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Probiotics and Gestational Diabetes Control

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Probiotics don't improve the metabolic health of women with GDM but may help those at risk for future metabolic and cardiovascular disease.

Gestational diabetes mellitus (GDM) is among the most frequent metabolic complications of pregnancy, and researchers are constantly striving to better understand and develop new therapies for GDM. One such avenue of study involves probiotics, which are live microorganisms that may benefit the health of the host. There have been 3 randomized controlled trials that have studied how probiotics may influence metabolic health in pregnancy, but none of those studies evaluated their use in women with GDM.

However, new research presented February 5th at The Pregnancy Meeting, the Society for Maternal-Fetal Medicine's annual meeting, held this year in San Diego, evaluated the effect of a probiotic capsule on metabolic parameters and pregnancy outcomes in women with GDM.

Titled "Impact of Probiotics in Women with Gestational Diabetes Mellitus on Metabolic Health: A Randomized Controlled Trial," the study looked at the effect of a daily probiotic supplement, compared with placebo, on fasting glucose, other metabolic parameters, and pregnancy outcome among women with a new diagnosis of either impaired glucose tolerance or GDM not treated with pharmacological therapy. The diagnosis of GDM was made following the results of a 3-hour 100 g glucose tolerance test.

Of 115 women randomized in the study, 15 required insulin (9 in the probiotic group and 6 in the placebo group). Of the remaining 100 women managed with diet and exercise alone, 48 received the probiotic Lactobacillus salivarious UCC118 and 52 received a placebo capsule, both given from GDM diagnosis until delivery. Fasting plasma glucose decreased significantly in both the probiotic and placebo groups. This decrease was likely because of improved dietary habits resulting from healthy lifestyle advice given to all study participants as part of routine care.

In the probiotic group, the intervention had no effect on glucose control in women with GDM. However, the intervention was associated with a significant reduction in the normal pregnancy-related increase in total and LDL cholesterol levels compared with placebo.

“This study indicates a potential role in probiotics to improve the metabolic profile of an obstetric group at risk of future metabolic syndrome and cardiovascular disease,” explained Fionnuala McAuliffe, MD, senior principal investigator, chair and professor of Obstetrics & Gynaecology at the University College Dublin. Karen Lindsay, PhD, who conducted the research trial, presented the research.

Lindsay K, Brennan L, Kennelly M, et al. Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Abstract 32. Presented at: The Pregnancy Meeting, the Society for Maternal-Fetal Medicine's annual meeting; February 5, 2015; San Diego, Calif.

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