Role of vitamin D‐calcium supplementation on metabolic profile and oxidative stress in gestational diabetes mellitus: A randomized controlled trial

Abstract

Aim To assess role of vitamin D‐calcium supplementation on the metabolic profile and oxidative stress in women with Gestational Diabetes Mellitus (GDM) controlled on diet. Methods A randomized controlled trial was conducted at a tertiary care teaching hospital. Seventy women diagnosed as GDM at 24–28 weeks of gestation, controlled on a diabetic diet, were randomized to receive either vitamin D 1000 IU and calcium 1000 mg (group A, n = 34) or vitamin D 250 IU and calcium 500 mg (group B, n = 36) daily for 6 weeks. Levels of serum 25‐hydroxy vitamin D, fasting plasma glucose (FPG), serum insulin, fasting lipid profile and total glutathione (GSH) were analyzed both prior to and after supplementation. Means, standard deviations and mean change were computed. Paired and independent t‐tests were used to determine statistical significance between the two groups. Results Women in group A showed a significant reduction in FPG level (P‐value = 0.007), fasting serum insulin level (P‐value = 0.000), LDL (P‐value = 0.000), total cholesterol levels (P‐value = 0.000) and increase in HDL levels (P‐value = 0.000). Group B had a significant fall only in FPG after 6 weeks supplementation. A significant change in total glutathione level (P‐value = 0.000) was observed in both groups. Conclusion Vitamin D and calcium supplementation at a dose of 1000 IU and 1000 mg, respectively, has a beneficial role in glucose metabolism, lipid metabolism and oxidative stress in GDM.

Gestational Diabetes Mellitus: The Crosslink among Inflammation, Nitroxidative Stress, Intestinal Microbiota and Alternative Therapies

“…Among these alternative approaches, investigations identified that some of them would have a positive influence only on the attenuation of inflammatory processes and oxidative stress, such as selenium [ 165 ], olive oil [ 166 ], fish oil [ 167 ], and soy oligosaccharide [ 168 ], and others only on optimizing insulin sensitivity or by decreasing insulin resistance, such as pepper with capsaicin [ 169 ]; mugwort [ 170 ]; the dietary approaches to stop hypertension (DASH) diet [ 171 ]; co-supplementation of magnesium, zinc, calcium, and vitamin D [ 172 ]; vitamin D supplementation associated with evening primrose oil [ 173 ] and ginger [ 174 ]. Co-supplementation of vitamin D and calcium [ 175 , 176 ], in addition to co-supplementation of zinc and vitamin E [ 177 ], cod liver oil [ 178 ], flaxseed oil [ 179 ], and selenium [ 180 ] participate positively to reduce inflammatory processes, oxidative stress, and insulin resistance, contributing favorably to normal serum glucose levels.…”

“…Regarding micronutrients, isolated selenium supplementation, as well as co-supplementation of vitamin D + calcium and zinc + vitamin E, also led to the attenuation of the expression of pro-inflammatory cytokines and RONS [ 165 , 175 , 176 , 177 ]. Selenium is a trace element that can alleviate the inflammatory response by inhibiting the NF-κβ signaling pathway and TLR through the expression of PPAR-γ, which is a complementary way to attenuate insulin resistance and to improve the performance of glucose transporters (GLUT) and neutralize RONS [ 165 ].…”

“…Vitamin D and calcium are generally reduced in pregnancies with GDM and are even considered risk factors for developing the disease by the mechanisms observed in Box 3 . For this, researchers analyzed vitamin D and calcium supplementation together, as when combined, they can exert activity on oxidative stress through cell cycle regulation, activation of antioxidant enzymes, and PTH suppression, generally improving insulin resistance and the inflammatory processes [ 175 , 176 ]. For zinc associated with vitamin E, its antioxidant and anti-inflammatory effects follow routes similar to those in which selenium participates [ 177 ].…”

Dietary Intake in Early Pregnancy and Glycemia in Late Pregnancy among Women with Obesity

“…Magnesium has several beneficial effects, but the effect of dietary magnesium on glucose metabolism during pregnancy has not been studied much. In one small diet-controlled, randomized trial of 1000 IU vitamin D and 1000 mg calcium supplementation versus 250 IU vitamin D and 500 mg calcium supplementation in women with GDM, the group that received the largest doses had significant reductions in several markers of glucose metabolism, including fasting glucose and insulin concentrations after six weeks [ 36 ]. The lower doses of these supplements also reduced fasting glucose but had no effect on insulin concentrations.…”

Association of Serum Vitamin D Status with gestational diabetes mellitus and other laboratory parameters in early pregnant women

“…Studies on the association between VD status and pregnancy complications are still controversial. On the one hand, some studies indicated that the alteration of VD was associated with a variety of adverse pregnancy outcomes, especially GDM [8][9][10]. On the other hand, some studies failed to correlate VD status with the above-mentioned consequences [11,12].…”