Dietary Interventions, Lifestyle Changes, and Dietary Supplements in Preventing Gestational Diabetes Mellitus

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute’s methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.

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Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes

Clinical Nursing Studies ◽

10.5430/cns.v9n1p15 ◽

2020 ◽

Vol 9 (1) ◽

pp. 15

Author(s):

Enas Sabry Fathy Elbeltagy ◽

Nahed Fikry Hassan Khedr ◽

Nadia Youssef Ahmed Abd-Ella

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antenatal Care ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Lifestyle Changes ◽

Neonatal Complications ◽

Pregnancy And Childbirth ◽

Routine Antenatal Care

Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.

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Designing to enhance experiences through mobile-based applications for gestational diabetes mellitus

Journal of Design Business & Society ◽

10.1386/dbs_00014_1 ◽

2020 ◽

Vol 6 (2) ◽

pp. 259-277 ◽

Cited By ~ 1

Author(s):

Miranda Phillips ◽

Lindsay Page ◽

Karla Straker ◽

Erez Nusem

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Mobile Applications ◽

Community Support ◽

Dietary Interventions ◽

Future Design ◽

Design Considerations ◽

Barriers And Challenges ◽

Care Support

Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes in Australia, with the needs, barriers and challenges of women managing GDM being well recognized in the literature. Despite these recent advances in knowledge, mobile-based offerings designed to assist women with their management do not holistically address users’ needs. This study therefore aims to answer how the features and functionalities of a mobile-based application could be designed to better address GDM patient needs. We undertook a co-design session with four GDM stakeholders and identified eleven overarching issues across four main themes that encapsulate the requirements of women with GDM: (1) tracking and monitoring, (2) physical activity, (3) community support and (4) dietary interventions. The results were synthesized into key design considerations for the future design of mobile applications in the GDM context. These considerations include unobtrusive care, support through connection, increasing capability and personalization of information. Each consideration is accompanied by design recommendations for features and functionalities to be implemented in future app developments.

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A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-024 ◽

2007 ◽

Vol 32 (3) ◽

pp. 596-601 ◽

Cited By ~ 133

Author(s):

Raul Artal ◽

Rosemary B. Catanzaro ◽

Jeffrey A. Gavard ◽

Dorothea J. Mostello ◽

Joann C. Friganza

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Lifestyle Changes ◽

Obese Women ◽

Office Visits ◽

Maternal Weight ◽

Obese Subjects ◽

Adverse Pregnancy

Objective: This study assessed whether a weight-gain restriction regimen, with or without exercise, would impact glycemic control, pregnancy outcome, and total pregnancy weight gain in obese subjects with gestational diabetes mellitus (GDM). A total of 96 subjects with GDM met the inclusion criteria and were sequentially recruited, with 39 subjects self-enrolled in the exercise and diet (ED) group, and the remaining 57 subjects self-enrolled in the diet (D) group owing to contraindications or a lack of personal preference to exercise. All patients were provided a eucaloric or hypocaloric consistent carbohydrate meal plan and instructed in the self-monitoring of blood glucose. In addition, all ED subjects were prescribed an exercise routine equivalent to a 60% symptom-limited VO2 max. Subjects were followed at weekly or biweekly office visits. Results showed maternal weight and body mass index (35.2 ± 7.2 (ED) vs. 33.5 ± 9.2 (D)) at study entry as well as number of weeks into the study (7.7 ± 5.7 (ED) vs. 9.4 ± 4.7 (D)) were similar in both the ED and D groups. Weight gain per week was significantly lower in the ED group than in the D group (0.1 ± 0.4 kg vs. 0.3 ± 0.4 kg; p < 0.05). Subjects (either ED or D) who gained weight had a higher percentage of macrosomic infants than those subjects who lost weight or had no weight change during pregnancy. Other pregnancy and fetal outcomes such as complications, gestational age at delivery, and rate of cesarean delivery were similar in both groups. Conclusions of this study were that caloric restriction and exercise result in limited weight gain in obese subjects with GDM, less macrosomic neonates, and no adverse pregnancy outcomes. Pregnancy is an ideal time for behaviour modification, and this intervention may also help promote long-term healthy lifestyle changes.

