Objective To overview the systematic review (SR) of the effects of dietary pattern intervention during pregnancy on pregnant women with gestational diabetes mellitus (GDM). Methods The Cochrane Library, The Joanna Briggs Institute Library, Embase, PubMed, Web of Science, CINAHL, CBM, CNKI, WanFang Data, and VIP databases were electronically searched to collect SR and meta-analysis on the effects of different dietary patterns on maternal and infant outcomes of gestational diabetes mellitus from inception to October 1, 2024. Two reviewers independently screened literature, extracted data, and then AMSTAR 2 tool was used to assess the methodological quality of included studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 15 relevant SR were included, the methodological quality of the included SR was generally low, with 3 SR at a low level and 12 SR at a very low level. Major dietary patterns included the low glycemic index (GI) diet, carbohydrate (CHO) restricted diet, energy restricted diet, dietary approaches to stop hypertension (DASH) diet, high-fiber diet, polyunsaturated fatty acid (PUFA) rich diet, soy protein-enriched diet, low glycemic load (GL) diet, and mediterranean diet. A meta-analysis of primary outcome measures showed that the low GI diet, DASH diet and low GL load diet had a lower incidence of blood glucose levels and adverse pregnancy outcomes (including maternal weight gain, insulin use, cesarean section, macrosomia) compared with the control diets. Conclusion It was recommended that GDM pregnant women follow the low GI diet, DASH diet, or low GL diet to control blood glucose levels and improve pregnancy outcomes. There is currently insufficient evidence to support the effects of other dietary patterns on GDM.
ObjectiveTo systematically review the association between folic acid supplementation before and/or during pregnancy and the risk for gestational diabetes mellitus (GDM). MethodsThe PubMed, EMbase, The Cochrane Library, SinoMed and CNKI databases were searched to collect studies on folic acid supplementation and GDM from inception to November 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 19 studies involving 53 128 cases were included. The results of meta-analysis showed that there was no significant association between folic acid supplementation and the risk for GDM (RR=0.98, 95%CI 0.85 to 1.13, P=0.74). Subgroup analysis revealed that folic acid supplementation was associated with a decreased risk for GDM in Europe and the United States (RR=0.81, 95%CI 0.71 to 0.92, P<0.001), in areas that fortified grain cereal products with folic acid (RR=0.81, 95%CI 0.69 to 0.94, P=0.005). ConclusionThere is no significant association between folic acid supplementation and the risk for GDM. However, supplementation may decrease the risk for GDM among women in Europe and the United States. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To systematically review the association between periodontal disease during pregnancy and the risk of gestational diabetes mellitus (GDM). Methods PubMed, Web of Science, CBM and CNKI databases were electronically searched to collect studies on periodontal disease and GDM from inception to October 23, 2021. Two researchers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 11 studies were included, involving 2 910 pregnant women. The results of meta-analysis showed that pregnant women with periodontal disease during pregnancy reported more GDM than normal pregnant women (OR=1.81, 95%CI 1.31 to 2.50, P=0.000 3). Conclusion The current evidence suggests that there is a positive association between periodontal disease during pregnancy and the risk of GDM. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the prevalence rate of gestational diabetes mellitus in Chinese population.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant literature of the prevalence rate of gestational diabetes in Chinese population from inception to October 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using R 3.4.1 software.ResultsA total of 27 studies were included involving 183 338 peoples, of whom 23 834 were diagnosed as gestational diabetes mellitus by oral glucose tolerance test (75g). The prevalence rate was 13% (95%CI 10 to 16). The prevalence rate of gestational diabetes mellitus in north area was 13% (95%CI 9 to 19), central area was 11% (95%CI 2 to 39), east area was 15% (95%CI 12 to 19), south area was 12% (95%CI 11 to 14), northwest area was 5% (95%CI 3 to 8) and southwest area was 4% (95%CI 3 to 4). The prevalence rate of gestational diabetes mellitus during January 2005 to December 2012 was 11% (95%CI 7 to 16), during December 2012 to June 2016 was 17% (95%CI 14 to 20). The prevalence of specialist hospitals was 9% (95%CI 6 to 14), and which of comprehensive hospital was 14% (95%CI 11 to 18). The prevalence of gestational diabetes screening at 24 to 28 weeks gestation remained at 13% (95%CI 10 to 17).ConclusionThe prevalence rate of gestational diabetes mellitus is high in China. The prevalence rate of gestational diabetes mellitus in north China, central China and east China is significantly higher than that in southern China, northwest China and southwest China. The prevalence rate during 2012-2016 is significantly higher than that in 2005 to 2012. Improvement of lifestyle and living standard should be considered be closely related with that. The prevalence of comprehensive hospitals is higher than specialist hospitals. It is related to the China’s economic conditions, medical care situations and the medical habits of patients.
