Nutritional aspects in the management of gestational Diabetes mellitus
DOI:
https://doi.org/10.33448/rsd-v12i6.42173Keywords:
Gestational diabetes; Risk factors; Health risks; Glycemic index; DASH; Mediterranean diet.Abstract
Diabetes mellitus is characterized as a pathology that can be found mainly in three different types, and among these is gestational diabetes mellitus (GDM). GDM develops during pregnancy from insulin resistance and presents some risk factors for its development, such as obesity and overweight, family history and advanced maternal age. Thus, the objective is to understand its pathology and the role of nutrition in treatment and prevention, based on reading articles and carrying out an integrative literature review. The risks that this type of diabetes can generate to the health of the mother and the fetus are presented, such as pre-eclampsia, predisposition to the development of type 2 diabetes mellitus, macrosomia and greater risks of obesity. From the understanding of these points, nutritional monitoring is understood as effective in the prevention and treatment of gestational diabetes. The low glycemic index diet, DASH and the Mediterranean diet are efficient in glycemic control during gestational diabetes and also occur in the prevention of this pathology, in order to promote pregnancies without major intercurrences and healthier eating habits.
References
Alejandro, E. U., Mamerto T. P., Chung, G., Villavieja, A., Gaus, N. L., Morgan, E. & Pineida-Cortel, M. R. B. (2020). gestational diabetes mellitus: a harbinger of the vicious cycle of diabetes. International Journal of Molecular Science, 21(14), 5003. https://doi.org/10.3390%2Fijms21145003
Altemani, A. H. & Alzaheb, R. A. (2022). The prevention of gestational diabetes mellitus (The role of lifestyle): a meta-analysis. Diabetology & Metabolic Syndrome, 14(83). https://doi.org/10.1186/s13098-022-00854-5
Amaefule, C. E., Bolou, A., Drymoussi, Z., Carreras, F. J. G., Llorente, M. del C. P., Lanz, D. & Thangaratinam, S. (2020). Effectiveness and acceptability of metformin in preventing the onset of type 2 diabetes after gestational diabetes in postnatal women: a protocol for a randomised, placebo-controlled, double-blind feasibility trial — optimising health outcomes with metformin to prevent diabetes after pregnancy (OMAHA). BMJ Open, 10(5). http://dx.doi.org/10.1136/bmjopen-2019-036198
American Diabetes Association. (2020). Management of diabetes in pregnancy: standards of medical care in diabetes—2020. Diabetes Care, 43(1). https://doi.org/10.2337/dc20-S014
Baena-Díez, J. M., Peñafiel, J., Subirana, I., Ramos, R., Elosua, R., Marín-Ibañez, A. & Grau, M. (2016). Risk of cause-specific death in individuals with diabetes: a competing risks analysis. Diabetes Care, 39(11), 1987-1995. https://doi.org/10.2337/dc16-0614
Bianco, M. E. & Josefson, J. L. (2019). Hyperglycemia during pregnancy and long-term offspring outcomes. HHS Public Access, 19(12), 143.
Bruno, R., Patrella, E., Bertarini, V., Pedrielli G., Neri, I., Facchinetti, F. (2016). Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial. Maternal & Child Nutrition, 13(3). https://doi.org/10.1111/mcn.12333
Catalano, P. M. & Shankar, K. (2017). Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ, 2017(356). https://doi.org/10.1136/bmj.j1
Chen, C., Xu, X., Yan, Y. (2018). Estimated global overweight and obesity burden in pregnant women based on panel data model. PLoS One. 13(8). https://doi.org/10.1371%2Fjournal.pone.0202183
Choudhury, A. A. & Rajeswari, V. D. (2021). Gestational diabetes mellitus - A metabolic and reproductive disorder. Biomedicine & Pharmacotherapy. 143(112183). https://doi.org/10.1016/j.biopha.2021.112183
Davis, C., Bryan, J., Hodgson, J., Murphy, K. (2015). Definition of the Mediterranean Diet: A Literature Review. Nutrients, 7(11), 9139-9153. https://doi.org/10.3390%2Fnu7115459
Dos Santos, P. A., Madi, J. M., Da Silva, E. R., Vergani, D. D. O. P., Araújo, B. F. D., & Garcia, R. M. R. (2020). Gestational diabetes in the population served by fbrazilian public health care. prevalence and risk factors. Ginecology & Obstetrics, 42(1), 12-18. https://doi.org/10.1055/s-0039-1700797
Faculdade de Ciências Agronômicas. (2015). Tipos de revisão de literatura. Unesp. Recuperado, 2015, em https://www.fca.unesp.br/Home/Biblioteca/tipos-de-evisao-de-literatura.pdf.
