Probiotic Supplementation may Improve Insulin Resistance in Pregnant Women

When most women think of nutrient supplementation during pregnancy, prenatal vitamins come to mind. These pills usually consist of vitamins and minerals such as folic acid, iron, vitamin D, and calcium that help both the mother and baby during the fetal development. Recent studies have shown that pregnant women may want to add probiotics to their regimen as way to manage blood glucose (blood sugar) levels.

Please contact your healthcare provider before supplementing with probiotics.

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus (GDM) is the most common pregnancy complication. It is characterized as the development of hyperglycemia (high blood sugar) and insulin (used to regulate blood glucose or blood sugar levels) resistance during pregnancy. Women with GDM are 20-60% more likely to develop type II Diabetes Mellitus in five to ten years after pregnancy. Overweight and obesity can contribute to half of GDM’s prevalence. Both GDM and obesity can result in metabolic traits such as hyperglycemia, hyperinsulinemia (excessive insulin production), and insulin resistance.

Typically, medication usage as well as lifestyle intervention is used to control maternal hyperglycemia and insulin resistance. Lifestyle interventions include the use of Medical Nutrition Therapy, exercise intervention, and self-monitoring blood glucose. Recently, the use of probiotics has been explored as an option in the treatment and prevention of Gestational Diabetes and insulin resistance in pregnant women. One study (Pan, 2021) examined at the effect of probiotic usage on insulin resistance in pregnant women with and without GDM.

Probiotic Supplements

Probiotics are live microorganisms that play an important function in improving the intestinal microbiome, regulating the immune system, and preventing systemic disease and inflammation. Individuals with obesity and diabetes have an altered function of their microbiota when compared to a healthy microbiota. The use of probiotics can help prevent these metabolic changes that result from changes in the microbiota.

How can Probiotics improve glycemic control? – Probiotics utilize three mechanisms to help improve insulin resistance:

1. Probiotics interact with the microbiota and produce SCFAs (short chain fatty acids)

2. Probiotics improve the intestinal epithelial barrier (lining of the gastrointestinal tract)

3. Probiotics regulate the secretion of pro-inflammatory mediators (help reduce inflammation)

The Study

This study included an analysis of 20 different studies that explored probiotic usage on pregnant women from around the world. Three subgroups were identified: overweight or obese pregnant women, women with GDM, and healthy pregnant women. Among the studies, intervention methods included the usage of probiotic capsules, food, and probiotic yogurt with the frequency being mostly once a day.

The results indicated that probiotic supplementation has a positive effect on improving fasting plasma glucose levels (blood glucose levels), insulin levels, and insulin resistance and insensitivity especially in women with GDM and healthy pregnant women. It was also shown that capsule supplementation had a better effect than probiotic yogurt and that a short-term intervention of less than 12 weeks was more effective in glucose metabolism. The number of probiotic doses also played a factor. Large doses played a role in decreasing fasting plasma glucose levels. However, probiotic supplementation did not have any effect on HbA1c, the 1 h and 2 h OGGT (75g oral glucose tolerance test), or the incidence of GDM.

This study illustrated the use of probiotics in women with GDM or healthy women. More studies need to be done to determine the effect of probiotic supplementation on women with obesity or overweight. Although there is no specific dosage of probiotics that is proven to be beneficial, greater than or equal to 109 CFU has been shown to be more effective than lower dosages. It was also identified that the best method of supplementation is the use of capsules due to their higher probiotic survival rate when compared to other sources of probiotics. With this information, probiotics can be used as an assistant treatment strategy for diabetes in pregnant women.

References

Pan, Y.-Q., Zheng, Q.-X., Jiang, X.-M., Chen, X.-Q., Zhang, X.-Y., & Wu, J.-L. (2021). Probiotic supplements improve blood glucose and insulin resistance/sensitivity among healthy and GDM pregnant women: A systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2021, 1–17. https://doi.org/10.1155/2021/9830200