Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives

Abstract

Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM.

Keywords: ALA α-linolenic acid; AMPK AMP-activated protein kinase; AT adipose tissue; Adipokines; Akt protein kinase B; C3G cyanidin-3-glucoside; Dietary polyphenols; EGCG epigallocatechin gallate; FA fatty acids; FABP FA-binding protein; GDM gestational diabetes mellitus; Gestational diabetes mellitus; IR insulin resistance; IRS-1 insulin receptor substrate 1; LA linoleic acid; LC-PUFA long-chain PUFA; MedDiet Mediterranean-style diet; Mediterranean diet; MicroRNA; Molecular mechanisms; PUFA; RSV resveratrol; T2D type 2 diabetes; miRNA microRNA.

Fig. 1

Chemical structure and main dietary source of polyphenols discussed in this review regarding their capability to modulate glucose metabolism signalling.

Fig. 2

Crosstalk among signalling pathways in regulating glucose metabolism. All of the factors that appear in this scheme are potential points of action of polyphenols. , Activation; , inhibition; , modulation; JAK/STAT, Janus kinase/signal transducer and activator of transcription; AMPK, AMP-activated protein kinase; JNK, c-Jun N-terminal kinase; IRS1/2, insulin receptor substrate 1/2; MAPK, mitogen-activated protein kinases; PDK1, 3-phosphoinositide-dependent protein kinase-1; PI3K, phosphatidylinositol-3-kinase; Akt, protein kinase B; SIRT-1, sirtuin 1; NO, nitric oxide; eNOS, endothelial NO synthase; FOXO1, forkhead box protein O1; TF, transcription factors; miRNA, microRNA; FA, fatty acids.