Abstract
Objectives
At the time of diagnosis, the blood glucose of women with gestational diabetes mellitus
(GDM) who require subsequent insulin treatment does not differ from that of women
with adequate diet control. Hence, in this study, we aimed to determine the role of
maternal gut microbiota as a marker of insulin necessity in GDM and to identify the
effect of insulin therapy on gut microbiota composition in GDM mothers and their newborns.
Methods
Seventy-one pregnant women were enrolled onto the study, including 38 GDM and 33 non-GDM
participants. During the follow-up period, 8 of the 38 GDM subjects required insulin
therapy (GDM-I group), whereas 30 of the 38 GDM cases with sufficient glycemic control
by diet alone (GDM-D group). Maternal blood and feces were obtained at the time of
GDM diagnosis (pretreatment; 24 to 28 weeks of gestation) and before delivery (posttreatment;
≥37 weeks of gestation). Meconium and first feces of the newborns were also collected.
Results
Pretreatment, the glycemic profile did not differ between the GDM-D and GDM-I groups.
However, the proportions of Clostridiales, Lactobacillus and Bacteroidetes were higher in the GDM-I group than in the non-GDM and GDM-D groups. After treatment,
gut microbiota composition showed no difference between non-GDM and GDM-I groups.
Interestingly, a higher Firmicutes/Bacteroidetes (F/B) ratio was displayed in GDM-D mothers at posttreatment, and this was also observed
in both meconium and first feces of GDM-D newborns.
Conclusion
Insulin therapy changed maternal gut microbiota composition, which could be transferable
to the mothers’ newborns.
Résumé
Objectifs
Au moment du diagnostic, la glycémie des femmes atteintes d’un diabète sucré gestationnel
(DSG) qui ont besoin d’une insulinothérapie subséquente ne diffère pas de celle des
femmes qui ont un bon régime alimentaire. Par conséquent, dans la présente étude,
nous avions pour objectif de déterminer si le microbiote intestinal maternel joue
le rôle de marqueur des besoins en insuline lors de DSG et de cerner les effets de
l’insulinothérapie sur la composition du microbiote intestinal des mères atteintes
du DSG et de leurs nouveau-nés.
Méthodes
Nous avons inscrit 71 femmes enceintes à l’étude, à savoir 38 participantes atteintes
du DSG et 33 participantes non atteintes du DSG. Durant la période de suivi, 8 des
37 sujettes atteintes du DSG ont eu besoin de l’insulinothérapie (groupe DSG-I), alors
que, grâce au régime alimentaire seul (groupe DSG-R), la glycémie de 30 des 38 cas
atteints du DSG a bien été maîtrisée. Nous avons obtenu le sang et les selles maternelles
au moment du diagnostic du DSG (prétraitement; 24 à 28 semaines de grossesse) et avant
l’accouchement (post-traitement; ≥ 37 semaines de grossesse). Nous avons également
collecté le méconium et les premières selles des nouveau-nés.
Résultats
Avant le traitement, le bilan glycémique ne différait pas entre le groupe DSG-R et
le groupe DSG-I. Toutefois, les pourcentages de Clostridiales, de Lactobacillus et de Bacteroidetes étaient plus élevés au sein du groupe DSG-I qu’au sein du groupe DSG-R. Après le
traitement, la composition du microbiote intestinal ne montrait aucune différence
entre le groupe sans DSG et le groupe DSG-I. De façon intéressante, nous avons observé
que les mères atteintes du DSG-R montraient un ratio de Firmicutes/Bacteroidetes (F/B) plus élevé après le traitement, et ce, dans le méconium et les premières selles
des nouveau-nés des mères atteintes du DSG-R.
Conclusion
La composition du microbiote intestinal maternel modifiée par l’insulinothérapie pourrait
être transmise aux nouveau-nés des mères.
Keywords
Mots clés
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Article Info
Publication History
Published online: May 31, 2022
Accepted:
May 24,
2022
Received in revised form:
May 11,
2022
Received:
October 24,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.
