The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: A systematic review and meta-analysis

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-10-29 DOI:10.1111/dme.15435

Danielle Jones, Anna Kyriakidou, Louise Cooper, Nooria Atta, Patrycja Tobolska, Suzanne Smith, Elizabeth Turner, Clive Petry, Clare Gillies, Claire L. Meek

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Abstract

Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy.

Methods

We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high-fibre diets or fibre supplementation on fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes. Data were pooled for each outcome to calculate change from baseline mean (SD) and overall mean difference (MD) between control and intervention groups.

Results

Of 1462 identified studies, data from 20 eligible trials containing 1061 participants were pooled. On meta-analysis, a higher fibre intake was associated with reduced FBG (MD: −0.35 mmol/L, 95% CI: −0.53, −0.18, p < 0.01), PBG (MD: −0.90 mmol/L, 95% CI: −1.39, −0.40, p < 0.01) and requirement for insulin (OR: 0.24, 95% CI: 0.13, 0.46, p < 0.01). There was significant heterogeneity for FBG and PBG (>90%), attributable to differences in Intervention type for PBG (Dietary Approach to Stop Hypertension [DASH] diet, low glycaemic index, supplement; p < 0.01) and study duration (for FBG: p = 0.002; not for PBG). Studies were mostly scored as high risk of bias due to lack of blinding (Cochrane Risk of Bias Tool v.2.0).

Conclusion

High-quality dietary intervention studies in pregnancy are lacking. Our results suggest that high-fibre diets improve fasting and postprandial glycaemia and reduce the likelihood of requiring insulin in women with diabetes in pregnancy.

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高纤维饮食对妊娠期糖尿病妇女血糖控制的影响：系统回顾和荟萃分析。

膳食纤维可改善 2 型糖尿病患者的血糖控制，但其对妊娠期糖尿病妇女的治疗作用尚不明确。我们评估了膳食纤维对妊娠期糖尿病妇女血糖控制指标的影响：我们检索了四个数据库（Cochrane Library、MEDLINE、Embase 和 Web of Science），以确定探讨膳食纤维、高纤维膳食或纤维补充剂对糖尿病孕妇空腹血糖 (FBG)、餐后 2 小时血糖 (PBG) 和胰岛素治疗需求以及其他血糖指标影响的 RCT。对每项结果的数据进行汇总，以计算对照组和干预组之间从基线平均值（SD）到总体平均差（MD）的变化：在已确定的 1462 项研究中，汇总了 20 项合格试验的数据，其中有 1061 名参与者。经荟萃分析，纤维摄入量增加与 FBG 降低有关（MD：-0.35 mmol/L，95% CI：-0.53，-0.18，P 90%），这归因于 PBG 干预类型的差异（Dietary Approach to Stop Hypertension [DASH] diet、low glycaemic index、supplement；P 结论：缺乏高质量的孕期饮食干预研究。我们的研究结果表明，高纤维膳食可改善妊娠期糖尿病妇女的空腹和餐后血糖，并降低其需要胰岛素的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”