According to a new study published earlier this month in The Journal of Maternal-Fetal & Neonatal Medicine researchers demonstrated the efficacy of probiotic supplementation in gestational diabetes.
This was a meta-analysis of six random controlled trials involving 830 patients. The two outcomes assessed were fasting insulin and fasting blood glucose. As a result probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting insulin; however no significant effect was seen on fasting glucose levels.
During a probiotic workshop at Yale I remember one of the presentations from Max Nueuwdrop MD PHD an internist and endocrinologist from Amsterdam. He went into detail on the topic of the microbiota and metabolism. He showed how butyrate a SCFA improved insulin resistance and brown fat activation.
Probiotics help encourage microbial diversity especially if the probiotic supplement is of a mixed species. In ecological terms it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome.
Inositol is another nutrient that should be considered for these women. Previous research has demonstrated that myo-inositol with d-chiro-inositol helps to prevent gestational diabetes.
Inositol acts as second messenger which regulates several hormones such as follicle stimulating hormone thyroid stimulating hormone and insulin.
Studies have shown that an inositol deficiency is common in women with insulin resistance. There appears to be a reduced ability to process metabolize and effectively use inositol from foods which is a distinctive characteristic feature of insulin resistance. As a result the nutritional requirements of these patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.
Myo-inositol and D-chiro-inositol are both essential for patients with insulin resistance. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in these patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others. Along this spectrum people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion but with less than optimal efficiency may benefit from large doses of myo-inositol. And other individuals in between might see the best results from a blend of the two.
Essential fatty acids should also be considered not only for overall health but most individuals with insulin resistance are deficient in EFAs. Fish oils are great nutrients in helping to improve insulin sensitivity and reduce inflammation.
By Michael Jurgelewicz DC DACBN DCBCN CNS
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