In a large randomized, controlled trial in women living in
Mumbai slums, a daily micronutrient-rich snack starting preconceptionally
and continuing throughout pregnancy almost
halved the prevalence of GDM based on WHO 1999 criteria
(27) (OR: 0.56; 95% CI: 0.36, 0.86). The effect was independent
of maternal adiposity. There was no effect on GDM diagnosed
based on WHO 2013 criteria (29).