By TAP Integrative

 

Risk factors for gestational diabetes include pre-pregnancy obesity, excessive weight gain during pregnancy, polycystic ovarian syndrome (PCOS), older age, higher parity, and family history of diabetes. Emerging evidence suggests that the gut microbiota may also influence risk. The diversity of intestinal microorganisms decreases during pregnancy, but the most depleted microbial richness is found in women with gestational diabetes.   

 

A Finnish trial, published in 2010, reported that probiotic supplementation beginning in the first trimester reduced the prevalence of gestational diabetes from 36% to 13% among women at high risk. More recently, in a study published in 2017 in the British Journal of Nutrition, researchers evaluated whether probiotic supplementation would reduce the prevalence of gestational diabetes in women not selected on the basis of risk.  

 

The study was a double-blind, randomized, placebo-controlled trial including pregnant women in New Zealand with a personal or partner history of atopic disease. The trial was designed originally to evaluate the outcome of eczema in the child at 12 months, and the secondary outcome of gestational diabetes was decided in advance.  

 

Women were enrolled in the study at 14-16 weeks’ gestation and randomized to probiotic capsules or placebo. The probiotic contained Lactobacillus rhamnosus HN001 (6 x 109 CFUs) and was manufactured by Fonterra Co-operative Group Ltd using aseptic fermentation, concentration, and freeze-drying. Participants took the capsules from the time of enrollment until 12-months postpartum. Evaluation for gestational diabetes was done at 24-30 weeks’ gestation.  

 

The results of the study differed, depending on whether the definition of gestational diabetes was determined by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) or by the New Zealand (NZ) guidelines. The NZ guidelines are more specific, requiring a higher baseline glucose and higher 2-hour glucose test threshold than the IADPSG guidelines.  

 

When using the IADPSG definition, the prevalence of gestational diabetes was lower in the probiotic group than in the placebo group, reducing the risk from 13.8% to 8.2%, but the difference was not significant. When using the NZ definition, the prevalence of gestational diabetes was significantly lower in the probiotic group, reducing the risk from 6.5% to 2.1%. The risk reduction was more marked in older women. 

 

The authors of this study conclude that probiotic supplementation during pregnancy may be a simple and safe way to decrease the prevalence of gestational diabetes.  

 

Reference  

Wickens KL, Barthow CA, Murphy R, et al. Early pregnancy probiotic supplementation with Lactobacillus rhamnosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial. Br J Nutr. 2017;117(6):804-813. 


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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease