title: Is there a value for probiotic supplements in gestational diabetes mellitus? A randomized clinical trial The effects of synbiotic supplementation on insulin resistance/sensitivity, lipid profile and total antioxidant capacity in women with gestational diabetes mellitus: A randomized double blind placebo controlled clinical trial. The Effects of Synbiotic Supplementation on Pregnancy Outcomes in Gestational Diabetes Cardiovascular Risk Factors and Total Serum Antioxidant Capacity in Healthy Men and in Men with Coronary Heart Disease Perinatal sclerostin concentrations in abnormal fetal growth: the impact of gestational diabetes The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effects of probiotics in patients with diabetes mellitus type 2: study protocol for a randomized, double-blind, placebo-controlled trial Effects of a Multispecies Probiotic Mixture on Glycemic Control and Inflammatory Status in Women with Gestational Diabetes: A Randomized Controlled Clinical Trial The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: A randomized, double-blind, placebo-controlled trial. Effects of probiotic supplements on insulin resistance in gestational diabetes mellitus: A double‐blind randomized controlled trial The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes Effect of probiotic yogurt containing Lactobacillus acidophilus and Bifidobacterium lactis on lipid profile in individuals with type 2 diabetes mellitus. The effects of vitamin D and probiotic co-supplementation on glucose homeostasis, inflammation, oxidative stress and pregnancy outcomes in gestational diabetes: A randomized, double-blind, placebo-controlled trial. Effect of probiotic yoghurt on plasma glucose in overweight and obese pregnant women: a randomized controlled clinical trial
abstract: Background Although several studies have found probiotics encouraging in prevention of gestational diabetes mellitus ( GDM ) , the evidence for the use of probiotics in diagnosed GDM is largely limited . The aim of this study was to assess the effect of a probiotic supplement capsule containing four bacterial strains on glucose metabolism indices and weight changes in women with newly diagnosed GDM . Methods Sixty-four pregnant women with GDM were enrolled into a double-blind placebo-controlled r and omized clinical trial . They were r and omly assigned to receive either a probiotic or placebo capsule along with dietary advice for eight consecutive weeks . The trend of weight gain along with glucose metabolism indices was assayed . Results During the first 6 weeks of the study , the weight gain trend was similar between the groups . However , in the last 2 weeks of the study , the weight gain in the probiotic group was significantly lower than in the placebo group ( p < 0.05 ) . Fasting blood sugar ( FBS ) decreased in both intervention ( from 103.7 to 88.4 mg/dl ) and control ( from 100.9 to 93.6 mg/dl ) groups significantly , and the decrease in the probiotic group was significantly higher than in the placebo group ( p < 0.05 ) . Insulin resistance index in the probiotic group had 6.74 % reduction over the study period ( p < 0.05 ) . In the placebo group , however , there was an increase in insulin resistance index ( 6.45 % ) , but the observed change in insulin resistance was not statistically significant . Insulin sensitivity index was increased in both groups . The post-intervention insulin sensitivity index in the probiotic group was not significantly different from placebo when adjusted for the baseline levels . Conclusions The probiotic supplement appeared to affect glucose metabolism and weight gain among pregnant women with GDM . This needs to be confirmed in other setting s before a therapeutic value could be approved AIMS The role of gut microbiota in the management of diabetes is shown . In this r and omized clinical trial we assessed the effects of synbiotic supplementation on insulin , lipid profile