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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Diabetes".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 14735

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Dr. Clive J. Petry

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School of Clinical Medicine, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
Interests: diabetes; metabolism; hypertension; growth; development; imprinted genes; biomarkers; nutritional therapies
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Dear Colleagues,

Gestational diabetes mellitus (GDM) is a common complication of pregnancy affecting 20 million women worldwide each year. Its prevalence is rising as part of a diabetes pandemic. Nutrition plays a key role in GDM, whether (1) as part of an ‘unhealthy’ diet, which contributes to its cause, or (2) as part of changes in dietary intake, which act as the frontline treatment for GDM (sometimes supplemented with increased activity and pharmacological intervention). Dietary changes, therefore, can alter the risk of developing GDM in the first place, and once GDM has emerged during pregnancy, dietary changes can mitigate the risk of developing GDM-related complications, such as neonatal macrosomia, respiratory distress, hypoglycemia and jaundice, and maternal pre‑eclampsia, Caesarean section and placental abruption. In this Special Issue, we aim to highlight the role of nutrition in the etiology of GDM, whether directly or indirectly through weight gain and obesity, and in its role as a GDM treatment to lower hyperglycemia and the risk of the aforementioned complications.

Dr. Clive J. Petry
Guest Editor

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Keywords

diabetes
pregnancy
obesity
insulin resistance
dietary intake
carbohydrate
glycemic index
lipids
fiber
micronutrients

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Published Papers (7 papers)

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Editorial

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4 pages, 230 KiB

Open AccessEditorial

Nutrients as Risk Factors and Treatments for Gestational Diabetes

by Clive J. Petry

Nutrients 2023, 15(22), 4716; https://doi.org/10.3390/nu15224716 - 8 Nov 2023

Cited by 1 | Viewed by 2584

Abstract

Gestational diabetes (GDM), traditionally defined as any form of glucose intolerance first detected in pregnancy [...] Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

Research

Jump to: Editorial

21 pages, 648 KiB

Open AccessArticle

Prenatal Physical Activity, Pre-Pregnancy BMI, and Their Relationship with Gestational Diabetes: A Retrospective-Prospective Single-Center Study

by Martyna Kiljan and Anna Weronika Szablewska

Nutrients 2025, 17(5), 786; https://doi.org/10.3390/nu17050786 - 24 Feb 2025

Viewed by 1046

Abstract

Background: In recent years, there has been an increase in the incidence of gestational diabetes (GDM) with serious risks for both mother and child. Pre-pregnancy BMI and physical activity significantly influence GDM development. Promoting a healthy lifestyle is essential to prevent GDM and improve health outcomes for mother and baby. Objective: The aim of this study was to evaluate the relationship between pre-pregnancy physical activity and pre-pregnancy BMI and the occurrence of gestational diabetes, as well as to assess their impact on the development of complications associated with gestational diabetes. Methods: A retrospective-prospective study was conducted from October 2024 to December 2024 at a tertiary referral hospital in Poland. The study included 205 pregnant women (42 with gestational diabetes, 163 without gestational diabetes) who met the inclusion criteria. Data were collected using a self-administered questionnaire and the Polish version of the Get Active Questionnaire for Pregnancy (GAQ-P). The impact of pre-pregnancy physical activity and pre-pregnancy BMI on the occurrence of gestational diabetes was assessed based on data collected from both surveys and medical records analysis. Statistical analyses included Pearson’s chi-square tests, logistic regression, and Cramér’s V coefficient to determine the relationship between pre-pregnancy physical activity and ppBMI and the occurrence of gestational diabetes. Results: The study revealed that pre-pregnancy BMI and gestational weight gain were significant predictors, with a higher BMI increasing the risk of gestational diabetes. In contrast, physical activity before pregnancy—including its frequency, intensity, and duration—was not a significant predictor. Additionally, no significant associations were found between physical activity and birth weight, mode of delivery, or preterm birth. These findings highlight the role of pre-pregnancy BMI in gestational diabetes risk while suggesting that physical activity before conception may have a limited impact. Conclusions: These results highlight the significant role of pre-pregnancy body mass index (BMI) in the development of gestational diabetes, emphasizing the need for targeted interventions aimed at maintaining a healthy weight before conception. They suggest that weight management strategies should be an important component of gestational diabetes prevention. Future research should further investigate the complex interaction between lifestyle factors and metabolic health to refine preventive recommendations and improve health outcomes for mothers and newborns. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

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12 pages, 229 KiB

Open AccessArticle

Predictors of Cardiometabolic Health a Few Months Postpartum in Women Who Had Developed Gestational Diabetes

by Cristina Gómez Fernández, Rajna Golubic, Rea Mitsigiorgi, Tanvi Mansukhani, Josip Car and Kypros H. Nicolaides

