Abstract
Gestational diabetes mellitus (GDM) is prevalent worldwide, leading to a high risk of significant morbidity for both the mother and offspring with complications. Increasing evidences suggest that gut microbiota plays a role in the pathogenesis of GDM. Lifestyle modification is the cornerstones of GDM treatment. However, a number of patients whose blood glucose is not controlled by lifestyle modification still require exogenous insulin to control blood glucose. No observational study is available about the relationship between the gut microbiota in GDM patients and lifestyle modifications. Thus, we investigated the differences in gut microbiota between GDM patients with successful glycemic control (GDM1) and failure of glycemic control (GDM2) by lifestyle modifications. We sequenced the V3-V4 regions of 16S ribosomal ribonucleic acid (rRNA) gene from stool samples of 52 singleton pregnant women with 24–28 weeks of gestation. Our results showed that Blautia, Eubacterium_hallii_group, and Faecalibacterium in the gut microbiota showed significant differences among the normoglycemic mother, GDM1, and GDM2 groups, respectively. The combined diagnostic performance of Blautia, Eubacterium_hallii_group, and Faecalibacterium in differentiating GDM2 from GDM was considered as the most reasonable identification indicator. Gut bacteria may participate in the pathological development of GDM2 through the peroxisome proliferator-activated receptor (PPAR) signaling pathway. These results indicated that Blautia, Eubacterium_hallii_group, and Faecalibacterium had important characteristic changes in the gut microbiota of women with GDM2.
Highlights
Gestational diabetes mellitus (GDM) is defined as glucose intolerance or hyperglycemia of varying severity with the onset or first recognition during pregnancy [1]
The results showed no significant difference between the N group and the GDM1 group
The results revealed that Faecalibacterium, Blautia, and Eubacterium_hallii_group among all the bacteria showed significant discriminatory function between the GDM1 group and the GDM2 group (Figure 4)
Summary
Gestational diabetes mellitus (GDM) is defined as glucose intolerance or hyperglycemia of varying severity with the onset or first recognition during pregnancy [1]. The mother’s body undergoes a series of physiological changes (i.e., metabolic adaptation) in order to support the demands of the growing fetus. Insulin sensitivity increases, promoting the uptake of glucose into adipose stores in preparation for the energy demands of later pregnancy. In the second and third trimesters of pregnancy, the antagonism of insulin-like substances leads to decreased insulin sensitivity in pregnant women. The demand for insulin increases to maintain normal blood glucose levels. The normal insulin levels during pregnancy do not adequately occur in all pregnancies, except in those with preexisting insulin resistance or women who cannot increase insulin secretion, resulting in GDM [2, 3]
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