Nutritional influences on gestational diabetes: A review on macronutrient and micronutrient impacts

Gestational diabetes mellitus (GDM) is a condition characterized by glucose intolerance leading to hyperglycemia, which is first recognized during mid-pregnancy. It poses a significant risk to both the mother and fetus. There is an increase in the global prevalence of GDM, which stands at 14.7% and in Asia, it is about 11.5%. In countries like India, where there is a high rate of lifestyle disorders such as obesity, metabolic syndrome, and cardiovascular diseases, the prevalence is about 13%. The pathophysiology of GDM is due to the physiological insulin resistance exacerbated by placental hormones, which is compounded by risk factors such as obesity, high maternal age, low physical activity, family history, and nutrition. Maternal nutrition also plays an important role in the pathogenesis of GDM. This review examines how the quality and quantity of macro and micronutrient intake influence the progression and development of GDM. High intake of refined carbohydrates, processed foods, saturated fatty acids, and inadequate proteins and fiber, coupled with micronutrient deficiency, is linked to GDM risk. Conversely, a diet rich in complex carbohydrates, plant-based proteins and minerals, and unsaturated fats has a protective role. Since nutritional therapy is the first line of management in GDM, the nutritional condition of the mother will have a hand in the disease process. Research gaps include the need for longitudinal studies to find the impact of dietary patterns, quality, quantity, and frequency of micro and macronutrients on GDM in the preconception and conceptional stages. Addressing these gaps will enhance our understanding of the relationship between maternal nutrition and GDM, informing more effective preventive and management strategies for this growing health concern.