Nutrients 2025, 17(3), 390; https://doi.org/10.3390/nu17030390 - 22 Jan 2025

Cited by 1 | Viewed by 1042

Abstract

Background: To assess the incidence of dysglycaemia and metabolic syndrome and factors associated with them 5 months postpartum in women with gestational diabetes mellitus (GDM) in their last pregnancy. Methods: We conducted an observational prospective cohort study in 558 women with previous GDM who attended a 5-month postpartum follow-up clinic. Backward elimination was performed to select significant factors for the multivariable logistic regression model. Dysglycaemia (prediabetes and type 2 diabetes (T2D)) and metabolic syndrome were used as outcomes in separate models. Results: Dysglycaemia was diagnosed in 202 (36.2%) women, including 174 (31.2%) with prediabetes and 28 (5.0%) with T2D. Women with dysglycaemia, compared with those with normoglycaemia, were more likely to be of black ethnicity (33.2 vs. 20.5%) and have severe GDM (31.7 vs. 16%), a higher postpartum BMI (29.5 vs. 27.6 kg/m²), and metabolic syndrome (20 vs. 7%). Multivariable logistic regression analysis showed that significant predictors of dysglycaemia were black (OR 2.09; 95% CI: 1.27–3.46) and mixed ethnicity (OR 3.05; 95% CI: 1.26–7.42), diagnosis of GDM before 24 weeks gestation (OR 3.05, 95% CI: 1.90–4.91), and treatment of GDM with metformin (OR 1.63; 95% CI: 1.05–2.55) or insulin (OR 2.08; 95% CI: 1.14–3.79) rather than diet alone. Significant predictors of metabolic syndrome were postpartum maternal BMI (OR 5.49; 95% CI: 2.60–11.59) and absence of breastfeeding (OR 2.14; 95% CI: 1.21–3.77). Conclusions: At 5 months postpartum, a high proportion of women who developed GDM showed evidence of dysglycaemia. Future studies should investigate interventions that could reduce the risk of short- and long-term consequences of suboptimal cardiometabolic health in such women. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

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11 pages, 1584 KiB

Open AccessArticle

25-Hydroxyvitamin D, Vitamin D Binding Protein and Gestational Diabetes Mellitus: A Two-Sample Mendelian Randomization Study

by Yiwen Qiu, Diliyaer Ainiwan, Ye Huang, Libi Zhang, Haoyue Cheng, Xialidan Alifu, Haibo Zhou, Nuo Xv, Boya Wang, Shuhui Wang, Zexin Chen, Hui Liu, Danqing Chen and Yunxian Yu

Nutrients 2024, 16(16), 2603; https://doi.org/10.3390/nu16162603 - 7 Aug 2024

Viewed by 2029

Abstract

Background: Numerous studies have examined whether vitamin D is associated with gestational diabetes mellitus (GDM). Nevertheless, it is still challenging to determine the causality, due to a number of shortcomings in observational research and randomized controlled trials. Objective: Mendelian randomization (MR) with two samples was conducted to investigate the potential causative association between 25-hydroxyvitamin D (25(OH)D), vitamin D binding protein (VDBP) and GDM risk. Methods: Publicly accessible summary data from independent cohorts were used for two-sample MR. For 25(OH)D, we obtained data from UK Biobank, IEU and EBI, then performed a meta-analysis to enhance the statistical power (via METAL); for VDBP, data were obtained from the INTERVAL study; for GDM, data were obtained from FinnGen. The inverse variance weighted (IVW) approach was performed as the main analysis, together with several sensitivity analyses, such as MR–Egger, maximum likelihood, weighted median, and weighted mode. Results: The IVW results revealed a weak negative causal connection between 25(OH)D and GDM risk [OR (95% CI) = 0.71 (0.50, 0.99), p = 0.046]. However, the causal association was unstable according to sensitivity analyses, and Cochran’s Q test revealed significant heterogeneity. After removing BMI-related IVs, the causal association between 25(OH)D and GDM disappeared [OR (95% CI) = 0.76 (0.55, 1.06), p = 0.101]. In addition, our study found no proof to support the assumption that VDBP level was related to GDM risk causally [OR (95% CI) = 0.98 (0.93, 1.03), p = 0.408]. Conclusions: According to this study, a weak negative causal association between 25(OH)D and GDM risk was found, while we had little proof to support the link between VDBP and GDM. To further explore whether total or free 25(OH)D levels and GDM are causally related, GWAS data with an emphasis on women of reproductive age and other ethnic groups are required. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

