The Effects of Probiotic Supplementation on Genetic and Metabolic Profiles in Patients with Gestational Diabetes Mellitus: a Randomized, Double-Blind, Placebo-Controlled Trial

  • Mahtab Babadi
  • Ahmad KhorshidiEmail author
  • Esmat Aghadavood
  • Mansooreh Samimi
  • Elham Kavossian
  • Fereshteh Bahmani
  • Alireza Mafi
  • Rana Shafabakhsh
  • Mahbobeh Satari
  • Zatollah AsemiEmail author


This study was carried out to evaluate the effects of probiotic supplementation on genetic and metabolic profiles in patients with gestational diabetes mellitus (GDM) who were not on oral hypoglycemic agents. This randomized, double-blind, placebo-controlled clinical trial was conducted in 48 patients with GDM. Participants were randomly divided into two groups to intake either probiotic capsule containing Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, Lactobacillus fermentum (2 × 109 CFU/g each) (n = 24) or placebo (n = 24) for 6 weeks. Probiotic intake upregulated peroxisome proliferator-activated receptor gamma (P = 0.01), transforming growth factor beta (P = 0.002) and vascular endothelial growth factor (P = 0.006), and downregulated gene expression of tumor necrosis factor alpha (P = 0.03) in peripheral blood mononuclear cells of subjects with GDM. In addition, probiotic supplementation significantly decreased fasting plasma glucose (β, − 3.43 mg/dL; 95% CI, − 6.48, − 0.38; P = 0.02), serum insulin levels (β, − 2.29 μIU/mL; 95% CI, − 3.60, − 0.99; P = 0.001), and insulin resistance (β, − 0.67; 95% CI, − 1.05, − 0.29; P = 0.001) and significantly increased insulin sensitivity (β, 0.009; 95% CI, 0.004, 0.01; P = 0.001) compared with the placebo. Additionally, consuming probiotic significantly decreased triglycerides (P = 0.02), VLDL-cholesterol (P = 0.02), and total-/HDL-cholesterol ratio (P = 0.006) and significantly increased HDL-cholesterol levels (P = 0.03) compared with the placebo. Finally, probiotic administration led to a significant reduction in plasma malondialdehyde (P < 0.001), and a significant elevation in plasma nitric oxide (P = 0.01) and total antioxidant capacity (P = 0.01) was observed compared with the placebo. Overall, probiotic supplementation for 6 weeks to patients with GDM had beneficial effects on gene expression related to insulin and inflammation, glycemic control, few lipid profiles, inflammatory markers, and oxidative stress.


Probiotic supplementation Gestational diabetes mellitus Metabolic status Insulin resistance Inflammation 



The authors would like to thank the staff of Naghavi Clinic (Kashan, Iran) for their assistance in this project. We are grateful to thank LactoCare®, Zisttakhmir Company, in Tehran that provided probiotic capsules for the present study.

Author Contributions

ZA: conception, design, and statistical analysis, drafting of the manuscript, and supervised the study.

MB, AK, EA, FB, AM, RS, and MS: data collection and manuscript drafting.


This study was supported by the research grant provided by the Research Deputy of Kashan University of Medical Sciences (KAUMS).

Compliance with Ethical Standards

Competing Interests

The authors declare no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Mahtab Babadi
    • 1
  • Ahmad Khorshidi
    • 1
    Email author
  • Esmat Aghadavood
    • 2
  • Mansooreh Samimi
    • 3
  • Elham Kavossian
    • 3
  • Fereshteh Bahmani
    • 2
  • Alireza Mafi
    • 1
  • Rana Shafabakhsh
    • 1
  • Mahbobeh Satari
    • 1
  • Zatollah Asemi
    • 2
    Email author
  1. 1.Department of Microbiology and Immunology, School of MedicineKashan University of Medical SciencesKashanIran
  2. 2.Research Center for Biochemistry and Nutrition in Metabolic DiseasesKashan University of Medical SciencesKashanIran
  3. 3.Department of Gynecology and Obstetrics, School of MedicineKashan University of Medical SciencesKashanIran

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