Effects of a single post-partum injection of a high dose of vitamin D on glucose tolerance and insulin resistance in mothers with first-time gestational diabetes mellitus
H. Mozaffari-Khosravi1, M. Hosseinzadeh-Shamsi-Anar1, M.-A. Salami2, H. Hadinedoushan3, M. R. Mozayan4
Diabetic Medicine Vol. 28 Issue 10
Aim? This study was performed to determine the effect of a single, large, intramuscular injection of vitamin D post-partum on glucose tolerance and insulin resistance in women with gestational diabetes.
Methods? Forty-five participants in a randomized controlled trial on gestational diabetes mellitus were divided into an intervention group and a control group. Only subjects in the intervention group received one intramuscular injection of 300 000 IU of vitamin D3. HbA1c, serum 25-hydroxyvitamin D3, fasting insulin and blood glucose, C-peptide, homeostasis model assessment insulin resistance index, ?-cell function, insulin sensitivity and the Quantitative Insulin Sensitivity Check Index were measured at baseline and after 3 months of intervention.
Results? Approximately 80% of the mothers had a degree of vitamin D deficiency. Post-intervention, this was found in 4.2 and 71.4% in the intervention and control groups, respectively. The medians of homeostasis model assessment insulin resistance indices before and after intervention were 0.6 and 0.5 (P = 0.7), respectively, in subjects in the intervention group, and 0.5 and 0.9 (P = 0.01) in subjects in the control group. The mean of the Quantitative Insulin Sensitivity Check Index fell only in the control group (P = 0.008). In the control group, ?-cell function increased by ?8% (P = 0.01) and insulin sensitivity decreased after 3 months (P = 0.002). Post-intervention, the median C-peptide decreased in the intervention group and increased in the control group, but the change was significant only in the control group (P = 0.03).
Conclusions? A single injection of 300 000 IU of vitamin D3 achieves a 3-month serum 25-hydroxyvitamin D range of 50–80 nmol/l and is an efficient, effective and safe procedure for improving the vitamin status and indices of insulin resistance in mothers with gestational diabetes after delivery.
- - - - - - - - - - - Subsequent RCT to check safety - - - - - - - - - - - - - - - - -
The efficacy and safety of a high dose of vitamin D in mothers with gestational diabetes mellitus: a randomized controlled clinical trial.
Iran J Med Sci. 2012 Sep;37(3):159-65.
Hosseinzadeh-Shamsi-Anar M, Mozaffari-Khosravi H, Salami MA, Hadinedoushan H, Mozayan MR.
Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Background: During pregnancy and lactation outstanding changes occur in mother's vitamin D metabolism. This study was carried out to evaluate the efficacy of 300,000 IU vitamin D given intramuscularly on body status in new cases of gestational diabetes mellitus (GDM).
Methods: This is a randomized clinical trial with the follow-up period of 3 months. Totally 45 participants were randomly divided into intervention group (IG) and control group (CG). The IG received an IM injection of 300,000 IU of vitamin D, whereas CG did not. The glycosylated hemoglobin A1C (HBA1C), serum 25-OH-D, parathyroid hormone (PTH), serum calcium and phosphorus were measured.
Results: Forty five patients including 24 with the mean age of 30.7±6.2 years in the IG and 21 with the mean age of 29.5±4.0 years in the CG participated in the study. The median concentration of serum 25(OH)D3 in the IG was to 62.10 nmol/l after the intervention, showing an increase of around 158%, compared to before intervention (24.25 nmol/l) whereas the CG showed a decrease of around 4.5%. Of the patients, 79.2% of IG and 81.9% of CG suffered to some degree from vitamin D deficiency.
These figures were 4.2% and 71.4% for the IG and CG, respectively after the intervention.For the IG, the PTH was significantly lower and Ca was significantly higher after the intervention. The serum Phosphorus before and after the intervention in each group or between the two groups was not significant.
Conclusions: The single 300,000 IM dose of vitamin D is regarded as an effective and safe to promptly improve vitamin D status in GDM. 138902113840N1
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- Did they use vitamin D2 or Vitamin D3?
