Efficacy of diet interventions on pregnant women with gestational diabetes mellitus: an umbrella review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Huiyi , XING Nianlu , WU Xiaochen , RUAN Yuye ,  ZHOU Yingfeng

Department of Nursing, Fudan University, Shanghai 200032, P. R. China;

Corresponding?author：

ZHOU Yingfeng, Email: zyingfeng@fudan.edu.cn

Keywords：

Diet therapy; Gestational diabetes mellitus; Systematic review; Umbrella review

DOI：

10.7507/1672-2531.202501112

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To overview the systematic review (SR) of the effects of dietary pattern intervention during pregnancy on pregnant women with gestational diabetes mellitus (GDM). Methods The Cochrane Library, The Joanna Briggs Institute Library, Embase, PubMed, Web of Science, CINAHL, CBM, CNKI, WanFang Data, and VIP databases were electronically searched to collect SR and meta-analysis on the effects of different dietary patterns on maternal and infant outcomes of gestational diabetes mellitus from inception to October 1, 2024. Two reviewers independently screened literature, extracted data, and then AMSTAR 2 tool was used to assess the methodological quality of included studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 15 relevant SR were included, the methodological quality of the included SR was generally low, with 3 SR at a low level and 12 SR at a very low level. Major dietary patterns included the low glycemic index (GI) diet, carbohydrate (CHO) restricted diet, energy restricted diet, dietary approaches to stop hypertension (DASH) diet, high-fiber diet, polyunsaturated fatty acid (PUFA) rich diet, soy protein-enriched diet, low glycemic load (GL) diet, and mediterranean diet. A meta-analysis of primary outcome measures showed that the low GI diet, DASH diet and low GL load diet had a lower incidence of blood glucose levels and adverse pregnancy outcomes (including maternal weight gain, insulin use, cesarean section, macrosomia) compared with the control diets. Conclusion It was recommended that GDM pregnant women follow the low GI diet, DASH diet, or low GL diet to control blood glucose levels and improve pregnancy outcomes. There is currently insufficient evidence to support the effects of other dietary patterns on GDM.

Citation： WANG Huiyi, XING Nianlu, WU Xiaochen, RUAN Yuye, ZHOU Yingfeng. Efficacy of diet interventions on pregnant women with gestational diabetes mellitus: an umbrella review. Chinese Journal of Evidence-Based Medicine, 2025, 25(7): 811-817. doi: 10.7507/1672-2531.202501112 Copy