and antioxidative status among women with gestational diabetes mellitus ( GDM ) . METHODS Ninety pregnant women with GDM were r and omly assigned into two groups to receive either a daily synbiotic capsule - consisting of L. acidophilus , L. plantarum , L. fermentum , L. gasseri ( 1.5 - 7.0 × 109 - 10 CFU/g ) - with fructooligosaccharide ( 38.5 mg ) , or placebo for 6 weeks . Fasting plasma glucose ( FPG ) , insulin , homeostasis model assessment -insulin resistance ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , high- and low density lipoprotein cholesterol ( HDL-C , LDL-C ) , total cholesterol ( TC ) , triglycerides ( TG ) , total antioxidant capacity ( TAC ) , and systolic and diastolic blood pressure ( SBP , DSP ) were assessed before and after the intervention . RESULTS No significant changes in FPG , insulin resistance/sensitivity , lipid profile and TAC indices were seen in synbiotic group compared to the placebo one ( p > 0.05 ) . Significant within group increases for HDL-C and TAC levels in synbiotic group were observed ( p < 0.05 ) . LDL-C showed significant increment in the placebo group compared to the baseline of the study ( 6.9 mg/dL , p < 0.05 ) . Between group comparison showed significant decrease in SBP and DBP in synbiotic group compared to placebo ( -2.5 vs. 8.6 mmHg , and -1.8 vs. 2.1 mmHg , p < 0.05 ) . CONCLUSIONS The results showed that , in women with GDM , synbiotic supplementation had no effect on FPG and insulin resistance/sensitivity indices . Lipid profile and TAC status may be affected by synbiotic supplementation . Synbiotic is effective in reducing of blood pressure in women with GDM Abstract Synbiotics are known to exert multiple beneficial effects , including anti-inflammatory and antioxidative actions . This study was design ed to evaluate the effects of synbiotic administration on biomarkers of inflammation , oxidative stress , and pregnancy outcomes among gestational diabetic ( GDM ) women . This r and omized , double-blind , placebo-controlled clinical trial was carried out among 60 subjects with GDM who were not on oral hypoglycemic agents . Patients were r and omly assigned to consume either one synbiotic capsule containing Lactobacillus acidophilus strain T16 ( IBRC-M10785 ) , L. casei strain T2 ( IBRC-M10783 ) , and Bifidobacterium bifidum strain T1 ( IBRC-M10771 ) ( 2 × 109 CFU/g each ) plus 800 mg inulin ( HPX ) ( n = 30 ) or placebo ( n = 30 ) for 6 weeks . Compared with the placebo , synbiotic supplementation significantly decreased serum high-sensitivity C-reactive protein ( hs-CRP ) ( − 1.9 ± 4.2 vs. + 1.1 ± 3.5 mg/L , P = 0.004 ) , plasma malondialdehyde ( MDA ) ( − 0.1 ± 0.6 vs. + 0.3 ± 0.7 μmol/L , P = 0.02 ) , and significantly increased total antioxidant capacity ( TAC ) ( + 70.1 ± 130.9 vs. − 19.7 ± 124.6 mmol/L , P = 0.009 ) and total glutathione ( GSH ) levels ( + 28.7 ± 61.5 vs. − 14.9 ± 85.3 μmol/L , P = 0.02 ) . Supplementation with synbiotic had a significant decrease in cesarean section rate ( 16.7 vs. 40.0 % , P = 0.04 ) , lower incidence of hyperbilirubinemic newborns ( 3.3 vs. 30.0 % , P = 0.006 ) , and newborns ’ hospitalization ( 3.3 vs. 30.0 % , P = 0.006 ) compared with the placebo . Synbiotic supplementation did not affect plasma nitric oxide ( NO ) levels and other pregnancy outcomes . Overall , synbiotic supplementation among GDM women for 6 weeks had beneficial effects on serum hs-CRP , plasma TAC , GSH , and MDA ; cesarean section ; incidence of newborn ’s hyperbilirubinemia ; and newborns ’ hospitalization but did not affect plasma NO levels and other pregnancy outcomes . http://www.i rct .ir : www.i rct .ir : I RCT Whether the incidence of coronary heart disease ( CHD ) is related to a decrease in total antioxidant capacity ( TAC ) has not yet been completely clarified . We assessed  TAC  of blood serum in a group of 163 men with CHD aged 34.8–77.0 years and in 163 age-matched peers without CHD .  