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Fish oil, probiotics fail to protect against gestational diabetes
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Consuming fish oil or probiotics during pregnancy is not an effective means of avoiding gestational diabetes in women with overweight or obesity, according to study results published in Diabetes Care.
“The need to find a means to lower the risk [for gestational diabetes] is important, as it affects the health of mother and child both acutely and over the long term. ... The pathogenesis of GDM consists of two main factors: high insulin resistance and the decreased ability of pancreatic -cells to produce insulin,” Outi Pellonperä, a doctoral student in the department of obstetrics and gynecology at the University of Turku and Turku University Hospital in Turku, Finland, and colleagues wrote. “Both probiotics and the n-3 long-chain polyunsaturated fatty acids present in fish oil have been demonstrated to possess anti-inflammatory properties and a capability to reduce insulin resistance.”
Pellonperä and colleagues recruited 439 pregnant women with a BMI of at least 25 kg/m2 and no history of diabetes before 18 gestational weeks and randomly assigned them to a daily regimen of two fish oil capsules with 2.4 g of n-3 fatty acids plus placebo (n = 110; mean age, 30.4 years; mean BMI, 30 kg/m2), one probiotic capsule with 1010 colony-forming units each of Lactobacillus rhamnosus and Bifidobacterium animalis ssp. lactis plus placebo (n = 109; mean age, 30.8 years; mean BMI, 29.9 kg/m2), both fish oil and probiotics (n= 109; mean age, 30.8 years; mean BMI, 29.3 kg/m2) or placebo only (n = 110; mean age, 30.4 years; mean age, 29.7 kg/m2).
The women, recruited at Turku University Hospital in Finland from October 2013 to July 2017, received the regimens from a first visit until 6 months after giving birth.
Between 24 and 28 gestational weeks, participants underwent a 2-hour 75-g oral glucose tolerance test to assess gestational diabetes. The researchers used diagnostic criteria from Finnish guidelines and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) to confirm gestational diabetes. The Finnish criteria require OGTT values of at least 5.3 mmol/L when the test is administered and at least 10 mmol/L and 8.6 mmol/L at 1 hour and 2 hours after the test, respectively. The IADPSG requires OGTT values of at least 5.1 mmol/L when the test is administered and at least 10 mmol/L and 8.5 mmol/L at 1 hour and 2 hours, respectively.
The researchers identified 145 women who developed gestational diabetes during the study using the IADPSG requirements. The number was lower when using the Finnish guidelines (n = 94). Despite these incidence rates, the researchers noted that gestational diabetes risk was similar among the four treatment groups. Events of miscarriages, hypertensive complications and macrosomia also were similar among the groups.
“In the light of the previous literature, the reasons why we failed to detect an intervention effect remain unknown,” the researchers wrote. “It may be that the metabolic burden of obesity in our recruited women was so severe that it could not be overcome by the potential interventional effect in regulating glucose metabolism.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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