The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency

Corcoy, Rosa; Mendoza, Lilian; Simmons, David; Desoyé, Gernot; Adelantado, Juan M.; Chico, Ana; Devlieger, Roland; Assche, Ado Van; Galjaard, Sander; Timmerman, Dirk; Lapolla, Annunziata; Dalfrà, Maria Grazia; Bertolotto, Alessandra; Harreiter, Jürgen; Wender-Ożegowska, Ewa; Zawiejska, Agnieszka; Kautzky‐Willer, Alexandra; Dunne, Fidelma; Damm, Peter; Mathiesen, Elisabeth Reinhardt; Jensen, Dorte Møller; Andersen, Lise Lotte Torvin; Tanvig, Mette; Hill, David J.; Jelsma, Judith G. M.; Snoek, Frank J.; Köfeler, Harald; Trötzmüller, Martin; Lips, Paul; Poppel, Mireille N. M. van

doi:10.1016/j.clnu.2019.04.006

Cited by 54 publications

(57 citation statements)

References 36 publications

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“…However, the optimal 25(OH)D levels for GDM prevention remain unknown. A European multicenter RCT of early intervention (before 26 th week of pregnancy) randomized women at risk for GDM (BMI ≥ 29 (kg/m 2 ) with various intervention arms, including diet+physical activity+vitamin D and vitamin D alone (DALI study) (134). Unfortunately, supplementation with 1,600 IU/day of vitamin D did not show a clear effect in reducing the risk of GDM.…”

Section: Nutritional Requirements and Role Of Nutraceuticals In Gdmmentioning

confidence: 99%

Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes

Parrettini

Caroli

Torlone³

2020

Front. Endocrinol.

140

108

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Pregnancy offers a window of opportunity to program the future health of both mothers and offspring. During gestation, women experience a series of physical and metabolic modifications and adaptations, which aim to protect the fetus development and are closely related to both pre-gestational nutritional status and gestational weight gain. Moreover, pre-gestational obesity represents a challenge of treatment, and nowadays there are new evidence as regard its management, especially the adequate weight gain. Recent evidence has highlighted the determinant role of nutritional status and maternal diet on both pregnancy outcomes and long-term risk of chronic diseases, through a transgenerational flow, conceptualized by the Development Origin of Health and Diseases (Dohad) theory. In this review we will analyse the physiological and endocrine adaptation in pregnancy, and the metabolic complications, thus the focal points for nutritional and therapeutic strategies that we must early implement, virtually before conception, to safeguard the health of both mother and progeny. We will summarize the current nutritional recommendations and the use of nutraceuticals in pregnancy, with a focus on the management of pregnancy complicated by obesity and hyperglycemia, assessing the most recent evidence about the effects of ante-natal nutrition on the long-term, on either maternal health or metabolic risk of the offspring.

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Section: Nutritional Requirements and Role Of Nutraceuticals In Gdmmentioning

confidence: 99%

Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes

Parrettini

Caroli

Torlone³

2020

Front. Endocrinol.

140

108

View full text Add to dashboard Cite

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“…Whether any of the associations we have identified reflect a causal relationship and whether vitamin D supplementation might modulate PE risk for women with diabetes are unknown. A recent study showed a marginal reduction in fasting glucose with vitamin D supplementation but was underpowered to address PE [53]. In that study, in contrast to our T1DM patients, the women were largely vitamin D sufficient at study entry.…”