Two spectrophotometric methods were applied to assess  TAC : ferric reducing ability of serum ( TAC-FRAS ) and 2.2-diphenyl-1-picryl-hydrazyl ( TAC-DPPH ) tests .  In the CHD group , multivariate analysis revealed that uric acid ( UA ) , triglycerides , and systolic blood pressure contributed independently to the TAC-FRAS variance .  TAC-DPPH  was favorably predicted by UA concentration , but negatively so by current smoking and glucose levels . In men without CHD , UA was the only independent determinant of both TAC-FRAS and TAC-DPPH . Presence of CHD was not an independent predictor of TAC — observed between-group differences ( higher TAC in CHD patients ) disappeared after adjustment for other confounders . We conclude that UA is the main determinant of TAC of blood serum in men .  TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome , especially in patients with CHD Abstract Objective : To prospect ively evaluate maternal and cord blood concentrations of sclerostin – an osteocyte-secreted factor , inhibiting osteoblast differentiation and bone formation and associated with adverse metabolism – in pregnancies with normal and abnormal fetal growth . Methods : Plasma sclerostin concentrations were determined by ELISA in 80 maternal and 80 cord blood sample s from asymmetric intrauterine-growth-restricted ( IUGR , n = 30 ) , large-for-gestational-age ( LGA , n = 30 ) , and appropriate-for-gestational-age ( AGA , n = 20 ) singleton full-term pregnancies . Fourteen out of 30 mothers with LGA offspring presented with gestational diabetes mellitus ( GDM ) . Results : Maternal and fetal sclerostin concentrations did not differ among LGA , IUGR , and AGA groups . Fetal concentrations were higher than maternal . In LGA group , maternal concentrations were elevated in cases of GDM ( b = 13.009 , 95%CI 1.425–24.593 , p = .029 ) . In a combined group and the IUGR  group , maternal concentrations were elevated in older mothers ( b = 0.788 , 95%CI 0.190–1.385 , p = .010 , and b = 0.740 , 95%CI 0.042–1.438 , p = .039 , respectively ) . Conclusions : Maternal and fetal sclerostin concentrations may not be differentially regulated in pregnancies complicated by abnormal fetal growth . Circulating maternal levels are higher in cases of GDM , probably implying reduced bone formation . Sclerostin up-regulation with aging may be one of the molecular pathways responsible for the observed age-related decline in bone synthesis , leading to accelerated bone loss in humans Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Low grade chronic inflammation is observed in patients with type 2 diabetes mellitus ( T2DM ) . Endotoxin derived from gut bacteria may act as a potent inflammatory stimulant . Probiotics , which are believed to contain health promoting live microorganisms , may influence circulating endotoxin levels . Ingestion of live probiotic cultures may alter gut microbiota in a beneficial manner to reduce inflammation ; no information is available whether or not they do so in patients with T2DM . Therefore , the aim of this study is to characterize the beneficial effects of probiotics on circulating endotoxin levels and other biomarkers related to systemic low- grade inflammation in patients with T2DM . Methods One hundred and twenty consenting adult Saudi T2DM patients ( naïve or newly diagnosed and without co-morbidities ) will be enrolled in this clinical trial and r and omized to receive daily placebo or probiotics ( Ecologic ® Barrier ) for 26 weeks in a double-blind manner . Inflammatory and metabolic markers will be measured and fecal sample s analyzed . Measurements / sample s will be obtained at baseline and after 4 , 8 , 12/13 and 26 weeks of treatment . Discussion It is expected that the probiotic product will induce beneficial changes in gut microbiota , reduce the systemic inflammatory state through altering systemic endotoxin levels and , as such , reduce the systemic inflammatory