Effect of vitamin D combined with probiotic-assisted insulin pump on glucose-lipid metabolism, intestinal flora and pregnancy outcome in gestational diabetes mellitus.

OBJECTIVE: This study aimed to observe the effect of vitamin D combined with probiotic-assisted insulin pump on glucose-lipid metabolism, intestinal flora and pregnancy outcome in gestational diabetes mellitus (GDM). METHODS: A total of 150 GDM patients were randomized into the study and control groups (n=75 each). All patients were admitted to the hospital to receive diet, nutrition and exercise guidance, the control group was given insulin aspart pump therapy plus vitamin D, and the study group received insulin aspart pump therapy plus vitamin D and Viable Bifidobacterium Tablets. Outcomes included glycemic and lipid metabolic indices, gut microbiota changes, standard-reaching rates of blood glucose, and adverse pregnancy outcomes. RESULTS: After treatment, levels of HDL-C, counts of Bifidobacterium and Lactobacillus were increased in both groups (P < 0.05), and levels of FINS, FPG, 2hPG, HbA1c, LDL-C, TC, TG, counts of Coccidioides, Enterobacteriaceae, and Saccharomycetes were all reduced (P < 0.05); and all of them were improved in the study group versus the control group (P < 0.05). The study group also showed higher standard-reaching rates of blood glucose (96.00% vs. 84.00%) and lower overall incidence of adverse pregnancy outcomes (14.67% vs. 33.33%) than the control group (all P < 0.05). CONCLUSION: Compared with insulin pump plus vitamin D therapy, the addition of probiotics may improve blood glucose and lipid metabolism in GDM patients, maintain intestinal microbiota balance, and reduce the risk of adverse pregnancy outcomes. Further multicenter, large sample size, double blind and placebo-controlled studies are needed to confirm these findings.