Objective Based on the methodology of evidence-based medicine, we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidence of type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer fromspontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.
ObjectiveTo systematically review the effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort studies on the correlation between assisted reproductive technology (ART) and gestational diabetes mellitus (GDM) incidence in single pregnancy from inception to June 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 16 cohort studies involving 2 017 573 cases of single pregnancy were included. The results of meta-analysis showed that compared with the natural pregnancy group, the incidence of GDM was higher in the ART group (RR=1.54, 95%CI 1.30 to 1.83, P<0.000 01). In East Asia and Non-East Asia, the incidence of GDM in the ART group was higher than that in the natural pregnancy group (East Asia: RR=1.55, 95%CI 1.26 to 1.92, P<0.000 01; Non-East Asia: RR=1.49, 95%CI 1.18 to 1.89. P<0.000 1).ConclusionsCurrent evidence shows that the incidence of GDM may increase in single pregnancy with ART compared with natural pregnancy. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.
Objective To formulate an evidence-based treatment plan for a patient with gestational diabetes mellitus. Methods Based on the clinical questions raised from a real-life patient of gestational diabetes mellitus, we searched ACP Journal Club (1991 to Dec. 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1966 to Dec. 2006) and Chinese Biological Medical Database (1980 to Dec. 2006) for systematic reviews, randomized controlled trials, cohort and case-control studies. We used the following keywords: gestational diabetes, metformin, and pregnancy complication. The quality of the included studies was assessed.Results One meta-analysis (from MEDLINE) and two randomized controlled trials (from the Cochrane Central Register of Controlled Trials) were included. These studies concluded that there was no clear evidence on the benefits of metformin for gestational diabetes. Based on the current evidence, integrated with clinical expertise and the patient’s values, metformin was not used for this patient. Instead, intensive dietary control, blood glucose control, and appropriate exercise were administered. After this individual treatment, the patient gave birth to a healthy baby in 39+4 Weeks. Conclusion The appropriate management for gestational diabetes mellitus has been formulated with the approach of evidence-based medicine. Large-scale, methodologically-sound trials are required.
ObjectivesTo systematically review the efficacy of telemedicine on blood glucose level and pregnancy outcomes in patients with gestational diabetes mellitus.MethodsThe Cochrane Library, PubMed, Web of Science, CINAHL, Scopus, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on efficacy of telemedicine on blood glucose and pregnancy outcomes in patients with gestational diabetes from inception to January 1st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by RevMan 5.3 software.ResultsA total of 10 RCTs involving 1 267 patients were included. The results of meta-analysis showed that there were no statistical significances in fasting blood glucose (MD=?0.34, 95%CI ?1.62 to 0.93, P=0.60), HbA1c (MD=?0.22, 95%CI ?0.61 to 0.17, P=0.27), gestational age at delivery (MD=0.03, 95%CI ?0.13 to 0.19, P=0.72), premature rate (OR=0.52, 95%CI 0.26 to 1.01, P=0.05), caesarean delivery rate (OR=0.87, 95%CI 0.57 to 1.31, P=0.51), infant birth weight (MD=13.01, 95%CI ?45.75 to 71.78, P=0.66), large for gestational age rate (OR=1.16, 95%CI 0.83 to 1.62, P=0.40), pre- eclampsia/pregnancy induced hypertension rate (OR=1.04, 95%CI 0.52 to 2.09, P=0.91), neonatal hypoglycaemia rate (OR=1.21, 95%CI 0.75 to 1.95, P=0.44) and neonatal jaundice rate (OR=1.09, 95%CI 0.59 to 2.00, P=0.78) between telemedicine management and outpatient follow-up of gestational diabetes mellitus. However, the telemedicine management group had lower 2h postprandial blood glucose (MD=?3.45, 95%CI ?5.53 to ?1.37, P=0.001).ConclusionsThe current evidence shows that telemedicine management of gestational diabetes mellitus achieves similar efficacy and safety in blood glucose level and pregnancy outcomes as outpatient follow-up. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.