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

Created June 2014

Diabetologia, DOI 10.1007/s00125-014-3293-x

Z. Asemi: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran

M. Karamali: Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran

A. Esmaillzadeh (*)

Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran e-mail: Esmaillzadeh@hlth.mui.ac.ir

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 randomized placebo-controlled trial was performed at maternity clinics affiliated with 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 a placebo. All study participants were blinded to group assignments. Individuals in the calcium-vitamin D group (n=28) received 1,000 mg calcium per day and a 50,000 U vitamin D3 pearl twice during the study (at the 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 the 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 mol/l,p=0.03) and prevented a rise in MDA levels (+0.06±0.66 vs +0.93± 2.00 mol/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.

Trial registration www.irct.ir IRCT201311205623N11

Funding The study was supported by a grant (no. 92110) from Kashan University of Medical Sciences.