response observed in T2DM subjects . Trial registration Clinical Trials.gov Identifier : Objective . This trial aims to examine the effects of a Probiotic Mixture ( VSL#3 ) on glycemic status and inflammatory markers , in women with GDM . Material s and Methods . Over a period of 8 weeks , 82 women with gestational diabetes were r and omly assigned to either an intervention group ( n = 41 ) which were given VSL#3 capsule or to a control group which were given placebo capsule ( n = 41 ) . Fasting plasma glucose , homeostatic model assessment of insulin resistance , glycosylated hemoglobin , high-sensitivity C-reactive protein , tumor necrosis factor-α , interleukin-6 , Interferon gamma , and interleukin-10 were measured before and after the intervention . Results . After 8 wk of supplementation FPG , HbA1c , HOMA-IR , and insulin levels remained unchanged in the probiotic and placebo groups . The comparison between the two groups showed no significant differences with FPG and HbA1c , but there were significant differences in insulin levels and HOMA-IR ( 16.6 ± 5.9 ; 3.7 ± 1.5 , resp . ) . Unlike the levels of IFN-g ( 19.21 ± 16.6 ) , there was a significant decrease in levels of IL-6 ( 3.81 ± 0.7 ) , TNF-α ( 3.10 ± 1.1 ) , and hs-CRP ( 4927.4 ± 924.6 ) . No significant increase was observed in IL-10 ( 3.11 ± 5.7 ) in the intervention group as compared with the control group . Conclusions . In women with GDM , supplementation with probiotics ( VSL#3 ) may help to modulate some inflammatory markers and may have benefits on glycemic control Background Probiotics can alter the colonic microbiota and might improve bowel function . Objectives The aim of this study was to evaluate the effect of the consumption of yogurt , enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 ( CFU ) on the symptoms of constipated pregnant women . Material s and Methods This triple-blind r and omized controlled trial was conducted on 60 constipated pregnant women who were diagnosed by the ROME III criteria in Tabriz , Iran from December 2014 to July 2015 . Participants were r and omly put into two groups including the treatment and the control group through block r and omization . The treatment group received 300 g of yogurt enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 colony forming units ( CFU ) ( n = 30 ) while the control group received conventional yogurt ( n = 30 ) for 4 weeks . The defecation frequency , stool consistency , straining during defecation , sensation of anorectal obstruction , sensation of incomplete evacuation and manual manoeuvres to facilitate defecation were primary outcomes while the amount of defecation , stool colure , and quality of life were secondary outcomes . Results The frequency of defecation was increased from 2.1 ( 0.8 ) at baseline to 8.3 ( 4.4 ) in the probiotic yogurt group vs. 2.3 ( 0.7 ) at baseline to 8.1 ( 4.3 ) in the conventional yogurt group at the end of 4th week . These results were based on the repeated measure ANOVA test and there was no statistically significant difference between the two groups ( mean difference : 0.1 ; Confidence Interval 95 % : -1.4 to 1.7 ; P = 0.872 ) . Constipation symptoms including straining , anorectal obstruction , manipulation to facilitate defecation , consistency of stool and color of stool were improved significantly ( P < 0.05 ) in both groups . In addition , the amount of defecation was significantly increased in both groups ( P < 0.05 ) , while incomplete evacuation was significantly reduced in the treatment group ( P = 0.01 ) . There was no statistically significant difference between the groups in the mean scores of physical ( P = 0.726 ) and mental ( P = 0.678 ) aspects of quality of life after the intervention with the adjusting of baseline scores . Conclusions Consumption of 300 g/day probiotic and conventional yogurt can play a role in improving the symptoms of constipation during pregnancy BACKGROUND To