PUFA treatment in patients with gestational diabetes mellitus: Lights and shadows

The systematic review and meta-analysis published by Liu et al. summarizes existing evidence and suggests potential metabolic benefits of treatment with polyunsaturated fatty acids (PUFA) in pregnant women with gestational diabetes. According to the findings of this study, treatment with PUFA is able to decrease fasting plasma glucose (FPG) and fasting insulin levels and improves insulin resistance, with a positive effect also on inflammation and a number of lipid fractions, including triglycerides and very-low density lipoprotein cholesterol. These promising results can be reached in the included clinical studies with PUFA daily dose up to 2000 mg, that are very high dosages of PUFA for which human teratogenic risk has not been proven nor has it been ruled out. This is of course a critical issue that should be always considered when evaluating findings from clinical trials involving pregnant women, mainly due to the difficulties of assessing the drugassociated risk of teratogenesis.