Dietary fibre intake reduces risk of gestational diabetes, preterm birth in pregnant women with high TyG index

The study was published as a preprint on Research Square and has yet to be peer-reviewed.

The single-centre, randomized study of 295 pregnant women having a high level of insulin resistance according to their TyG (triglyceride and glucose) index before 20 weeks' gestation showed a reduced risk of gestational, improved glucose metabolism, and significantly fewer preterm birth on daily treatment with an oral fibre supplement for five weeks versus untreated controls.

Women with gestational diabetes mellitus (GDM) are at risk for perinatal and maternal complications and type 2 diabetes later in life. The researchers noted that improving glucose metabolism in pregnant women with a high TyG index might help prevent gestational diabetes. A high TyG index in the first trimester is tied to the development of gestational diabetes. However, no trials have tested the effects of dietary fibre on GDM prevention in women with high TyG index.

To address the knowledge gap, Dongyao Zhang, Shanghai General Hospital, China, and colleagues aimed to determine whether gestational diabetes can be prevented by dietary fibre supplementation among women with a TyG index ≥ 8.5 during early pregnancy (< 20 weeks).

For this purpose, the researchers performed a randomized clinical trial among 295 women with a higher TyG index ( ≥ 8.5) before 20 gestation weeks. They were divided into a fibre group (24 g dietary fibre powder/day; n=89) or a control group (usual care; n=186). The intervention was conducted from 20 to 24+ six gestational weeks, and both groups got guidance on diet and exercise.

GDM incidence was the primary outcome diagnosed by a 75 g OGTT (oral glucose tolerance test) at gestational weeks 25–28, and lipids and blood glucose levels. Secondary outcomes were preterm birth, postpartum haemorrhage, gestational hypertension, and other neonatal and maternal complications.

The study revealed the following findings:

• Gestational diabetes occurred at 11.2% in the fibre group, significantly lower than 23.7 (44 of 186) in the control group.
• There was a dramatic increase in the mean gestational weeks in the fibre group compared with the control group (38.58 ± 1.44 weeks versus 39.07 ± 1.08 weeks).
• The incidence of preterm birth was 2.3% of women randomized to the fibre group compared with 9.4% in the control group.
• The 2-hour postprandial blood glucose concentrations were statistically higher in the control group compared with the intervention group (6.69 ± 1.65 mmol/L vs. 6.45 ± 1.25 mmol/L).
• There were no other significant differences between groups in lipid profile values or other secondary outcomes.

"An intervention with dietary fibre supplementation during pregnancy may prevent preterm birth and GDM and in women with a TyG index ≥ 8.5 before 20 weeks of gestation," the researchers conclude.

Reference:

Dongyao Zhang, Jing Sheng, Li Chen et al. The Role of Dietary Fiber on Preventing Gestational Diabetes Mellitus in an At-Risk Group of High Triglyceride-Glucose Index Women: A Randomized Controlled Trial, 02 May 2023, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-2638326/v1]