our knowledge , data on the effects of probiotic supplementation on glycaemic control and lipid concentrations in patients with gestational diabetes mellitus ( GDM ) are scarce . AIM The aim of the present study was to determine the effects of probiotic supplementation on glycaemic control and lipid profiles in GDM patients . METHODS Sixty pregnant women with GDM , primigravida and aged 18 - 40years , were divided into two groups to receive either probiotic capsules ( n=30 ) or a matching placebo ( n=30 ) in this r and omized double-blind , placebo-controlled trial . The patients in the probiotic group took a daily capsule that contained three viable freeze-dried strains : Lactobacillus acidophilus ( 2 × 10(9)CFU/g ) , L. casei ( 2 × 10(9)CFU/g ) and Bifidobacterium bifidum ( 2 × 10(9)CFU/g ) for 6weeks . The placebo group took capsules filled with cellulose for the same time period . Fasting blood sample s were taken at the beginning and end of the study to quantify the relevant markers . RESULTS After 6weeks of intervention , probiotic supplementation vs a placebo result ed in significant decreases in fasting plasma glucose ( -9.2±9.2mg/dL vs + 1.1±12.2mg/dL , P<0.001 ) , serum insulin levels ( -0.8±3.1μIU/mL vs + 4.5±10.6μIU/mL , P=0.01 ) , homoeostasis model assessment ( HOMA ) for insulin resistance ( -0.4±0.9 vs + 1.1±2.5 , P=0.003 ) and HOMA for β-cell function ( + 1.1±9.8 vs + 18.0±42.5 , P=0.03 ) , and a significant increase in the quantitative insulin sensitivity check index ( + 0.007±0.01 vs -0.01±0.02 , P=0.007 ) . In addition , significant decreases in serum triglycerides ( -1.6±59.4mg/dL vs + 27.1±37.9mg/dL , P=0.03 ) and VLDL cholesterol concentrations ( -0.3±11.9mg/dL vs + 5.4±7.6mg/dL , P=0.03 ) were seen following supplementation with the probiotics compared with the placebo . However , no significant changes in other lipid profiles were seen with the intervention . CONCLUSION Overall , the results of our study have demonstrated that taking probiotic supplements for 6weeks in patients with GDM had beneficial effects on glycaemic control , triglycerides and VLDL cholesterol concentrations , although there was no effect on other lipid profiles Abstract Aims / Introduction To evaluate the effect of probiotic supplements on insulin resistance in pregnant women with diet‐controlled gestational diabetes mellitus . Material s and Methods A r and omized , double‐blind , placebo‐controlled trial was carried out between June 2016 and February 2017 . Pregnant women with diet‐controlled gestational diabetes mellitus were enrolled in the study at 24–28 weeks‐of‐gestation and r and omized to receive either probiotic supplements containing Bifidobacterium and Lactobacillus or a placebo daily for four consecutive weeks . Primary outcomes were mean differences in insulin resistance ( homeostatic model assessment for insulin resistance ) , fasting insulin and fasting plasma glucose between the two groups . Secondary outcomes were changes in maternal weight after the intervention . Results Data from 28 patients in the probiotic group and 29 in the placebo group were analyzed . The changes in metabolic parameters after r and omization showed significant improvement in glucose metabolism in the probiotic group compared with the placebo group , including fasting plasma glucose ( 0.68 ± 5.88 vs 4.620 ± 7.78 mg/dL , mean difference −3.94 mg/dL , 95 % confidence interval −7.62 , −0.27 , P = 0.034 ) , fasting plasma insulin ( 1.11 ± 1.71 vs 3.77 ± 1.70 mIU/L , mean difference −2.67 mIU/L , 95 % confidence interval −3.57 , −1.76 , P = 0.001 ) and homeostatic model assessment for insulin resistance ( 0.25 ± 0.37 vs 0.89 ± 0.46 , mean difference −0.63 , 95 % confidence interval −0.86 , −0.41 , P = 0.001 ) . Weight gain during r and omization was similar between the two groups . Conclusions Four weeks of probiotic supplements  in women with diet‐controlled gestational diabetes in the late second