Farabi, S. S., & Hernandez, T. L. (2019). Low-carbohydrate diets for gestational diabetes. Nutrients, 11(8), 1737. https://doi.org/10.3390%2Fnu11081737
Filardi, T., Panimolle, F., Crescioli, C., Lenzi, A., & Morano, S. (2019). Gestational diabetes mellitus: the impact of carbohydrate quality in diet. Nutrients, 11(7), 1549. https://doi.org/10.3390/nu11071549
Fuhr, J. C., Ramos, M. E. R., Piovesan, F., Renner, L. D. O., & Siqueira, L. D. O. (2022). Relationship of advanced glycation end-products in hypertension in diabetic patients: a systematic review. Brazilian Journal of Nephrology, 44(4), 557-572. https://doi.org/10.1590/2175-8239-JBN-2022-0006en
García-Patterson, A., Balsells, M., Yamamoto, J. M., Kellett, J. E., Solá, I., Gich, I. … Corcoy, R. (2018). Usual dietary treatment of gestational diabetes mellitus assessed after control diet in randomized controlled trials: subanalysis of a systematic review and meta-analysis. Acta Diabetologica, 56(2), 237-240. https://doi.org/10.1007/s00592-018-1238-4
Gantenbein, K. V. & Kanaka- Gantenbein, C. (2021). Mediterranean diet as an antioxidant: the impact on metabolic health and overall wellbeing. Nutrients, 13(6), 1951. https://doi.org/10.3390%2Fnu13061951
Gustafson, B., Hedjazifar, S., Gogg, S., Hammarstedt, A., & Smith, U. (2015). Insulin resistance and impaired adipogenes. Tren in Endocrinology & Metabolism, 26(4), 193-200. https://doi.org/10.1016/j.tem.2015.01.006
Harding, J. L., Pavkov, M. E., Magliano, D. J., Sahw, J. E., & Gregg, E. W. (2018). Global trends in diabetes complications: a review of current evidence. Diabetologia, 62, 3-16. https://doi.org/10.1007/s00125-018-4711-2
International Diabetes Federation. (2019). IDF Atlas. (9a ed.). https://diabetesatlas.org/idfawp/resource-files/2019/07/IDF_diabetes_atlas_ninth_edition_en.pdf
Kanguru, L., Bezawada, N., Hussein, J., & Bell, J. (2014). The burden of diabetes mellitus during pregnancy in low- and middle-income countries: a systematic review. Global Health Action, 7(1), 1-2. http://dx.doi.org/10.3402/gha.v7.23987
Lee, S.-H., Park, S.-Y., & Choi, S. C. (2021). Insulin resistance: from mechanisms to therapeutic strategies. Diabetes & Metabolism Journal, 46(1), 15-37. https://orcid.org/0000-0001-9627-058X
Lende, M. & Rijhsinghani, A. (2020). Gestational diabetes: overview with emphasis on medical management. International Journal of Environmental Research and Public Health, 17(24), 9573. https://doi.org/10.3390/ijerph17249573
Looman, M., Schoenaker, D. A. J. M., Soedamah-Muthu, S. S., Geelen, A., Feskens, E. J. M., & Mishra, G. D. (2018). Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women’s Health. British Journal of Nutrition, 120(4). https://doi.org/10.1017/s0007114518001277
Lu, J., Gu, Y., Wang, L., Li, W., Zhang, S., Liu, H. & Hu, G. (2020). Glucose metabolism among obese and non-obese children of mothers with gestational diabetes. BMJ Open Diab Res Care, 8(1), e000822. http://dx.doi.org/10.1136/bmjdrc-2019-000822
Ma, W., Huang, Z., Huang, B., Qi, B., Zhang, Y., Xiao, B., & Zhu, H. (2015). Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: A randomized control trial. Public Health Nutrition, 18(8), 1506-1513. https://doi.org/10.1017/S1368980014001992
