Impact of Nutritional Intervention on Feto-Maternal Outcomes in Gestational Diabetes Cases

Gestational diabetes is characterized by varying degrees of carbohydrate intolerance that develop or are first recognized during pregnancy. Diabetes in Pregnancy Study Group of India (DIPSI) criteria suggests that pregnant women whose 2-hour postprandial glucose levels are above 120 mg/dl and below 140 mg/dl can be categorized as Gestational glucose intolerance (GGI) group. 

A recent study investigated whether intervention in the GGI group improves feto-maternal outcomes.

This open-label randomized control trial was conducted at the Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow. The study included all antenatal women attending the antenatal clinic and diagnosed with GGI; overt diabetes cases were excluded from the study.

Overall, 1,866 antenatal women were screened, of which 220 (11.8%) were diagnosed with gestational diabetes and 412 (22.1%) with GGI. The study compared the mean fasting blood sugar levels in women with GGI who received medical nutrition therapy with those who did not receive any intervention. It was observed that women with GGI who underwent medical nutrition therapy had significantly lower fasting blood sugar levels than those who did not receive any intervention.

Further, women with GGI experienced higher complications, including polyhydramnios, preterm premature rupture of membranes (PPROM), fetal growth restriction, macrosomia (large babies), preeclampsia, preterm labor, and vaginal candidiasis, in comparison to euglycemic women (women with normal blood sugar levels).

The findings demonstrate that nutritional intervention in the GGI group reduced the risk of complications. Implementing medical nutrition therapy resulted in delayed development of gestational diabetes mellitus (GDM) and lower rates of neonatal hypoglycemia and hyperbilirubinemia. Hence, early intervention through medical nutrition therapy may positively impact the feto-maternal outcomes in women with GGI during pregnancy.

Source: Kumar N, Das V, Srivastava A, Agarwal A, et al. The Journal of Obstetrics and Gynecology of India. 2022 Dec 8:1-6.