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Authors: Spyridon Zarogiannis
Affiliations: University of Glasgow, College of Medical, Veterinary & AMP; Life Sciences, Institute of Cardiovascular & AMP; Medical Sciences, Glasgow, Greece
Background: Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance first recognized in pregnancy. GDM is associated with maternal and fetal adverse outcomes. Dietary approaches, including energy restriction, have the potential to prevent and treat GDM. The aim of the two systematic reviews is to evaluate the effect and safety of energy-restricted dietary approaches on both prevention and management of GDM. Methods: The Medline database was searched for relevant articles and reference lists of retrieved studies. Randomized controlled trials, clinical trials and observational studies related to energy-restricted diets were included in the two systematic reviews. Results: Eight RCTs assessing the effect and safety of energy-restricted intervention compared to non-energy-restricted intervention on GDM prevention were included in the first systematic review (1792 women and their babies). Only two were found to significantly reduce GDM incidence, but all were found to reduce gestational weight gain (GWG). No difference on maternal and fetal adverse outcomes was reported. Three RCTs assessing the effect and safety of energy-restricted intervention compared to non-energy-restricted intervention on GDM management were included in the second systematic review (437 women and their babies). Furthermore, one clinical trial and one observational study related to energy restriction were also added. Three studies reported improved glycemic control in women with GDM receiving energy restricted diet, but without increasing the risk of adverse outcomes. Conclusion: The results indicate that there may be some benefits of energy restriction on reducing GWG on women without GDM and improving glycemic control in women with GDM, without increasing the risk of adverse maternal and fetal outcomes.
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