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Diet-Gut Microbiota Interactions and Gestational Diabetes Mellitus (GDM)

Nutrients ◽

10.3390/nu11020330 ◽

2019 ◽

Vol 11 (2) ◽

pp. 330 ◽

Cited By ~ 18

Author(s):

Valentina Ponzo ◽

Debora Fedele ◽

Ilaria Goitre ◽

Filomena Leone ◽

Antonela Lezo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gut Microbiota ◽

Gestational Diabetes Mellitus ◽

Current Knowledge ◽

Nutritional Therapy ◽

Dietary Interventions ◽

Few Data ◽

Gut Microbiota Composition ◽

In Pregnancy

Medical nutritional therapy is the first-line approach in managing gestational diabetes mellitus (GDM). Diet is also a powerful modulator of the gut microbiota, whose impact on insulin resistance and the inflammatory response in the host are well known. Changes in the gut microbiota composition have been described in pregnancies either before the onset of GDM or after its diagnosis. The possible modulation of the gut microbiota by dietary interventions in pregnancy is a topic of emerging interest, in consideration of the potential effects on maternal and consequently neonatal health. To date, very few data from observational studies are available about the associations between diet and the gut microbiota in pregnancy complicated by GDM. In this review, we analyzed the available data and discussed the current knowledge about diet manipulation in order to shape the gut microbiota in pregnancy.

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Prevention of gestational diabetes in pregnant women with risk factors for gestational diabetes: a systematic review and meta-analysis of randomised trials

Obstetric Medicine ◽

10.1177/1753495x15576673 ◽

2015 ◽

Vol 8 (2) ◽

pp. 68-85 ◽

Cited By ~ 10

Author(s):

P Madhuvrata ◽

Gemma Govinden ◽

R Bustani ◽

S Song ◽

TA Farrell

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Standard Care ◽

Dietary Intervention ◽

Gestational Hypertension ◽

Meta Analysis ◽

Lifestyle Changes ◽

Randomised Trials

Background Gestational diabetes mellitus can be defined as ‘glucose intolerance or hyperglycaemia with onset or first recognition during pregnancy.’ Objective The objective of our systematic review was to see if there was any intervention that could be used for primary prevention of gestational diabetes mellitus in women with risk factors for gestational diabetes mellitus. Search strategy Major databases were searched from 1966 to Aug 2012 without language restriction. Selection criteria Randomised trials comparing intervention with standard care in women with risk factors for gestational diabetes were included. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. The primary outcome assessed was the incidence of gestational diabetes. Data collection and analysis Data from included trials were extracted independently by two authors and analysed using Rev-Man 5. Main results A total of 2422 women from 14 randomised trials were included; which compared diet (four randomised trials), exercise (three randomised trials), lifestyle changes (five randomised trials) and metformin (two randomised trials) with standard care in women with risk factors for gestational diabetes mellitus. Dietary intervention was associated with a statistically significantly lower incidence of gestational diabetes (Odds ratio 0.33, 95% CI 0.14 to 0.76) and gestational hypertension (Odds ratio 0.28, 95% CI 0.09, 0.86) compared to standard care. There was no statistically significant difference in the incidence of gestational diabetes mellitus or in the secondary outcomes with exercise, lifestyle changes or metformin use compared to standard care. Conclusions The use of dietary intervention has shown a statistically significantly lower incidence of gestational diabetes mellitus and gestational hypertension compared to standard care in women with risk factors for gestational diabetes mellitus.

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Women’s Views on Their Diagnosis and Management for Borderline Gestational Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2015/209215 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Shanshan Han ◽

Philippa F. Middleton ◽

Tanya K. Bubner ◽

Caroline A. Crowther

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Lifestyle Change ◽

Lifestyle Changes ◽

Future Health ◽

Face To Face ◽

Diagnosis And Management ◽

Semistructured Interviews ◽

Women’S Views

Introduction. Little is known about women’s views relating to a diagnosis of borderline gestational diabetes mellitus (GDM) and the subsequent management. This study aimed to explore women’s experiences after being diagnosed with borderline GDM, their attitudes about treatment, and factors important to them for achieving any lifestyle changes.Methods. We conducted face-to-face, semistructured interviews with women diagnosed with borderline GDM.Results. A total of 22 women were interviewed. After a diagnosis of borderline GDM, 14 (64%) women reported not being concerned or worried. Management of borderline GDM was thought by 21 (95%) women to be very important or important. Eighteen (82%) women planned to improve their diet and/or exercise to manage their borderline GDM. The most frequently mentioned enabler for achieving intended lifestyle change was being more motivated to improve the health of their baby and/or themselves (15 women). The most frequent barrier was tiredness and/or being physically unwell (11 women).Conclusions. A diagnosis of borderline GDM caused some concern to one-third of women interviewed. The majority of women believed managing their borderline GDM was important and they planned to improve their lifestyle. Women’s own and their babies’ future health were powerful motivators for lifestyle change.

