Probiotics combined with healthy lifestyle may be a viable treatment for post-gestational diabetes, expert flag

21 Sep 2022 --- Gestational diabetes mellitus (GDM) – a metabolic disorder occurring during pregnancy – increases the risk of developing Type 2 diabetes almost tenfold following birth. Efforts to prevent the advancement of the disease have been largely unsuccessful, but a recent study has found that introducing probiotics may improve preventative treatment outcomes.

According to the Malaysia-based study, GDM is “an episode of high blood glucose levels detected during the second or third trimester in pregnant women without overt diabetes.” Women diagnosed with the ailment during pregnancy are considered post-GDM and more susceptible to developing Type 2 diabetes later in life, as well as other negative health effects, even if they are asymptomatic. 

Current treatments depend on the patient maintaining a healthy lifestyle indefinitely following pregnancy and, in some cases, taking metformin even though they may be asymptomatic. However, the study found that many patients do not comply with the recommended lifestyle changes and metformin, which has potential side effects, may not be necessary.Post-GDM interventions often fail because patients do not always comply with the prescribed lifestyle modifications.

Postpartum probiotics
The study, published in Nutrients, found that the currently prescribed treatments, as recommended by the American Diabetes Association, are reported to decrease the risk of developing Type 2 diabetes by up to 53%. However, those numbers only apply to those patients who actually follow the lifestyle modifications. For the rest of the patients, many of whom may have been unhealthy to begin with, those numbers do hold up. 

The authors used a 12-week, randomized, placebo-controlled, double-blind study of 166 post-GDM women who had given birth within three to six months and between the ages of 18 and 45. Eighty-three percent of the participants were given a powder containing 30 billion colony-forming units of six different probiotic strains twice a day before meals. The remaining 83 participants were given the placebo.

The packet included 107 mg each of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus lactis, Bifidobacterium bifidum, Bifidobacterium infantis and Bifidobacterium longum. All of the strains have been shown to aid in treating microbiome imbalances and immunity. 

The participants were also asked to abstain from prebiotic, probiotic and synbiotic-rich foods for the duration of the study. They were further encouraged not to change their current levels of physical activity.

Measuring the effectsWomen who suffered from GDM during pregnancy are ten times as likely to develop Type 2 diabetes in their lifetime.
The researchers measured blood sugar, blood pressure and cholesterol levels. They also analyzed the microbiome makeup of 12 participants from each group before and after the study in order to correlate the buildup of probiotics with effects on diabetic precursors. 

The results revealed that the placebo had higher fasting blood glucose levels compared to the control group at the end of 12 weeks. Moreover, though there was no noticeable difference in body mass index between the two groups, the researchers reported a significant difference in waist circumference by the end of the study, positively favoring the test group.

Furthermore, cholesterol levels were also lower in the participants who received the probiotic supplement. 

Significant outcomes?
According to the authors, “taking probiotics helped to restore gut microbial profiles, gut microbial functions and metabolic pathways without having a negative impact on health.” The supplemental probiotics also improved glucose metabolism. 

However, 37% of the test group showed no improvement in diabetic propensity. This finding leads the researchers to conclude that probiotics alone is not a significant enough treatment for all sufferers of post-GDM.

“Given that the probiotics’ overall beneficial effects on metabolic outcomes were minimal, we deduced that their activities in this trial were geared more toward reducing illness severity than treating it,” conclude the authors. “In practice, a combination of a healthy lifestyle and probiotics supplementation should be adopted as a viable preventive therapy.”

Edited by William Bradford Nichols