Relationship Between Intestinal Flora Characteristics Of Pregnant Women With Gestational Diabetes Mellitus And Glycemic Control After Nutrition Intervention

Background Gestational diabetes mellitus(GDM)is a common complication during pregnancy and has a tendency of increasing year by year.Poor glycemic control in pregnant women with GDM is the main cause of maternal and child health.Nutrition intervention is the priority and essential measure for glycemic control in pregnant women with GDM.In reality,it is difficult for some GDM pregnant women to achieve good glycemic control after simple nutrition intervention,and further consideration of drug treatment is needed.Insulin injection compliance and long-term safety uncertainty of oral hypoglycemic drugs affect the application of drug therapy to some extent.Therefore,how to improve the glycemic control effect of GDM pregnant women with simple nutrition intervention is a clinical practical problem worthy of further exploration.Studies have confirmed that intestinal flora imbalance caused by changes in intestinal flora abundance and diversity is involved in the development of diabetes.However,the characteristics of the intestinal flora of GDM pregnant women with poor glycemic control after simple nutrition intervention have not been studied.To explore the essential problem of intestinal flora in patients with GDM after simple nutrition intervention,this paper provides a reference for improving the effectiveness of GDM pregnant women’s simple nutrition intervention from the new perspective of intestinal flora.Objective This study analyzed the changes of intestinal flora characteristics of GDM pregnant women before and after simple nutrition intervention,identified the characteristics of intestinal flora of GDM pregnant women with poor blood glucose control after simple nutrition intervention,and explored the characteristics of intestinal flora of GDM pregnant women before and after simple nutrition intervention Relationship with blood glucose control effect.Methods By using prospective cohort study,we intends to enroll 100 pregnant women within one week of the first diagnosis of GDM by OGTT within 24 to 28 weeks of pregnancy.Researchers collected general demographic information,OGTT results,stool samples from pregnant women,and conducted a week-long finger nutrition intervention on all pregnant women.During the intervention,pregnant women need to record a3-day diet diary and exercise diary.One week later,a blood glucose test was performed to determine if blood glucose control was met,and a stool specimen was collected.The intestinal flora was detected by 16 sr DNA sequencing method,and the abundance and species differences of the intestinal flora were analyzed by alpha diversity and beta diversity and linear discrimination.Using a nested case-control study design,GDM pregnant women with poor glycemic control after weekly nutrition interventions were considered as case groups(N group).GDM pregnant women with blood glucose control standards with age differences ≤ 5 years and the same level of pre-BMI were used as matching requirements,and the control group(Y group)was matched 1: 1.This study measures and analyzes the characteristics of intestinal flora before and after simple nutrition intervention in the case group and the control group,and analyzes the relationship between the characteristics of intestinal flora in GDM pregnant women and the effect of blood glucose control after simple nutrition intervention.Results(1)There was no statistical difference in the Shannon index and simpson index before and after the intervention in the N and Y groups,and there was no statistical difference in the weighted and unweighted Pco A analysis;(2)Comparison between group N and group Y before the intervention,enrichment of Roseburia,Clostridium,Bifidobacterium,Bifidoideae,Bifidobacterium,Holdermania and Proteus in the Y1 group,Desulfovibrio,Aeromonas,Leuconostocaceae,Weisseria,Pseudomonas,Bacillales incertae sedis XI,Gemella and Bacillales enriched in the N1 group;(3)Compared with before the intervention,there was no obvious difference in the N group after the intervention,while the abundance of Oscillibacter enriched in the Y group was significantly reduced;(4)after the intervention,Bifidobacterium and Actinomycetes are enriched in the Y2 group,while Holdermania,Proteus,Botobacteria and Streptomyces are enriched in N2 group.Conclusions(1)There was no difference in the intestinal flora of GDM pregnant women who met or failed the blood glucose control.The alpha diversity and beta diversity indicators of the two groups of intestinal flora were not statistically significant,and both are enriched for characteristic bacteria that are positively and negatively correlated with blood glucose levels;(2)Whether the abundance of characteristic bacteria that are positively related to blood glucose during nutrition intervention may be one of the reasons leading to the failure of glycemic control in pregnant women with GDM.There is no difference in the characteristics of intestinal flora before and after the nutrition intervention.After one week of intervention in the Y group,the abundance of Oscillibacter,which was positively correlated with blood glucose,was significantly reduced;(3)Enriching more characteristic bacteria that are negatively related to blood glucose is beneficial to GDM pregnant women to control their own blood glucose levels.After nutrition intervention,compared with N group,the abundance of bifidobacteria in the intestinal flora of the Y group is higher;The higher abundance in the N group was characteristic bacteria that were positively correlated with blood glucose.