Integrating probiotics into a one-day diabetes clinic: outcomes in gestational diabetes.

OBJECTIVE

To investigate the effects of a one-day diabetes clinic management model combined with probiotic supplementation in patients with gestational diabetes mellitus (GDM).

METHODS

A total of 682 patients diagnosed with GDM who received prenatal care at our hospital between January 2023 and May 2024 were enrolled in this study. All participants underwent oral glucose tolerance test (OGTT) screening at 24-28 weeks of gestation and attended the one-day diabetes clinic management program. Patients were divided into a probiotic group and a control group based on oral probiotic administration. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. Generalized estimating equations (GEE) were applied to analyze intergroup differences and temporal trends in blood glucose, lipid metabolism, and inflammatory markers. Pearson correlation analysis was used to examine maternal and neonatal perinatal outcomes.

RESULTS

After PSM, no statistically significant differences were observed in baseline characteristics between the two groups (P > 0.05). Generalized estimating equation (GEE) analyses revealed significant group-by-time interaction effects for fasting blood glucose (FPG) and C-reactive protein (CRP). After Benjamini-Hochberg false discovery rate (FDR) correction for multiple testing, lower levels of FPG and CRP were observed in the probiotic group at several follow-up time points, with group differences emerging gradually over the intervention period. Triglycerides showed only a nominally significant group effect without adjustment. Total gestational weight change differed statistically between the two groups. GEE analyses indicated weak crude associations between probiotic supplementation, maternal group B streptococcal colonization (GBS), and neonatal jaundice; however, these associations were no longer statistically significant following FDR correction.

CONCLUSION

Probiotic supplementation combined with one-day diabetes clinic management was associated with lower FPG and CRP levels among women with GDM. Weak associations between probiotic use, maternal GBS colonization and neonatal jaundice disappeared after adjustment for multiple testing, and these findings can only be used to generate hypotheses. As an observational study, this analysis cannot confirm clinical benefits of probiotics. All observed findings represent exploratory associations, which require further verification in randomized controlled trials.

TRIAL REGISTRATION: This observational study was retrospectively registered with the Chinese Clinical Trial Registry (ChiCTR2500100649) on April 11, 2025. Registration was delayed because the research team was initially unaware that registration is mandatory for observational clinical studies.