen JE. et al. Effect of a high monounsaturated fatty acid diet on blood pressure and glucose metabolism in women with gestational diabetes mellitus. Eur J Clin Nutr 2001; 55 (06) 436-443
    CrossrefPubMedGoogle Scholar
  • 101 Reader D, Splett P, Gunderson EP. Diabetes Care and Education Dietetic Practice Group. Impact of gestational diabetes mellitus nutrition practice guidelines implemented by registered dietitians on pregnancy outcomes. J Am Diet Assoc 2006; 106 (09) 1426-1433
    CrossrefPubMedGoogle Scholar