Mahjoub, F., Jemma, H. B., Sabeh, F. B., Amor, N. B., Gamoudi, A., & Jamoussi, H. (2021). Impact of nutrients and Mediterranean diet on the occurrence of gestational diabetes. Libyan Journal of Medicine, 16(1). https://doi.org/10.1080/19932820.2021.1930346
Maris, S. A., Williams, J. S., Sun, B., Brown, S., Mitchell, G. F., & Conlin, P. R. (2019). Interactions of the DASH Diet with the Renin-Angiotensin-Aldosterone System. Current Developments in Nutrition, 3(9), 091. https://doi.org/10.1093/cdn/nzz091
Martínez-Cruz, C. F., Guido-Campuzano, M. A., Ramírez-Maya, A. M., Themann, P. G.-A., Poblano-Alcalá, A., López-Navarrete, G. E. & Poblano, A. (2021) Body mass index in offspring of mothers with diabetes mellitus: follow-up at 2, 4, 6, and 8 years of age. Boletín Médico del Hospital Infantil de México, 78(5), 395-403. https://doi.org/10.24875/BMHIM.20000311
Martín-Pelaéz, S., Fito, M., & Castaner, O. (2020). Mediterranean diet effects on type 2 diabetes prevention, disease progression, and related mechanisms. A review. Nutrients, 12(8), 2236. https://doi.org/10.3390%2Fnu12082236
Melero, V., La Torre, N. G., Assaf-Balut, C., Jiménez, I., del Valle, L., Durán, A., & Calle-Pascual, A. L. (2020). Effect of a Mediterranean Diet-Based Nutritional Intervention on the Risk of Developing Gestational Diabetes Mellitus and Other Maternal-Fetal Adverse Events in Hispanic Women Residents in Spain. Nutrients, 12 (11). https://doi.org/10.3390%2Fnu12113505
Metzger, B. E. (2010). International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy. Diabetes Care, 33(3), 676-682. https://doi.org/10.2337/dc09-1848
Metzger, B. E. (2010). Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Preeclampsia. American Journal of Obstetrics Gynecology, 202(3), 255. https://doi.org/10.1016%2Fj.ajog.2010.01.024
Mitchell, S., & Shaw, D. (2015) The Worldwide Epidemic of Female Obesity. Best Practice & Research Clinical Obstetrics & Gynecology, 29(3), 289-299. https://doi.org/10.1016/j.bpobgyn.2014.10.002
Mustad, V. A., Huynh, D. T. T., López-Pedrosa, J. M., Campoy, C., & Rueda, R. (2020). The Role of Dietary Carbohydrates in Gestational Diabetes. Nutrients, 12(2), 382. https://doi.org/10.3390%2Fnu12020385
Mustaniemi, S., Vääräsmäki, M., Eriksson, J. G., Gissler, M., Laivuori, H., Ijäs, H., & Morin-Papunen, L. (2018). Polycystic ovary syndrome and risk factors for gestational diabetes. Endocrine Connections, 7(7), 859-869. https://doi.org/10.1530/EC-18-0076
Nunes, J. S., Ladeiras, R., Machado, L., Coelho, D., Duarte, C., & Furtado, J. M., (2020). The influence of preeclampsia, advanced maternal age and maternal obesity in neonatal outcomes among women with gestational diabetes. Revista Brasileira de Ginecologia Obstetrícia, 42(10). https://doi.org/10.1055/s-0040-1710300
Olmedo-Requena, R., Gómez-Fernández, J., Amezcua-Prieto, C., Mozas-Moreno, J., Khan, K. S., & Jiménez-Moleón, J. J., (2019). Pre-pregnancy adherence to the mediterranean diet and gestational diabetes mellitus: a case-control study. Nutrients, 11(5), 1003. https://doi.org/10.3390%2Fnu11051003
