Multiorgan Regulation Mechanisms and Nutritional Intervention Strategies in Gestational Diabetes Mellitus.

Abstract

Gestational diabetes mellitus (GDM) affects millions of pregnant women worldwide and leads to both short- and long-term complications for mothers and their fetuses. Managing GDM through diet, physical activity, and medical interventions can significantly reduce these risks. Studies have identified the individual and combined roles of organs regulated by placental hormones, cytokines, and gut microbiota as key pathways contributing to impaired glucose homeostasis. In this context, placental hormones mediate the crosstalk among the placenta, pancreas, and adipose tissue, stimulating endocrine pancreas adaptation and adipose tissue expansion. However, insufficient maternal physiological adaptations, such as dysregulated adipocytokines, adipokines, and oxidative stress in the pancreas, can create an environment conducive to the onset of GDM. Furthermore, gut dysbiosis implies potential mechanisms of gut-host interaction associated with the occurrence of GDM, with short-chain fatty acids possibly serving as crucial targets. Nutritional therapy is recognized as the first-line approach for managing GDM, encompassing dietary guidance and supplementation with micro- and macronutrients as well as bioactive components. Importantly, combined interventions involving multiple nutrients, such as probiotics and prebiotics with vitamins or minerals, may exert stronger beneficial effects on the prevention and treatment of GDM and its complications. This review paper discusses the regulatory role of multiorgans in GDM and the implementation of nutritional therapy for its prevention and management, along with associated complications.