Blood glucose rise following prenatal vitamins in gestational diabetes.

Abstract

Optimal outcome of gestational diabetes mellitus (GDM) is directly related to glucose control of the mother. If prenatal vitamins cause a large glycemic excursion, then the best prenatal vitamin would be one that produces the lowest blood glucose. Nine GDM women participated in two, 8-day test periods. Each subject ingested one of six prenatal vitamin-mineral preparations, a placebo, or a sucrose capsule, in random order. Blood glucose was determined by the One Touch System at 0, 30, and 60 minutes. The sucrose capsule contained 1 g sucrose (equivalent to highest glucose/carbohydrate content of any prenatal vitamin). The placebo contained 1 g table salt in the same color capsule. Relative glycemic index (RGI, defined as the area under glucose curve for the test substance divided by the area under glucose curve for 1 g sucrose) and maximum rise of blood glucose above time 0 were calculated for each preparation. RGI was significantly elevated for all vitamins: TRN 3.86, Natalins Rx 3.00, Filibon Forte 2.16, Prenatal Formula 2.10, Materna 1.66, Placebo 1.33, Stuartnatal 1 + 1 1.16. Two thousand mg vitamin C (n = 4) resulted in an RGI of 1.37. In conclusion, ingestion of prenatal vitamins produces a rise in blood glucose greater than that seen following ingestion of sucrose equal to the carbohydrate content of prenatal vitamins. The cause of the blood glucose rise is not known, but it would appear prudent to prescribe a prenatal vitamin with a low RGI.

High multivitamin intake by Wistar rats during pregnancy results in increased food intake and components of the metabolic syndrome in male offspring

“…Much higher intakes (4,000 IU) are being suggested as needed during pregnancy on the basis of 25-hydroxyvitamin D status in plasma (17). 4) Relevant to the present study, consumption of a prenatal vitamin pill has been shown to produce a higher blood glucose response upon an oral sucrose load than consumption of a placebo pill in women with gestational diabetes (45). Gestational glycemic control affects gestational outcomes in normal and diabetic pregnant women (19,44).…”

Glycemic Index and Insulin Response to a Liquid Nutritional Formula Compared with a Standard Meal

“…Isoenergic, isocarbohydrate feedings of white bread or white rice yield significantly different blood glucose responses [17]. Fiber content [18,19] and even the vitamin and mineral content of a food may affect the blood glucose response [20].…”

The Role of Oxidative Stress in the Pathophysiology of Gestational Diabetes Mellitus

“…Certainly, in type 1 diabetes, vitamins E and C have been shown to improve oxidative stress in children and improves fetal outcome in experimental diabetic pregnancy (88,149). However, in GDM, blood glucose levels rise following prenatal vitamins (332), which has been linked to the development of the components of metabolic syndrome in adulthood for the male offspring (339). The DAPIT study has shown no benefits of vitamins E and C supplementation in preventing preeclampsia in type I diabetic pregnant women, although the work suggests that a subgroup of diabetic women with lower antioxidant plasma concentrations could be a group that may be benefited with these treatments (240).…”