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Beliefs, Barriers, and Preferences of European Overweight Women to Adopt a Healthier Lifestyle in Pregnancy to Minimize Risk of Developing Gestational Diabetes Mellitus: An Explorative Study

Journal of Pregnancy ◽

10.1155/2016/3435791 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 13

Author(s):

Judith G. M. Jelsma ◽

Karen M. van Leeuwen ◽

Nicolette Oostdam ◽

Christopher Bunn ◽

David Simmons ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Lifestyle Modification ◽

Lifestyle Changes ◽

European Countries ◽

Perceived Barriers ◽

Chi Square ◽

Personal Risk

Introduction. We explored beliefs, perceived barriers, and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future lifestyle interventions in the prevention of gestational diabetes mellitus.Methods. An explorative mixed methods, two-staged study was conducted to gather information from pregnant European women (BMI≥25 kg/m2). In three European countries 21 interviews were conducted, followed by 71 questionnaires in six other European countries. Content analysis and descriptive and chi-square statistics were applied (p<0.05).Results. Women preferred to obtain detailed information about their personal risk. The health of their baby was a major motivating factor. Perceived barriers for physical activity included pregnancy-specific issues such as tiredness and experiencing physical complaints. Insufficient time was a barrier more frequently reported by women with children. Abstaining from snacking was identified as a challenge for the majority of women, especially for those without children. Women preferred to obtain support from their partner, as well as health professionals and valued flexible lifestyle programs.Conclusions. Healthcare professionals need to inform overweight pregnant women about their personal risk, discuss lifestyle modification, and assist in weight management. Lifestyle programs should be tailored to the individual, taking into account barriers experienced by overweight first-time mothers and multipara women.

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Lifestyle Changes and Long-Term Weight Gain in Women With and Without a History of Gestational Diabetes Mellitus: A Prospective Study of 54,062 Women in the Nurses' Health Study II

Diabetes Care ◽

10.2337/dc21-1692 ◽

2021 ◽

pp. dc211692

Author(s):

Jiaxi Yang ◽

Cuilin Zhang ◽

Jorge E. Chavarro ◽

Janet W. Rich-Edwards ◽

Molin Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Prospective Study ◽

Lifestyle Changes ◽

Health Study ◽

History Of ◽

A Prospective Study

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Frequency of Gestational Diabetes Mellitus Reappearance or Absence during the Second Pregnancy of Women Treated at Mayo Clinic between 2013 and 2018

Journal of Diabetes Research ◽

10.1155/2019/9583927 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Elizabeth Ann L. Enninga ◽

Aoife M. Egan ◽

Layan Alrahmani ◽

Alexey A. Leontovich ◽

Rodrigo Ruano ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Mayo Clinic ◽

Lifestyle Changes ◽

The Body ◽

Pharmacological Intervention ◽

Metabolic Memory ◽

Organ Systems

The Center for Disease Control and Prevention ranks diabetes mellitus (DM) as the seventh leading cause of death in the USA. The most prevalent forms of DM include Type 2 DM, Type 1 DM, and gestational diabetes mellitus (GDM). While the acute problem of diabetic hyperglycemia can be clinically managed through dietary control and lifestyle changes or pharmacological intervention with oral medications or insulin, long-term complications of the disease are associated with significant morbidity and mortality. These long-term complications involve nearly all organ systems of the body and share common pathologies associated with endothelial cell abnormalities. To better understand the molecular mechanisms underlying DM as related to future long-term complications following hyperglycemia, we have undertaken a study to determine the frequency that GDM did or did not occur in the second pregnancy of women who experienced GDM in their first pregnancy between 2013 and 2018 at Mayo Clinic, Rochester, MN. Within the five-year period of the study, the results indicate that 7,330 women received obstetrical care for pregnancy during the study period. Of these, 150 developed GDM in their first pregnancy and of these, 42 (28%) had a second pregnancy. Of these 42 women, 20 again developed GDM and 22 did not develop GDM in their second pregnancy within the study period. Following the occurrence of GDM in the first pregnancy, the study (1) established the number of women with and without GDM in the second pregnancy and (2) confirmed the feasibility to study diabetic metabolic memory using maternal placental tissue from GDM women. These studies represent Phase I of a larger research project whose goal is to analyze epigenetic mechanisms underlying true diabetic metabolic memory using endothelial cells isolated from the maternal placenta of women with and without GDM as described in this article.

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