Section: Discussionmentioning

confidence: 62%

Vitamin D Metabolites and Binding Protein Predict Preeclampsia in Women with Type 1 Diabetes

et al. 2020

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The risk for preeclampsia (PE) is enhanced ~4-fold by the presence of maternal type 1 diabetes (T1DM). Vitamin D is essential for healthy pregnancy. We assessed the total, bioavailable, and free concentrations of plasma 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), and vitamin D binding protein (VDBP) at ~12, ~22, and ~32 weeks’ gestation (“Visits” (V) 1, 2, and 3, respectively) in 23 T1DM women who developed PE, 24 who remained normotensive, and 19 non-diabetic, normotensive women (reference controls). 25(OH)D deficiency was more frequent in diabetic than non-diabetic women (69% vs. 22%, p < 0.05), but no measure of 25(OH)D predicted PE. By contrast, higher 1,25(OH)2D concentrations at V2 (total, bioavailable, and free: p < 0.01) and V3 (bioavailable: p < 0.05; free: p < 0.01), lower concentrations of VDBP at V3 (p < 0.05), and elevated ratios of 1,25(OH)2D/VDBP (V2, V3: p < 0.01) and 1,25(OH)2D/25(OH)D (V3, p < 0.05) were all associated with PE, and significance persisted in multivariate analyses. In summary, in women with T1DM, concentrations of 1,25(OH)2D were higher, and VDBP lower, in the second and third trimesters in women who later developed PE than in those who did not. 1,25(OH)2D may serve as a new marker for PE risk and could be implicated in pathogenesis.

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“…Evidence from one of these meta-analyses suggested that pregnancies with low blood vitamin D had a higher risk of GDM (odds ratio 1.85) and that vitamin D supplementation during pregnancy significantly reduced fasting plasma glucose (FPG), fasting insulin levels, and HOMA-IR [ 24 ]. On the other hand, results from the Diabetes and Pregnancy Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) European multicenter randomized controlled trial found only a minor beneficial effect of vitamin D supplementation on glucose metabolism [ 26 ]. These discrepancies might be due to differences in baseline vitamin D concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, in the review by Zhang et al [ 24 ], a positive effect of vitamin D concentration was seen among RCTs where the participants were vitamin D deficient and vitamin D doses in the intervention arm were high [ 24 , 27 ]. In contrast, the DALI study population had higher rate of vitamin D sufficiency at baseline and showed a minimal effect of vitamin D supplementation on markers of GDM development [ 26 ]. In the current review, participants from the three included RCTs had 25(OH)D concentration <50 nmol/L at baseline, with participants in the intervention arms reaching vitamin D insufficiency in one RCT [ 17 ] and sufficiency in the two others [ 20 , 21 ], while the control groups remained deficient.…”

Section: Discussionmentioning

confidence: 99%

The Role of Vitamin D in the Development of Diabetes Post Gestational Diabetes Mellitus: A Systematic Literature Review

et al. 2020

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Women diagnosed with gestational diabetes mellitus (GDM) are more likely to later develop diabetes. Evidence from some previous reviews suggests that low vitamin D status during pregnancy increases the risk of developing GDM, but whether vitamin D during pregnancy also influences the risk of diabetes post GDM is less well studied. Thus, the aim of this systematic literature review was to summarize the current available literature on that topic. This review considered observational studies and randomized controlled trials (RCTs). Five databases were searched. The risk of bias of the included studies was assessed. A total of six studies were included: three observational studies and three RCTs. Findings were inconsistent across the six included studies. However, when considering RCTs only, the findings more strongly suggested that vitamin D supplementation during and after pregnancy did not have an influence on markers of diabetes development or diabetes development post GDM. This systematic review highlights inconsistent findings on the associations between vitamin D supplementation or concentration during and after pregnancy and markers of diabetes development or diabetes development post GDM; and although results from randomized interventional studies more strongly suggested no associations, the conclusion holds a high degree of uncertainty.

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The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency

Abstract: M. N. M. (2020). The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency. Clinical Nutrition, 39(3), 976-984. https://doi.

Cited by 54 publications

References 36 publications

Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes

Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes

Vitamin D Metabolites and Binding Protein Predict Preeclampsia in Women with Type 1 Diabetes

The Role of Vitamin D in the Development of Diabetes Post Gestational Diabetes Mellitus: A Systematic Literature Review

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