and early third trimester lowered fasting glucose and increased insulin sensitivity  . Probiotic supplements may be considered as an adjunct treatment for glycemic control in these patients Abstract Objective : This study was design ed to evaluate the effects of probiotic supplementation on biomarkers of inflammation , oxidative stress and pregnancy outcomes  among subjects with gestational diabetes ( GDM ) . Methods : This r and omized , double-blind , placebo-controlled clinical trial was done among 60 subjects with GDM who were not on oral hypoglycemic agents . Patients were r and omly allocated to intake either probiotic capsule containing Lactobacillus acidophilus , Lactobacillus casei and Bifidobacterium bifidum ( 2 × 109 CFU/g each ) ( n = 30 ) or placebo ( n = 30 ) for six weeks . Results : Compared with the placebo , probiotic supplementation result ed in significant decreases in fasting plasma glucose ( FPG ) ( −5.3 ± 6.7 vs. + 0.03 ± 9.0 mg/dL , p = .01 ) , serum high-sensitivity C-reactive protein ( hs-CRP ) ( −2.2 ± 2.7 vs. + 0.5 ± 2.4 μg/mL , p < .001 ) , plasma malondialdehyde ( MDA ) concentrations ( −0.1 ± 0.8 vs. + 0.5 ± 1.5 μmol/L , p = .03 ) and MDA/TAC ratio ( −0.0003 ± 0.0008 vs. + 0.0009 ± 0.002 , p = .004 ) , and a significant increase in total antioxidant capacity ( TAC ) levels ( + 65.4 ± 103.3 vs. −37.2 ± 143.7 mmol/L , p = .002 ) . Probiotic supplementation did not affect pregnancy outcomes . Conclusions : Overall , probiotic supplementation among women with GDM for six weeks had beneficial effects on FPG , serum hs-CRP , plasma TAC , MDA and oxidative stress index , but did not affect pregnancy outcomes The purpose of this study was to investigate the effects of probiotic and conventional yogurt on the lipid profile in type 2 diabetic people . In a r and omized double-blind controlled trial , 60 people ( 23 males and 37 females ) with type 2 diabetes and low-density lipoprotein cholesterol ( LDL-C ) greater than 2.6 mmol/L were assigned to 2 groups . Participants consumed daily 300 g of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 or 300 g of conventional yogurt for 6 wk . Fasting blood sample s , anthropometric measurements and 3-d , 24-h dietary recalls were collected at the baseline and at the end of the trial . Probiotic yogurt consumption caused a 4.54 % decrease in total cholesterol and a 7.45 % decrease in LDL-C compared with the control group . No significant changes from baseline were shown in triglyceride and high-density lipoprotein cholesterol ( HDL-C ) in the probiotic group . The total cholesterol : HDL-C ratio and LDL-C : HDL-C ratio as atherogenic indices significantly decreased in the probiotic group compared with the control group . Probiotic yogurt improved total cholesterol and LDL-C concentrations in type 2 diabetic people and may contribute to the improvement of cardiovascular disease risk factors BACKGROUND AND AIMS This study was design ed to assess the effects of combined vitamin D and probiotic supplementation on metabolic status and pregnancy outcomes in women with gestational diabetes ( GDM ) . METHODS This r and omized , double-blind , placebo-controlled clinical trial was performed in 87 women with GDM . Patients were r and omly assigned three groups to receive either vitamin D ( 50,000 IU/every 2 weeks ) plus probiotic ( 8 × 109 CFU/day ) ( n = 30 ) , probiotic ( 8 × 109 CFU/day ) ( n = 29 ) or placebo ( n = 28 ) for 6 weeks . RESULTS Vitamin D and probiotic co-supplementation significantly reduced fasting plasma glucose ( β -10.99 mg/dL ; 95 % CI , -14.26 , -7.73 ; P < 0.001 ) , serum insulin levels ( β -1.95 μIU/mL ; 95 % CI , -3.05 , -0.84 ; P = 0.001 ) and homeostasis model of assessment -insulin resistance ( β -0.76 ; 95 % CI , -1.06 , -0.45 ; P < 0.001 ) , and significantly increased the quantitative insulin sensitivity check index ( β 0.01 ; 95 % CI , 0.008 , 0.03 ; P = 0.001 ) compared with the placebo . In