Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis

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Abstract
Background: Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus. Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model. Results: Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference = −0.95; 95% CI = −1.73 to −0.17; p < .00001) and HOMA-IR (Std. mean difference = −1.12; 95% CI = −2.05 to −0.18; p = .02), but showed no substantial impact on fasting plasma glucose (Std. mean difference = −0.49; 95% CI = −1.05–0.08; p = .09), gestational age (Std. mean difference = 0.07; 95% CI = −0.20–0.34; p = .63), and gestational weight (Std. mean difference = −0.11; 95% CI = −0.38–0.16; p = .43). Conclusions: Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.

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