Abstract
Background Probiotic supplements may be seen as a promising way to improve glucose metabolism. This study aimed to evaluate the effects of probiotic supplements on blood glucose, insulin resistance/sensitivity, and prevention of gestational diabetes mellitus (GDM) among pregnant women. Methods Eleven electronic databases were searched from inception to May 2020. Two authors independently identified randomized controlled trials (RCTs), assessed the eligibility and quality of the included studies, and then extracted data. The primary outcomes were fasting plasma glucose (FPG), 1 h and 2 h plasma glucose after 75 g oral glucose tolerance test (OGTT), HbA1c, fasting plasma insulin, insulin resistance, and insulin sensitivity. Fixed and random effect models were used to pool the results. Results A total of 20 RCTs involving 2972 participants were included according to the inclusion and exclusion criteria. The pooled results of this research showed that probiotic supplements could reduce the level of FPG (mean difference (MD) = −0.11; 95% CI = −0.15 to −0.04; P=0.0007), serum insulin (MD = −1.68; 95% CI = −2.44 to −0.92; P < 0.00001), insulin resistance (MD = −0.36; 95% CI = −0.53 to −0.20; P < 0.00001), and insulin sensitivity (MD = −21.80; 95% CI = −31.92 to −11.67; P < 0.00001). Regarding the subgroup analysis of different pregnant women, the effects of probiotics on FPG, insulin, and insulin resistance were more obvious among GDM and healthy women than among overweight/obese women. Furthermore, the differences were not significant in HbA1c (MD = −0.05; 95% CI = −0.12 to 0.03; P=0.23), 1 h OGTT (MD = −0.07; 95% CI = −0.25 to 0.10; P=0.42), and 2 h OGTT (MD = −0.03; 95% CI = −0.17 to 0.12; P=0.72). Conclusion This review found that probiotic supplements had certain functions to reduce the level of FPG and improve insulin, insulin resistance, and insulin sensitivity, especially for GDM and healthy pregnant women.
Highlights
Gestational diabetes mellitus (GDM) is the most common pregnancy complication, and its prevalence is continually rising worldwide due to increased obesity and the average age of pregnant women [1], from 4.5% to 20.3% in the Western Pacific [2] and 14.8% in China [3]
Selection Criteria. e inclusion criteria of this study were as follows: (1) randomized controlled trials (RCTs); (2) studies published in Chinese or English; (3) pregnant women with or without overweight or obesity (body mass index (BMI) 25.0–29.9 kg/m2 or ≥30.0 kg/m2 at the first antenatal visit, resp.), gestational diabetes mellitus (GDM), and over 16 years old; and (4) probiotic supplement was used as an intervention method
Among the rest of the studies, two studies did not utilize probiotics to intervene, eight studies reported irrelevant outcomes, and one study was a case report. e lone Chinese literature just reported the incident of GDM without any other relevant index
Summary
Gestational diabetes mellitus (GDM) is the most common pregnancy complication, and its prevalence is continually rising worldwide due to increased obesity and the average age of pregnant women [1], from 4.5% to 20.3% in the Western Pacific [2] and 14.8% in China [3]. Several system reviews indicated that probiotic supplements did not reduce the blood glucose of women with GDM in comparison with the placebo group [25,26,27]. Is study aimed to synthesize more high-quality randomized controlled trials (RCTs) to provide evidence of the effects of probiotic supplements on glycemic control, insulin resistance/sensitivity, and prevention of GDM among pregnant women. E inclusion criteria of this study were as follows: (1) RCTs; (2) studies published in Chinese or English; (3) pregnant women with or without overweight or obesity (body mass index (BMI) 25.0–29.9 kg/m2 or ≥30.0 kg/m2 at the first antenatal visit, resp.), GDM (diagnosed in the second or third trimester of pregnancy, without identified diabetes before gestation), and over 16 years old; and (4) probiotic supplement was used as an intervention method. A funnel plot test was utilized to assess potential publication bias if more than 10 studies were included
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
