Gestational Diabetes Mellitus and Diet: A Systematic Review and Meta-analysis of Randomized Controlled Trials Examining the Impact of Modified Dietary Interventions on Maternal Glucose Control and Neonatal Birth Weight
Open accessAbstract
OBJECTIVE: Medical nutrition therapy is a mainstay of gestational diabetes mellitus (GDM) treatment. However, data are limited regarding the optimal diet for achieving euglycemia and improved perinatal outcomes. This study aims to investigate whether modified dietary interventions are associated with improved glycemia and/or improved birth weight outcomes in women with GDM when compared with control dietary interventions. RESEARCH DESIGN AND METHODS: Data from published randomized controlled trials that reported on dietary components, maternal glycemia, and birth weight were gathered from 12 databases. Data were extracted in duplicate using prespecified forms. RESULTS: From 2,269 records screened, 18 randomized controlled trials involving 1,151 women were included. Pooled analysis demonstrated that for modified dietary interventions when compared with control subjects, there was a larger decrease in fasting and postprandial glucose (−4.07 mg/dL [95% CI −7.58, −0.57]; P = 0.02 and −7.78 mg/dL [95% CI −12.27, −3.29]; P = 0.0007, respectively) and a lower need for medication treatment (relative risk 0.65 [95% CI 0.47, 0.88]; P = 0.006). For neonatal outcomes, analysis of 16 randomized controlled trials including 841 participants showed that modified dietary interventions were associated with lower infant birth weight (−170.62 g [95% CI −333.64, −7.60]; P = 0.04) and less macrosomia (relative risk 0.49 [95% CI 0.27, 0.88]; P = 0.02). The quality of evidence for these outcomes was low to very low. Baseline differences between groups in postprandial glucose may have influenced glucose-related outcomes. As well, relatively small numbers of study participants limit between-diet comparison. CONCLUSIONS: Modified dietary interventions favorably influenced outcomes related to maternal glycemia and birth weight. This indicates that there is room for improvement in usual dietary advice for women with GDM.
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Pooled meta-analyses suggest that a modified carbohydrate-restricted diet may reduce birth weight and improve maternal glycaemic control without increasing blood ketone levels.
“However, pooled meta-analyses suggest that a modified carbohydrate-restricted diet may reduce birth weight and improve maternal glycaemic control without increasing blood ketone levels [79,80].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [79]
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- Authors
- Yamamoto, J. M., Kellett, J. E., Balsells, M., García-Patterson, A., Hadar, E., Solà, I., Gich, I., van der Beek, E. M., Castañeda-Gutiérrez, E., Heinonen, S., Hod, M., Laitinen, K., Olsen, S. F., Poston, L., Rueda, R., Rust, P., van Lieshout, L., Schelkle, B., Murphy, H. R., & Corcoy, R.
- Affiliations
- University of Calgary (CA)
- Norfolk and Norwich University Hospital (GB)
- University Hospital Mútua de Terrassa (ES)
- Institute of Biomedical Research, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Tel Aviv University (IL)
- Universitat Autònoma de Barcelona (ES)
- Nutricia Research, Utrecht, the Netherlands
- Nestlé Research Center, Lausanne, Switzerland
- University of Helsinki (FI)
- University of Turku (FI)
- Statens Serum Institut (DK)
- King's College London (GB)
- Research and Development Department, Abbott Nutrition, Granada, Spain
- University of Vienna (AT)
- International Life Sciences Institute Europe, Brussels, Belgium
- International Life Sciences Institute Europe (BE)
- University of East Anglia (GB)
- Corresponding author
- Murphy, Helen R.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-06-14
- Volume
- 41
- Issue
- 7
- Pages
- 1346-1361
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2800537826
- Cited by
- 301
- References
- 10
- Citations by year
- 2026: 31 · 2025: 40 · 2024: 38 · 2023: 51 · 2022: 37 · 2021: 34 · 2020: 40 · 2019: 22 · 2018: 8
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- green
- ueaeprints.uea.ac.uk
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0407-10452)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- gestational diabetes mellitus, dietary intervention, medical nutrition therapy, maternal glycemic control, postprandial blood glucose, fasting blood glucose, birth weight, macrosomia, perinatal outcomes, insulin requirement
- MeSH terms
- Birth Weight, Blood Glucose, Diet, Female, Fetal Macrosomia, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Randomized Controlled Trials as Topic, Diabetes, Gestational, Treatment Outcome
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