Table 3.
Summary of clinical trials of the effect of nutritional interventions on management of gestational diabetes among Iranian women
| Author; year | Sample Size | Mean maternal age ±SD | Dose of intervention | Duration (weeks) |
Outcome of interest | |||
|---|---|---|---|---|---|---|---|---|
| Glycemic | Lipid profiles | Inflammatory/ anti-oxidant | Neonatal outcomes | |||||
| Vitamin D | ||||||||
|
Hosseinzadeh- Shamsi-Anar [15], 2012 |
I: 24 C:21 |
I: 30.7±6.2 C: 29.5±4 |
Intramuscular 300,000 IU of vitamin D |
12 | HbA1C ↔ | |||
| Yazdchi [49]; 2016 |
I:33 P:33 |
I:31.64±4.40 P:32.11±3.61 |
50,000 IU vitamin | 8 |
FPG↓ Insulin ↔ HbA1C ↓ HOMA-IR ↔ |
TC ↔ TG ↔ LDL ↔ HDL ↔ |
hs-CRP ↔ | - |
| Keshavarzi [51] ; 2017 | 192; three groups (n=64) |
I:27.9 P: 28.8 |
a) Low dose: 400 IU tablet once daily b) High dose: 50,000 IU daily c) Placebo |
a) until the 36th week of gestation b) At study baseline and 21 days after c) Similar to group b |
- | - |
BW ↔ Macrosomia↔ |
|
| Probiotic capsule | ||||||||
| Dolatkhah [48]; 2015 |
I:29 P: 27 |
I: 28.1±6.24 P:26.5 ± 5.23 |
> 4 × 109 CFU; 4 strains | 8 |
FPG ↓ fasting serum insulin↔ HOMA-IR↓ QUICKI↔ |
- | - | - |
| Jafarnejad [50]; 2016 |
I:41 P:41 |
I: 32.4 ± 3.1 P: 31.9 ± 4.0 |
112.5 × 109 CFU; 8 strains | 8 |
FPG↔ Fasting serum Insulin↓ HOMA-IR↓ HbA1C↔ |
- |
hs-CRP↓ IL-10↔ IFN-γ ↔ IL-6↓ TNF-α↓ |
- |
| Hajifaraji [55]; 2018 |
I:29 P:27 |
I:28.1±6.25 P:26.5±5.24 |
> 4 × 109 CFU;4 strains | 8 | - | - |
CRP↓ IL-6↔ TNF-α↓ TAC↔ MDA ↓ |
- |
| Yoghurt probiotic | ||||||||
| Sahhaf Ebrahimi [59]; 2019 |
I: 42 P:42 |
I: 31.64 ± 5.97 P: 31.61 ± 5.49 |
300 mg/d contained 106 (Lactobacillus acidophilus and Bifidobacterium Lactis) |
8 |
FPG↓ PG↓ HbA1C↓ |
- | - |
BW↓ Risk of macrosomia ↓ |
| Synbiotic | ||||||||
| Nabhani [53]; 2018 |
I:45 P:45 |
I:29.4±5.8 P:30.3±5.6 |
500 mg lactobacillus bacteria consisting 4 strain+38.5 mg fructooligosaccharide (FOS) | 6 |
FPG↔ insulin↔ HOMA-IR↔ QUICKI↔ |
TG↔ TC↔ LDL↔ HDL↔ |
TAC↔ | - |
| Zinc | ||||||||
| Rahimi Sharbaf [62]; 2008 |
I:30 C:30 |
NA | Zinc sulfate: 15 mg/day | 6-8 | - | - | - |
BW↓ Risk of macrosomia↓ |
| Other supplementation | ||||||||
| Aslfalah [58]; 2018 |
I:30 P:30 |
I: 30.96 ± 0.93 P: 31.10 ± 0.92 |
Alpha-lipoic acid: 100 mg/d | 8 |
FPG↓ Insulin↔ HOMA-IR↓ QUICKI↑ |
MDA/TAC↓ | - | - |
| Hajimoosayi [61]; 2020 |
I: 37 P: 33 |
I: 29.68± 5.05 P:31.15± 5.26 |
Ginger: dose of 1500 mg including three tablets of ginger or placebo daily in three meals |
6 |
FBS↓ Insulin↓ HOMA-IR↓ PG↔ |
- | - | - |
BW, birth weight; C, control group; CFU, colony forming units; FPG, fasting plasma glucose; HbA1C; glycosylated hemoglobin; HDL, high density lipoprotein; hs-CRP, high sensitive C-reactive protein; HOMA-IR; homeostatic model assessment of insulin resistance; I, intervention group; IFN-γ, Interferon gamma; IU, international unit; IL-6, interleukin-6; LDL, low density lipoprotein; MDA, Malondialdehyde ; NA, not available; P, placebo group; PG, post-prandial blood glucose; QUICKI, Quantitative Insulin Sensitivity Check Index; TAC, total antioxidant capacity; TC, total cholesterol; TNF-α, tumor necrosis factor-𝛼. ↓ Final values were significantly lower in the intervention group compared to the placebo/control group. ↑ Final values were significantly higher in the intervention group compared to the placebo/control group. ↔ No significant differences in final values between the two groups