1.	中華醫學會婦產科學分會產科學組, 中華醫學會圍產醫學分會妊娠合并糖尿病協作組. 妊娠合并糖尿病診治指南(2014). 中國實用鄉村醫生雜志, 2017, 24(8): 45-52.
2.	Magliano DJ, Boyko EJ, IDF Diabetes Atlas 10th Edition Scientific Committee. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation, 2021.
3.	American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care, 2020, 43(Suppl 1): S14-S31.
4.	Juan J, Yang HX, Su RN, et al. Diagnosis of gestational diabetes mellitus in China: perspective, progress and prospects. Matern-Fetal Med, 2019, 1(1): 31-37.
5.	American Diabetes Association. 14. Management of diabetes in pregnancy: standards of medical care in diabetes-2020. Diabetes Care, 2020, 43(Suppl 1): S183-S192.
6.	National Institute for Health and Care Excellence (NICE). National Institute for Health and Care Excellence: guidelines. 2020.
7.	Song SJ, Lee JE, Paik HY, et al. Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia. Nutr Res Pract, 2012, 6(4): 349-356.
8.	Guastadisegni C, Donfrancesco C, Palmieri L, et al. Nutrients intake in individuals with hypertension, dyslipidemia, and diabetes: an italian survey. Nutrients, 2020, 12(4): 923.
9.	范巖峰, 鐘紅秀, 李麗榕, 等. 營養干預對妊娠期糖尿病孕婦孕期體重增長和血脂代謝水平及分娩結局的影響. 中國實用婦科與產科雜志, 2022, 38(9): 929-933.
10.	Amati F, Hassounah S, Swaka A. The impact of mediterranean dietary patterns during pregnancy on maternal and offspring health. Nutrients, 2019, 11(5): 1098.
11.	Louie JC, Markovic TP, Perera N, et al. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care, 2011, 34(11): 2341-2346.
12.	Rae A, Bond D, Evans S, et al. A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes. Aust N Z J Obstet Gynaecol, 2000, 40(4): 416-422.
13.	Asemi Z, Samimi M, Tabassi Z, et al. The effect of DASH diet on pregnancy outcomes in gestational diabetes: a randomized controlled clinical trial. Eur J Clin Nutr, 2014, 68(4): 490-495.
14.	Mijatovic J, Louie JCY, Buso MEC, et al. Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial. Am J Clin Nutr, 2020, 112(2): 284-292.
15.	Reece EA, Hagay Z, Caseria D, et al. Do fiber-enriched diabetic diets have glucose-lowering effects in pregnancy. Am J Perinatol, 1993, 10(4): 272-274.
16.	Assaf-Balut C, García de la Torre N, Durán A, et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): a randomized controlled trial: the St. Carlos GDM prevention study. PLoS One, 2017, 12(10): e0185873.
17.	Moreno-Castilla C, Hernandez M, Bergua M, et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus: a randomized controlled trial. Diabetes Care, 2013, 36(8): 2233-2238.
18.	Aromataris ELC, Porritt K, Pilla B, et al. JBI manual for evidence synthesis. 2024.
19.	陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具AMSTAR2解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
20.	Viana LV, Gross JL, Azevedo MJ. Dietary intervention in patients with gestational diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials on maternal and newborn outcomes. Diabetes Care, 2014, 37(12): 3345-3355.
21.	火睿. 飲食干預對2型糖尿病和妊娠期糖尿病患者的血糖及相關因素影響的Meta分析. 武漢: 華中科技大學, 2015.
22.	Wei J, Heng W, Gao J. Effects of low glycemic index diets on gestational diabetes mellitus: a meta-analysis of randomized controlled clinical trials. Medicine (Baltimore), 2016, 95(22): e3792.
23.	趙春媚, 周波. 妊娠糖尿病孕婦接受低血糖生成指數食物干預效果的系統評價. 實用臨床醫藥雜志, 2016, 20(15): 66-70.
24.	Han S, Middleton P, Shepherd E, et al. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev, 2017, (2): CD009275.
25.	Hillyard M, Casson K, Sinclair M, et al. Can physical activity and dietary interventions improve maternal and fetal outcomes in women with gestational diabetes mellitus. A systematic review and meta-analysis. Evidence Based Midwifery, 2018, 16(3): 76-83.
26.	Whitehead L. The effects of different types of dietary advice for women with gestational diabetes mellitus on pregnancy outcomes. Clin Nurse Spec, 2018, 32(4): 175-176.
27.	Yamamoto JM, Kellett JE, Balsells M, et al. 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. Diabetes Care, 2018, 41(7): 1346-1361.
28.	Wan CS, Nankervis A, Teede H, et al. Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis. Nutr Diet, 2019, 76(2): 211-232.
29.	Xu J, Ye S. Influence of low-glycemic index diet for gestational diabetes: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med, 2020, 33(4): 687-692.
30.	Feng Y, Zhao Z, Fu D, et al. Maternal and neonatal outcomes after energy-restricted diet for women with gestational diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore), 2021, 100(14): e25279.
31.	張琪. 低血糖生成指數飲食對妊娠期糖尿病治療作用的meta分析. 承德: 承德醫學院, 2022.
32.	Lin Q, Zhang Z, Meng Q, et al. Effects of different dietary patterns during pregnancy on birth outcomes and glucose parameters in women with gestational diabetes mellitus: a systematic review and meta-analysis. Prim Care Diabetes, 2023, 17(4): 287-308.
33.	盛金葉, 吳瑞臻, 梁肖肖, 等. 低升糖指數飲食模式對妊娠期糖尿病妊娠結局影響的Meta分析. 中國食物與營養, 2023, 29(12): 56-61.
34.	Wong MMH, Yuen-Man Chan M, Ng TP, et al. Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr, 2024, 18(1): 102941.
35.	Parums DV. Editorial: review articles, systematic reviews, meta-analysis, and the updated preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. Med Sci Monit, 2021, 27: e934475.
36.	Kintiraki E, Goulis DG. Gestational diabetes mellitus: multi-disciplinary treatment approaches. Metabolism, 2018, 86: 91-101.