addition , vitamin D and probiotic co-supplementation result ed in a significant reduction in triglycerides ( β -37.56 mg/dL ; 95 % CI , -51.55 , -23.56 ; P < 0.001 ) , VLDL- ( β -7.51 mg/dL ; 95 % CI , -10.31 , -4.71 ; P < 0.001 ) , HDL-/total cholesterol ratio ( β -0.52 ; 95 % CI , -0.79 , -0.24 ; P < 0.001 ) , high sensitivity C-reactive protein ( β -1.80 mg/L ; 95 % CI , -2.53 , -1.08 ; P < 0.001 ) and malondialdehyde ( β -0.43 μmol/L ; 95 % CI , -0.77 , -0.09 ; P = 0.01 ) ; also , a significant rise in HDL-cholesterol ( β 4.09 mg/dL ; 95 % CI , 1.11 , 7.08 ; P = 0.008 ) and total antioxidant capacity ( TAC ) levels ( β 97.77 mmol/L ; 95 % CI , 52.34 , 143.19 ; P < 0.001 ) were observed compared with the placebo . Vitamin D and probiotic co-supplementation did not change other metabolic parameters  . Vitamin D and probiotic co-supplementation  significantly decreased triglycerides ( P = 0.02 ) , VLDL-cholesterol ( P = 0.02 ) and hs-CRP ( P = 0.01 ) , and significantly increased TAC ( P = 0.006 ) and total glutathione levels ( P = 0.04 ) compared with only probiotic group . CONCLUSIONS In conclusion , vitamin D and probiotic co-supplementation  in women with GDM had beneficial effects on metabolic status . This trial was registered at www.i rct .ir as I RCT 201706075623N119 Introduction There is only some evidence about effectiveness of probiotics for preventing gestational hyperglycaemia . This trial examined the effects of probiotic yoghurts containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on maternal plasma glucose ( primary outcome ) and on some maternal and infant complications ( secondary outcomes ) in overweight and obese women with no diabetes in pregnancy . Methods Using stratified block r and omization , women with pre- or early-pregnancy BMI ≥ 25 and fasting plasma glucose < 92 mg/dl at 22 weeks of gestation were assigned into probiotic or conventional yoghurt group , consuming 100 g/day from 24 weeks of gestation until delivery . The women and their infants were followed up until 1 month after birth . Results In each group , one out of 65 women  had intra-uterine foetal death and were not analysed for other outcomes . The mean BMI was 29.2 ( SD 3.3 ) in probiotic and 30.3 ( SD 4.1 ) in conventional yoghurt group . Four weeks after initiation of the treatment , plasma glucose levels were significantly lower in the probiotic than in conventional yoghurt group at fasting ( mean difference adjusted for the BMI category ) and baseline FPG ( − 4.0 mg/dl ; 95 % confidence interval − 6.9 , − 1.1 ) and 2-h OGTT ( − 13.9 ; − 22.8 , − 5.0 ) . At the 1-h OGTT , however , the difference was not statistically significant ( − 9.8 ; − 20.6 , 0.9 ) . Further , there was a significantly lower infant bilirubin level in the probiotic group on days 3–5 after birth ( − 2.2 mg/dl ; − 3.3 , − 1.2 ) . There were not statistically significant differences between the groups regarding the risk of gestational diabetes ( 6 vs 11 ; odds ratio 0.5 ; 0.2 , 1.5 ) , preterm delivery ( 3 vs 8 ; 0.3 ; 0.1 , 1.2 ) , and other maternal and infant outcomes . Conclusion The probiotics supplementation has some beneficial effects on glucose metabolism of overweight and obese pregnant women . Nevertheless , further studies are required to judge the clinical significance of such effects
target: Conclusion Probiotic supplementation seemed to be able to reduce the risk of a newborn 's hyperbilirubinemia and improve glycemic control , blood lipid profiles and inflammation and oxidative stress in pregnant women with GDM .
background: Background Previous studies showed that probiotics could improve glycemic control and attenuate some of the adverse effects of type 2 diabetes .
  However , whether the effects are generalizable to gestational diabetes mellitus ( GDM ) remains uncertain .
  Objective We conducted a systematic review and meta- analysis to evaluate the effects of probiotic supplement in GDM .