Effects of calcium–vitamin D co-supplementation on glycaemic control, inflammation and oxidative stress in gestational diabetes: a randomised placebo-controlled trial

Abstract

Aims/hypothesis This study was designed to assess the effects of calcium and vitamin D supplementation on the metabolic status of pregnant women with gestational diabetes mellitus (GDM). Methods This randomised placebo-controlled trial was performed at maternity clinics affiliated to Kashan University of Medical Sciences, Kashan, Iran. Participants were 56 women with GDM at 24-28 weeks' gestation (18 to 40 years of age). Subjects were randomly assigned to receive calcium plus vitamin D supplements or placebo. All study participants were blinded to group assignment. Individuals in the calcium-vitamin D group (n=28) received 1,000 mg calcium per day and a 50,000 U vitamin D 3 pearl twice during the study (at study baseline and on day 21 of the intervention), and those in the placebo group (n=28) received two placebos at the mentioned times. Fasting blood samples were taken at study baseline and after 6 weeks of intervention. Results The study was completed by 51 participants (calcium-vitamin D n=25, placebo n=26). However, as the analysis was based on an intention-to-treat approach, all 56 women with GDM (28 in each group) were included in the final analysis. After the administration of calcium plus vitamin D supplements, we observed a significant reduction in fasting plasma glucose (−0.89 ± 0.69 vs +0.26 ± 0.92 mmol/l, p<0.001), serum insulin levels (−13.55±35.25 vs +9.17± 38.50 pmol/l, p=0.02) and HOMA-IR (−0.91±1.18 vs + 0.63±2.01, p=0.001) and a significant increase in QUICKI (+0.02 ±0.03 vs −0.002 ±0.02, p= 0.003) compared with placebo. In addition, a significant reduction in serum LDL-cholesterol (−0.23±0.79 vs +0.26±0.74 mmol/l, p= 0.02) and total cholesterol: HDL-cholesterol ratio (−0.49± 1.09 vs +0.18±0.37, p=0.003) and a significant elevation in HDL-cholesterol levels (+0.15±0.25 vs −0.02±0.24 mmol/l, p=0.01) was seen after intervention in the calcium-vitamin D group compared with placebo. In addition, calcium plus vitamin D supplementation resulted in a significant increase in GSH (+51.14±131.64 vs −47.27±203.63 μmol/l, p=0.03) and prevented a rise in MDA levels (+0.06±0.66 vs +0.93± 2.00 μmol/l, p=0.03) compared with placebo. Conclusions/interpretation Calcium plus vitamin D supplementation in women with GDM had beneficial effects on their metabolic profile.

Zinc supplementation and the effects on metabolic status in gestational diabetes: A randomized, double-blind, placebo-controlled trial

“…Patients with GDM are susceptible to insulin resistance and increased lipid profiles (Asemi, Karamali, & Esmaillzadeh, 2014).Our study demonstrated that GDM patients who received zinc supplements for 6 weeks had significant decreases in FPG, serum insulin concentrations, HOMA-IR, and HOMA-B and a significant rise in QUICKI compared with the placebo. Few studies have evaluated the effects of zinc administration on FPG and markers of insulin resistance in patients without GDM.…”

Calcium plus vitamin D supplementation affects pregnancy outcomes in gestational diabetes: randomized, double-blind, placebo-controlled trial

“…However, some reports have shown that Ca and vitamin D supplementation did not affect pregnancy outcomes in mothers without GDM (14,15) . Vitamin D and Ca might affect pregnancy outcomes through influencing skeletal composition and smooth muscle strength (13) as well as metabolic profiles (16) . Ca and vitamin D have been suggested to act jointly rather than independently.…”

Calcium Supplementation Enhanced Adipogenesis and Improved Glucose Homeostasis Through Activation of Camkii and PI3K/Akt Signaling Pathway in Porcine Bone Marrow Mesenchymal Stem Cells (pBMSCs) and Mice Fed High Fat Diet (HFD)

“…Meanwhile, our results showed that calcium supplementation significantly reduced blood glucose and serum insulin levels, and improved glucose tolerance and insulin sensitivity in HFD-fed mice. Similarly, the beneficial effects of dietary calcium on glycemic control has been indicated in many studies [16,18,38]. However, consumption of high calcium provided no effect on glycemic control in overweight patients with type 2 diabetes [17].…”