Organização Pan-americana da Saúde, Ministério da Saúde, Federação Brasileira das Associações de Ginecologia e Obstetrícia, Sociedade Brasileira de Diabetes (2017). Rastreamento e diagnóstico de diabetes mellitus gestacional no Brasil. https://www.febrasgo.org.br/images/pec/CNE_pdfs/Rastreamento-Diabetes.pdf
Petermann, F., Troncoso-Pantoja, C., Martínez, M. A., Leiva, A. M., Ramírez-Campillo, R., Poblete-Valderrama, F., & Celis-Morales, C. (2018). Asociación entre diabetes mellitus tipo 2, historia familiar de diabetes y deterioro cognitivo en adultos mayores chilenos. Revista médica de Chile, 146(8), 872-881. http://dx.doi.org/10.4067/s0034-98872018000800872
Petersmann, A., Müller-Wieland, D., Müller, U. A., Landgraf, R., Nauck, M., Freckmann, G., & Schleicher, E. (2019). Definition, classification and diagnosis of diabetes mellitus. German Diabetes Association: Clinical Practice Guidelines, 127(1), 1-7. https://doi.org/10.1055/a-1018-9078
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The pathophysiology of gestational diabetes mellitus. International Journal of Molecular Science, 19(11), 3342. https://doi.org/10.3390/ijms19113342
Radón-Pokracka, M., Adrianowicz, B., Płonka, M., Danił, P., Nowak, M., & Huras, H. (2019). Evaluation of pregnancy outcomes at advanced maternal age. Open Access Macedonian Journal of Medical Sciences, 7(12), 1.951-1.956. https://doi.org/10.3889%2Foamjms.2019.587
Rasmussen, L., Poulsen, C. W., Kampmann, U., Smedegaard, S. B., Ovesen, P. G., & Fuglsang, J. (2020). Diet and healthy lifestyle in the management of gestational diabetes mellitus. Nutrients, 12(10), 3050. https://doi.org/10.3390/nu12103050
Rodrigues, F. G., Lima, T. M., Zambrano, L., & Heilberg, I. P. (2020). Dietary pattern analysis among stone formers: resemblance to a DASH-style diet. Brazilian Journal of Nephrology, 42(3), 338-348. https://doi.org/10.1590/2175-8239-JBN-2019-0183
Scifres, C. M., Chen, B., Nelson, D. M., & Sadovsky, Y. (2011). Fatty acid binding protein 4 regulates intracellular lipid accumulation in human trophoblasts. The Journal of Clinical Endocrinology & Metabolism, 96(7), 1883-1091. https://doi.org/10.1210/jc.2010-2084
Shostrom, D. C. V., Sun, Y., Oleson, J. J., Snetselaar, L. G., & Bao, W. (2017). History of gestational diabetes mellitus in relation to cardiovascular disease and cardiovascular risk factors in US women. Frontiers in Endocrinology, 8(144). https://doi.org/10.3389/fendo.2017.00144
Silva, A. L., Amaral, A. R., Oliveira, D. S., Martins, L., Silva, M. R., & Silva, J. C. (2017). Desfechos neonatais de acordo com diferentes terapêuticas do diabetes mellitus gestacional. Jornal da Pediatria, 93(1), 87-93. https://doi.org/10.1016/j.jped.2016.04.004
Silva-Zolezzi, I., Samuel, T. M., Spieldenner, J. (2017). Maternal nutrition: opportunities in the prevention of gestational diabetes. Nutrition Reviews, 75(1), 32-50. https://doi.org/10.1093%2Fnutrit%2Fnuw033
Svensson, H., Wetterling, L., Bosaeus, M., Odén, B., Odén, A., Jennische, E., & Lönn, M. (2015). Body fat mass and the proportion of very large adipocytes in pregnant women are associated with gestational insulin resistance. International Journal of Obesity, 20(4), 646-653. https://doi.org/10.1038%2Fijo.2015.232
