32: Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial

Abstract

OBJECTIVE: Probiotics are live microorganisms which may confer health benefits on the host. Recent trials of probiotics in healthy pregnancy demonstrate potential for improved glycaemic control. The aim of this study was to investigate the effects of a probiotic capsule intervention on maternal metabolic indices among women with GDM. STUDY DESIGN: This double‐blind placebo‐controlled randomized trial (registration ISRCTN97241163) recruited pregnant women with a new diagnosis of GDM following a 3‐hour 100g GTT. Women were randomized to a daily probiotic (Lactobacillus salivarius UCC118) or placebo capsule from GDM diagnosis until delivery. Fasting blood samples were collected at baseline and 4‐6 weeks post capsule commencement for analysis of glucose, insulin, c‐peptide, HOMA and lipids. The primary outcome was change in fasting glucose among women not commenced on insulin therapy. Secondary outcomes were requirement for insulin and changes in other metabolic indices. A sample size of 100 was required to detect a 0.4mmol/l difference in fasting glucose with 80% power at the 0.05 level of significance. RESULTS: Of 115 women recruited and randomized, there were no differences between the groups in baseline characteristics or requirement for insulin therapy (9 probiotic, 6 placebo group; p=0.386). Among 100 women not treated with insulin, fasting plasma glucose decreased significantly within both the probiotic and placebo group, but the change between groups did not differ. The rise in total and LDL cholesterol was significantly attenuated in the probiotic versus placebo group. No differences were noted between groups in other metabolic indices. CONCLUSION: A probiotic capsule intervention among women with abnormal glucose tolerance had no impact on glycaemic control. However, a significant attenuation of the normal pregnancy‐induced rise in total and LDL cholesterol compared to placebo indicates a potential role of probiotics to improve the metabolic profile of an obstetric group at risk of future CVD. HOMA, homeostasis model assessment; HDL, high density lipoprotein; LDL, low density lipoprotein. Data presented as Mean (SD). a Within group differences from pre‐ to post‐intervention, calculated by paired sample t‐test. b between group differences in change in each parameter from pre‐ to post‐intervention, calculated by independent samples t‐test. (Table Presented).