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Article

Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial

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Department of Nutrition and Bioprogramming, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Departamento de Salud, Universidad Iberoamericana, Ciudad de México, Prolongación Paseo de la Reforma 880, Mexico City 01219, Mexico
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Department of Endocrinology, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Coordination of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Research Direction, Instituto Nacional de Perinatología, “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Clinical Research Branch, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Department of Translational Medicine, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes”, Montes Urales 800, Mexico City 11000, Mexico
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Direction of Centro de Investigación Materno Infantil del Grupo de Estudios al Nacimiento, CIMIGEN, Avenida Tlahuac 1004, Mexico City 09890, Mexico
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Deparment of Gynecologist and Obstetrics, Centro Medico ABC, Avenida Carlos Graef Fernández 154, Mexico City 05300, Mexico
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Author to whom correspondence should be addressed.
Academic Editor: Roberto Cangemi
Nutrients 2022, 14(1), 62; https://doi.org/10.3390/nu14010062
Received: 8 November 2021 / Revised: 17 December 2021 / Accepted: 22 December 2021 / Published: 24 December 2021
(This article belongs to the Special Issue Diet, Exercise and Gestational Diabetes Mellitus)
The aim of this study was to examine the efficacy of intensive medical nutrition therapy (MNT) plus metformin in preventing gestational diabetes mellitus (GDM) among high-risk Mexican women. An open-label randomized clinical trial was conducted. Inclusion criteria were pregnant women with three or more GDM risk factors: Latino ethnic group, maternal age >35 years, body mass index >25 kg/m2, insulin resistance, and a history of previous GDM, prediabetes, a macrosomic neonate, polycystic ovarian syndrome, or a first-degree relative with type 2 diabetes. Women before 15 weeks of gestation were assigned to group 1 (n = 45): intensive MNT-plus metformin (850 mg twice/day) or group 2 (n = 45): intensive MNT without metformin. Intensive MNT included individual dietary counseling, with ≤50% of total energy from high carbohydrates. The primary outcome was the GDM incidence according to the International Association of Diabetes Pregnancy Study Groups criteria. There were no significant differences in baseline characteristics and adverse perinatal outcomes between the groups. The GDM incidence was n = 11 (24.4%) in the MNT plus metformin group versus n = 7 (15.5%) in the MNT without metformin group: p = 0.42 (RR: 1.57 [95% CI: 0.67–3.68]). There is no benefit in adding metformin to intensive MNT to prevent GDM among high-risk Mexican women. Clinical trials registration: NCT01675310. View Full-Text
Keywords: diet; pregnancy; gestational weight gain; gestational diabetes; obesity diet; pregnancy; gestational weight gain; gestational diabetes; obesity
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MDPI and ACS Style

Perichart-Perera, O.; Mier-Cabrera, J.; Flores-Robles, C.M.; Martínez-Cruz, N.; Arce-Sánchez, L.; Alvarado-Maldonado, I.N.; Montoya-Estrada, A.; Romo-Yañez, J.; Rodríguez-Cano, A.M.; Estrada-Gutierrez, G.; Espino y Sosa, S.; Guzmán-Huerta, M.; Ayala-Yañez, R.; Reyes-Muñoz, E. Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial. Nutrients 2022, 14, 62. https://doi.org/10.3390/nu14010062

AMA Style

Perichart-Perera O, Mier-Cabrera J, Flores-Robles CM, Martínez-Cruz N, Arce-Sánchez L, Alvarado-Maldonado IN, Montoya-Estrada A, Romo-Yañez J, Rodríguez-Cano AM, Estrada-Gutierrez G, Espino y Sosa S, Guzmán-Huerta M, Ayala-Yañez R, Reyes-Muñoz E. Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial. Nutrients. 2022; 14(1):62. https://doi.org/10.3390/nu14010062

Chicago/Turabian Style

Perichart-Perera, Otilia, Jennifer Mier-Cabrera, Claudia M. Flores-Robles, Nayeli Martínez-Cruz, Lidia Arce-Sánchez, Itzel N. Alvarado-Maldonado, Araceli Montoya-Estrada, José Romo-Yañez, Ameyalli M. Rodríguez-Cano, Guadalupe Estrada-Gutierrez, Salvador Espino y Sosa, Mario Guzmán-Huerta, Rodrigo Ayala-Yañez, and Enrique Reyes-Muñoz. 2022. "Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial" Nutrients 14, no. 1: 62. https://doi.org/10.3390/nu14010062

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