Tranidou, A., Dagklis, T., Magriplis, E., Apostolopoulou, A., Tsakiridis, I., Chroni, V., & Chourdakis, M. (2023). Pre-pregnancy adherence to mediterranean diet and risk of gestational diabetes mellitus: a prospective cohort study in greece. Nutrients, 15(4). https://doi.org/10.3390%2Fnu15040848
Universidade Federal do Estado do Rio de Janeiro (UNIRIO). (2020). Protocolo clínico de diabetes mellitus na gestação. https://www.gov.br/ebserh/pt-br/hospitais-universitarios/regiao-sudeste/hugg-unirio/acesso-a-informacao/documentos-institucionais/ProtocoloClnicoDiabeteMellitusnaGestao.pdf
Uusitupa, M., Khan, T. A., Viguiliouk, E., Kahleova, H., Rivellese, A. A., Hermansen, K., & Sievenpiper, J. L. (2019). Prevention of type 2 diabetes by lifestyle changes: a systematic review and meta-analysis. Nutrients, 11(11), 2611. https://doi.org/10.3390/nu11112611
Vasile, F. C., Preda, A., Stefan, A. G., Vladu, M. I., Fortofoiu, M. C., Clenciu, D., & Mota, M. (2021). An update of medical nutrition therapy in gestational diabetes mellitus. Journal of Diabetes Research, 2021(5266919). https://doi.org/10.1155/2021/5266919
.
Wang, L., Wang, Q., Hong, Y., Ojo, O., Jiang, Q., Hou, Y. Y., & Wang, X. U. (2018). The effect of low-carbohydrate diet on glycemic control in patients with type 2 diabetes mellitus. Nutrients, 10(6), 661. https://doi.org/10.3390/nu10060661
Wei, J., Heng, W., & Gao, J. (2016). Effects of low glycemic index diets on gestational diabetes mellitus. Medicine, 95(22), 3792. https://doi.org/10.1097%2FMD.0000000000003792
WHO. (2013). Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. World Health Organization, https://apps.who.int/iris/bitstream/handle/10665/85975/WHO_NMH_MND_13.2_eng.pdf
Wu, C. S., Nohr, E. A., Bech, B. H., Vestergaard, M., & Olsen, J. (2012). Long-term health outcomes in children born to mothers with diabetes: a population-based cohort study. Plos One, 7(5), 36727. https://doi.org/10.1371/journal.pone.0036727
Yamamoto, J. M., Kellett, J. E., Balsells, M., García-Patterson, A., Hadar, E., Solà, I., & Solà, R. (2018). Gestational diabetes mellitus and diet: a systematic review and meta-analysis of randomized controlled trials examining the impact of modified dietary Interventions on maternal glucose control and neonatal birth weight. Diabetes Care, 41(7), 1.346-1.361. https://doi.org/10.2337/dc18-0102
Yen, I. W., Lee, C. N., Lin, M. L., Fã, K. C., Wei, J. N., Chen, K. Y., & Li, H. Y. (2019). Overweight and obesity are associated with clustering of metabolic risk factors in early pregnancy and the risk of GDM. Plos One, 14(12), 0225978. https://doi.org/10.1371%2Fjournal.pone.0225978
Zhang, C., & Ning, Yi. (2011). Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence 1-4. The American Journal of Clinical Nutrition, 94(6), 1975-1978. https://doi.org/10.3945/ajcn.110.001032
Zhang, Y., Xiao, C. M., Zhang, Y., Chen, Q., Zhang, X. Q., Li, X. F., & Gao, Y. M. (2021). Factors associated with gestational diabetes mellitus: a meta-analysis. Journal of Diabetes Research, 2021. https://doi.org/10.1155%2F2021%2F6692695
Zhu, Y., & Zhang, C. (2016). Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Current Diabetes Report, 16(1), 7. https://doi.org/10.1007/s11892-015-0699-x
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