Gestational Diabetes reduced 40 percent by 5,000 IU of vitamin D – RCT

Vitamin D Supplementation and the Effects on Glucose Metabolism During Pregnancy: A Randomized Controlled Trial.

Diabetes Care. 2014 Apr 23. [Epub ahead of print]

Yap C1, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M.

Diabetes and Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.

OBJECTIVE: Vitamin D deficiency in pregnancy is associated with an increased risk of gestational diabetes mellitus (GDM) and neonatal vitamin D deficiency. We conducted a double-blind, randomized controlled trial of low-dose (LD) versus high-dose (HD) vitamin D supplementation to investigate the effects of vitamin D supplementation on glucose metabolism during pregnancy.

RESEARCH DESIGN AND METHODS: Women with plasma 25-hydroxyvitamin D (25OHD) levels <32 ng/mL before 20 weeks' gestation were randomized to oral vitamin D3 at 5,000 IU daily (HD) (n = 89) or the recommended pregnancy dose of 400 IU daily (LD) (n = 90) until delivery. The primary end point was maternal glucose levels on oral glucose tolerance test (OGTT) at 26-28 weeks' gestation. Secondary end points included neonatal 25OHD, obstetric and other neonatal outcomes, and maternal homeostasis model assessment of insulin resistance. Analysis was by intention to treat.

RESULTS: There was no difference in maternal glucose levels on OGTT. Twelve LD women (13%) developed GDM versus seven (8%) HD women (P = 0·25). Neonatal cord 25OHD was higher in HD offspring (46 ± 11 vs. 29 ± 12 ng/mL, P < 0.001), and deficiency was more common in LD offspring (24 vs. 10%, P = 0.06). Post hoc analysis in LD women showed an inverse relationship between pretreatment 25OHD and both fasting and 2-h blood glucose level on OGTT (both P < 0·001). Baseline 25OHD remained an independent predictor after multiple regression analysis.

CONCLUSIONS: HD vitamin D supplementation commencing at a mean of 14 weeks' gestation does not improve glucose levels in pregnancy. However, in women with baseline levels <32 ng/mL, 5,000 IU per day was well tolerated and highly effective at preventing neonatal vitamin D deficiency.

PMID: 24760259

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Summary by VitaminDWiki

||Daily Vitamin D|Gestational Diabetes|offspring Vitamin D

5,000 IU| 8%|46 ng

400 IU|13%|29 ng||

VitaminDWiki is confused.

It appears that vitamin D intervention reduced Gestational Diabetes by 40%

Yet the study, just looking at oral glucose tolerance test results, says that vitamin D did not help

VitaminDWiki comment: study would probably have been successful if they had done any of the following

1. Loading dose to eliminate months while the body restocked vitamin D levels

2. Higher dose of vitamin D: 5,000 IU is just barely enough for pregnant women without diabetes.

3. Dose for longer period of time

See also VitaminDWiki

• gestational diabetes" 180 items as of April 2014

• Pregnancy category listing with associated searches

• Gestational Diabetes reduced with 50,000 IU of vitamin D every 3 weeks and daily Calcium – RCT June 2014

• Gestational diabetes 60 percent more likely below 20 ng of vitamin D – meta-analysis Feb 2012

• Gestational Diabetes mostly treated with just 2 doses of 50,000 IU of vitamin D – RCT Dec 2013

• 300,000 IU injection loading dose of vitamin D3 stopped gestational diabetes in RCT – Oct 2011

• Pages listed in BOTH the categories Diabetes and Pregnancy

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• Overview Pregnancy and vitamin D has the following summary

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See also web

• Lowering Diabetes Risk After Pregnancy NYT March 2015
  • 9% of pregnant women have gestational diabetes
  • about half these women will develop Type 2 diabetes later in life. (no mention of vitamin D)