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14 pages, 1519 KiB

Open AccessArticle

Weight Categories, Trajectories, Eating Behavior, and Metabolic Consequences during Pregnancy and Postpartum in Women with GDM

by Sybille Schenk, Yann Ravussin, Alain Lacroix, Dan Yedu Quansah and Jardena J. Puder

Nutrients 2024, 16(4), 560; https://doi.org/10.3390/nu16040560 - 18 Feb 2024

Cited by 3 | Viewed by 2624

Abstract

Pre-pregnancy overweight and obesity are associated with increased risk for adverse outcomes, such as gestational diabetes mellitus (GDM). This study investigated weight trajectories, eating behaviors, and metabolic consequences in women with GDM during pregnancy and postpartum according to pre-pregnancy BMI. We prospectively included 464 women with GDM. Intuitive eating (Intuitive Eating Scale-2 questionnaire), gestational weight gain (GWG), postpartum weight retention (PPWR) at 6–8 weeks and 1-year postpartum, and glucose intolerance (prediabetes and diabetes) at 1-year were assessed. Women with obesity (WOB) had lower GWG but gained more weight in the postpartum (p < 0.0001). PPWR at 1-year did not differ across BMI categories (p = 0.63), whereas postpartum weight loss was most pronounced in women with normal weight (p < 0.0001), and within this category, in their lowest tertile (p < 0.05). Intuitive eating was not linked to perinatal weight changes but differed among BMI categories. PPWR predicted a 2.5-fold increased risk of glucose intolerance at 1-year independent of pre-pregnancy BMI (p < 0.001), and the adverse metabolic impact of PPWR was most pronounced in WOB with odds of increased risk of glucose intolerance 8.9 times higher (95% CI 2.956;26.968). These findings suggest an adaptive capacity to relatively rapid weight changes in the perinatal period that is less present with higher BMI. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

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15 pages, 294 KiB

Open AccessArticle

Association of Maternal Diet with Infant Birthweight in Women with Gestational Diabetes Mellitus

by Aikaterini Apostolopoulou, Antigoni Tranidou, Violeta Chroni, Ioannis Tsakiridis, Emmanuella Magriplis, Themistoklis Dagklis and Michail Chourdakis

Nutrients 2023, 15(21), 4545; https://doi.org/10.3390/nu15214545 - 26 Oct 2023

Cited by 4 | Viewed by 2577

Abstract

Objective: This study aimed to explore the potential impact of pre-pregnancy and early pregnancy maternal nutrition on the incidence of small-for-gestational-age neonates (SGA) in women with gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24–28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence. Results: In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates. Conclusions: The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

12 pages, 1605 KiB

Open AccessArticle

Serum Sulfur-Containing Amino Acids and Risk of Maternal Gestational Diabetes and Adverse Growth Patterns in Offspring

by Ninghua Li, Jing Li, Hui Wang, Yijuan Qiao, Weiqin Li, Ming Gao, Enqing Liu, Zhijie Yu, Gang Hu, Zhongze Fang, Junhong Leng and Xilin Yang

Nutrients 2023, 15(18), 4089; https://doi.org/10.3390/nu15184089 - 21 Sep 2023

Cited by 2 | Viewed by 1827

Abstract

Background: To estimate associations of sulfur-containing amino acids (SAAs) in the early trimester of pregnancy and gestational diabetes mellitus (GDM) and estimate associations of maternal SAAs with adverse growth patterns in offspring. Methods: We established a 1:1 matched case-control study (n = 486) from our cohort of pregnant women, and 401 children were followed up at ages 1 to 8 years. We conducted binary conditional logistic regression to estimate the risk associations of serum SAAs with GDM. Multinomial logistic regression was implemented to explore associations of maternal SAAs with adverse growth patterns in the offspring. Results: High serum methionine and cystine were independently associated with increased GDM risk (OR: 1.92, 95%CI: 1.18–3.13 and 2.69, 1.59–4.53). Conversely, a low level of serum taurine was independently associated with increased GDM risk (2.61, 1.64–4.16). Maternal high cystine and low taurine were also associated with an increased risk of persistent obesity growth pattern (POGP) in offspring (OR: 2.79, 95%CI: 1.09–7.17 and 3.92, 1.11–13.89) and the effect was largely independent of GDM. Conclusions: High serum methionine, cystine and low serum taurine in the early trimester of pregnancy were associated with a greatly increased risk of GDM. Maternal high cystine and low taurine were associated with elevated risk of offspring POGP, largely independent of GDM. Full article

(This article belongs to the Special Issue Nutrients as Risk Factors and Treatments for Gestational Diabetes)

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