Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
What this study found
Results indicated that lifestyle interventions significantly reduced fasting glucose and insulin resistance in women with GDM, supporting the positive role of certain nutritional supplements, diet, and exercise practices in improving glycemic control.
- Study & population
- A total of 4845 records were screened, leading to the inclusion of 26 studies (8 on nutritional supplements, 12 dietary interventions, and 6 exercise interventions) focused on standard care for managing GDM, relying on random effects models to analyze the data.
- Intervention
- This systematic review and meta-analysis examined the effects of nutritional and exercise-focused lifestyle interventions on glycemic control specifically in women diagnosed with gestational diabetes mellitus (GDM).
- Key limitation
- The study had limitations concerning the generalizability of findings due to high heterogeneity among the included studies and a notable lack of evidence in various diabetes-related pregnancy cases beyond GDM.
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Open PDFOriginal abstract
Diabetes disrupts one in six pregnancies, bestowing immediate and long-term health risks to mother and child. Diet and exercise are commonly prescribed to control dysglycemia, but their effectiveness across sub-populations and types of diabetes (type-1; type-2; or gestational diabetes mellitus, GDM) is uncertain. Therefore, a systematic review and meta-analysis on the effect of diet and/or exercise on glycemia in pregnant women with diabetes was conducted. Random effects models were used to evaluate effect sizes across studies and anticipated confounders (e.g., age, ethnicity, BMI). Of the 4845 records retrieved, 26 studies (8 nutritional supplements, 12 dietary, and 6 exercise interventions) were included. All studies were conducted in patients with GDM. Overall, supplement- and exercise-based interventions reduced fasting glucose (−0.30 mmol/L; 95% CI = −0.55, −0.06; p = 0.02; and 0.10 mmol/L; 95% CI = −0.20, −0.01; p = 0.04); and supplement- and diet-based interventions reduced HOMA-IR (−0.40; 95% CI = −0.58, −0.22; p < 0.001; and −1.15; 95% CI = −2.12, −0.17; p = 0.02). Subgroup analysis by confounders only confirmed marginal changed effect sizes. Our results suggest a favorable role of certain nutritional supplements, diet, and exercise practices on glycemia in women with GDM and underline a lack of evidence in ~20% of other diabetes-related pregnancies (i.e., women with pre-existing diabetes).