- This was a safety trial only – no indication if it helped or not
- Many other studies have found that Vitamin D given at least monthly before, during and after pregnancy had many benefits, including reduction of the possibility of gestational diabetes
- Insulin resistance during pregnancy improved with 50,000 IU of vitamin D every 2 weeks – RCT April 2013 = 3,500 IU average daily
- Overview Loading dose for vitamin D
- Overview Pregnancy and vitamin D has the following summary
|IU||Cumulative Benefit||Blood level||Cofactors||Calcium||$*/month|
|200|| Better bones for mom|
with 600 mg of Calcium
|6 ng/ml increase||Not needed||No effect||$0.10|
|400|| Less Rickets (but not zero with 400 IU)|
3X less adolescent Schizophrenia
Fewer child seizures
|20-30 ng/ml||Not needed||No effect||$0.20|
|2000|| 2X More likely to get pregnant naturally/IVF |
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
|42 ng/ml||Desirable||< 750 mg||$1|
|4000|| 2X fewer pregnancy complications |
2X fewer pre-term births
|49 ng/ml|| Should have |
|< 750 mg||$3|
|6000||Probable: larger benefits for above items|
Just enough D for breastfed infant
More maternal and infant weight
|< 750 mg||$4|
Pages listed in BOTH the categories Diabetes and Pregnancy
- Gestational Diabetes 2.4X more likely if poor Vitamin D Receptor (region in China) – June 2019
- Vitamin D food fortification during pregnancy reduced gestational diabetes in daughters by 13 percent – Nov 2018
- Gestational Diabetes 3 X more likely if poor Vitamin D receptor (Turkey) – May 2019
- Type 1 Diabetes risk increased if high postpartum Vitamin D binding protein – Jan 2019
- Vitamin D treats Gestational Diabetes, decreases hospitalization and newborn complications – meta-analysis March 2019
- Maternal Diabetes and Risk of Autism in Offspring – JAMA June 2018
- Gestational Diabetes 39 percent more likely if insufficient Vitamin D – Meta-analysis March 2018
- Gestational Diabetes 1.9 X more likely if low vitamin D – review Dec 2017
- Congenital Heart Disease is associated with gestational diabetes in first trimester (need Vitamin D and Omega-3 early) Dec 2017
- Gestational Diabetes Mellitus associated with 4 Vitamin D genes – Oct 2015
- Gestational diabetes 30 percent less likely if consumed more than 400 IU of vitamin D daily – Oct 2017
- Low vitamin D plus gestational diabetes resulted in increased ICU use, SGA – Oct 2016
- Gestational diabetes treated by Vitamin D plus Omega-3 – RCT Feb 2017
- Gestational Diabetes reduce 3 times by 5,000 IU of Vitamin D – RCT Jan 2016
- Gestational Diabetes treated with 50,000 IU every two weeks – RCT Sept 2016
- Low vitamin D in pregnancy – epigenetic pancreas problems in offspring (mice) – May 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Gestational Diabetes 3.7 X more likely if smoke and have low vitamin D (no surprise) – Feb 2016
- Gestational Diabetes helped by Vitamin D and Calcium (also less C-section and LGA) – RCT Jan 2016
- Diabetes in child not prevented by a tiny amount of vitamin D during pregnancy – Nov 2015
- Gestational Diabetes Mellitus 1.5X more likely if low vitamin D – meta-analysis Oct 2015
- Gestational Diabetes increasing, especially in dark skinned women (low vitamin D) - 2007
- Increased Gestational Diabetes and poorer infant health associated with low vitamin D – June 2015
- Gestational Diabetes in 10 percent of pregnancies, vitamin D probably helps – Jan 2014
- Gestational diabetes – Vitamin D and Calcium provided huge benefits – RCT March 2015
- Gestational diabetes reduced by just two 50,000 IU doses of vitamin D – RCT Nov 2014
- Gestational Diabetes reduced with 50,000 IU of vitamin D every 3 weeks and daily Calcium – RCT June 2014
- Gestational Diabetes reduced 40 percent by 5,000 IU of vitamin D – RCT April 2014
- Insulin resistance during pregnancy improved with 50,000 IU of vitamin D every 2 weeks – RCT April 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- Will 1600 IU vitamin D prevent gestational diabetes – no, not enough, July 2013
- Vitamin D protects against many types of health problems – review May 2013
- Dr. Holick video on vitamin D - March 2013
- Gestational diabetes 2.2X more likely below 10 ng of vitamin D – June 2012
- Gestational diabetes 60 percent more likely below 20 ng of vitamin D – meta-analysis Feb 2012
- Type I diabetes 2X more likely if mother had low vitamin D – Jan 2012
- 300,000 IU loading dose of vitamin D3 stopped gestational diabetes in RCT – Oct 2011
- Less muscle and insulin resistance for children of vitamin D deficient mothers – Jan 2011
- Vitamin D Levels at Birth May Predict Obesity Risk at age 3 - Oct 2010