1. 中華醫學會婦產科學分會產科學組, 中華醫學會圍產醫學分會妊娠合并糖尿病協作組. 妊娠合并糖尿病診治指南(2014). 中國實用鄉村醫生雜志, 2017, 24(8): 45-52.
2. Magliano DJ, Boyko EJ, IDF Diabetes Atlas 10th Edition Scientific Committee. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation, 2021.
3. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care, 2020, 43(Suppl 1): S14-S31.
4. Juan J, Yang HX, Su RN, et al. Diagnosis of gestational diabetes mellitus in China: perspective, progress and prospects. Matern-Fetal Med, 2019, 1(1): 31-37.
5. American Diabetes Association. 14. Management of diabetes in pregnancy: standards of medical care in diabetes-2020. Diabetes Care, 2020, 43(Suppl 1): S183-S192.
6. National Institute for Health and Care Excellence (NICE). National Institute for Health and Care Excellence: guidelines. 2020.
7. Song SJ, Lee JE, Paik HY, et al. Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia. Nutr Res Pract, 2012, 6(4): 349-356.
8. Guastadisegni C, Donfrancesco C, Palmieri L, et al. Nutrients intake in individuals with hypertension, dyslipidemia, and diabetes: an italian survey. Nutrients, 2020, 12(4): 923.
9. 范巖峰, 鐘紅秀, 李麗榕, 等. 營養干預對妊娠期糖尿病孕婦孕期體重增長和血脂代謝水平及分娩結局的影響. 中國實用婦科與產科雜志, 2022, 38(9): 929-933.
10. Amati F, Hassounah S, Swaka A. The impact of mediterranean dietary patterns during pregnancy on maternal and offspring health. Nutrients, 2019, 11(5): 1098.
11. Louie JC, Markovic TP, Perera N, et al. A randomized controlled trial investigating the effects of a low-glycemic index diet on pregnancy outcomes in gestational diabetes mellitus. Diabetes Care, 2011, 34(11): 2341-2346.
12. Rae A, Bond D, Evans S, et al. A randomised controlled trial of dietary energy restriction in the management of obese women with gestational diabetes. Aust N Z J Obstet Gynaecol, 2000, 40(4): 416-422.
13. Asemi Z, Samimi M, Tabassi Z, et al. The effect of DASH diet on pregnancy outcomes in gestational diabetes: a randomized controlled clinical trial. Eur J Clin Nutr, 2014, 68(4): 490-495.
14. Mijatovic J, Louie JCY, Buso MEC, et al. Effects of a modestly lower carbohydrate diet in gestational diabetes: a randomized controlled trial. Am J Clin Nutr, 2020, 112(2): 284-292.
15. Reece EA, Hagay Z, Caseria D, et al. Do fiber-enriched diabetic diets have glucose-lowering effects in pregnancy. Am J Perinatol, 1993, 10(4): 272-274.
16. Assaf-Balut C, García de la Torre N, Durán A, et al. A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): a randomized controlled trial: the St. Carlos GDM prevention study. PLoS One, 2017, 12(10): e0185873.
17. Moreno-Castilla C, Hernandez M, Bergua M, et al. Low-carbohydrate diet for the treatment of gestational diabetes mellitus: a randomized controlled trial. Diabetes Care, 2013, 36(8): 2233-2238.
18. Aromataris ELC, Porritt K, Pilla B, et al. JBI manual for evidence synthesis. 2024.
19. 陶歡, 楊樂天, 平安, 等. 隨機或非隨機防治性研究系統評價的質量評價工具AMSTAR2解讀. 中國循證醫學雜志, 2018, 18(1): 101-108.
20. Viana LV, Gross JL, Azevedo MJ. Dietary intervention in patients with gestational diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials on maternal and newborn outcomes. Diabetes Care, 2014, 37(12): 3345-3355.
21. 火睿. 飲食干預對2型糖尿病和妊娠期糖尿病患者的血糖及相關因素影響的Meta分析. 武漢: 華中科技大學, 2015.
22. Wei J, Heng W, Gao J. Effects of low glycemic index diets on gestational diabetes mellitus: a meta-analysis of randomized controlled clinical trials. Medicine (Baltimore), 2016, 95(22): e3792.
23. 趙春媚, 周波. 妊娠糖尿病孕婦接受低血糖生成指數食物干預效果的系統評價. 實用臨床醫藥雜志, 2016, 20(15): 66-70.
24. Han S, Middleton P, Shepherd E, et al. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev, 2017, (2): CD009275.
25. Hillyard M, Casson K, Sinclair M, et al. Can physical activity and dietary interventions improve maternal and fetal outcomes in women with gestational diabetes mellitus. A systematic review and meta-analysis. Evidence Based Midwifery, 2018, 16(3): 76-83.
26. Whitehead L. The effects of different types of dietary advice for women with gestational diabetes mellitus on pregnancy outcomes. Clin Nurse Spec, 2018, 32(4): 175-176.
27. Yamamoto JM, Kellett JE, Balsells M, et al. 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. Diabetes Care, 2018, 41(7): 1346-1361.
28. Wan CS, Nankervis A, Teede H, et al. Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis. Nutr Diet, 2019, 76(2): 211-232.
29. Xu J, Ye S. Influence of low-glycemic index diet for gestational diabetes: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med, 2020, 33(4): 687-692.
30. Feng Y, Zhao Z, Fu D, et al. Maternal and neonatal outcomes after energy-restricted diet for women with gestational diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore), 2021, 100(14): e25279.
31. 張琪. 低血糖生成指數飲食對妊娠期糖尿病治療作用的meta分析. 承德: 承德醫學院, 2022.
32. Lin Q, Zhang Z, Meng Q, et al. Effects of different dietary patterns during pregnancy on birth outcomes and glucose parameters in women with gestational diabetes mellitus: a systematic review and meta-analysis. Prim Care Diabetes, 2023, 17(4): 287-308.
33. 盛金葉, 吳瑞臻, 梁肖肖, 等. 低升糖指數飲食模式對妊娠期糖尿病妊娠結局影響的Meta分析. 中國食物與營養, 2023, 29(12): 56-61.
34. Wong MMH, Yuen-Man Chan M, Ng TP, et al. Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr, 2024, 18(1): 102941.
35. Parums DV. Editorial: review articles, systematic reviews, meta-analysis, and the updated preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. Med Sci Monit, 2021, 27: e934475.
36. Kintiraki E, Goulis DG. Gestational diabetes mellitus: multi-disciplinary treatment approaches. Metabolism, 2018, 86: 91-101.

Chinese Journal of Evidence-Based Medicine

Efficacy of diet interventions on pregnant women with gestational diabetes mellitus: an umbrella review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content