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Gestational Diabetes reduced 40 percent by 5,000 IU of vitamin D – RCT April 2014

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


Publisher charges $25 for the PDF

Summary by VitaminDWiki

Daily Vitamin DGestational Diabetesoffspring Vitamin D
5,000 IU 8%46 ng
400 IU13%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

IU Cumulative Benefit Blood level CofactorsCalcium $*/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
cofactors
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
cofactors
< 750 mg $4

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)
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