Vitamin D deficiency during pregnancy increases risk of gestational diabetes
Severe vitamin D deficiency during the second trimester of pregnancy is significantly associated with increased risk for gestational diabetes mellitus (GDM).
Researchers at Postgraduate Institute of Medical Sciences, Rohtak, conducted a study to evaluate the association between vitamin D level and GDM. The results of the study have been published in the journal Diabetes and Metabolic Syndrome.
Vitamin D is a fat-soluble vitamin that regulates the absorption of calcium and phosphorus as well as facilitates normal immune system function. It is an essential nutrient important for strong bones and is produced by the body when skin is exposed to sunlight. Vitamin D has 2 forms: D2 (obtained from foods you eat) and D3 (obtained from sun exposure).
The researchers conducted the study on 50 diagnosed patients of GDM attending the antenatal clinic in the obstetrics and gynaecology department of Pt. B.D. Sharma PGIMS, Rohtak. 50 age and gestational age-matched normoglycemic women were taken as control group. The procedure of the study was explained to the participants and informed consent was taken. Their serum vitamin D levels were measured using the enzyme-linked immunosorbent assay method. Depending on vitamin D levels, the women with GDM were categorised as: sufficient (>75 nmol/L or 30 ng/mL), insufficient (<75 but >50 nmol/L or <30 but >20 ng/mL), deficient (<50 but >25 nmol/L or <20 but >10 ng/mL) and severe deficient (<25 nmol/L or 0-10 ng/mL).
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GDM women had higher age, BMI, and positive family history of type 2 DM as compared to pregnant women without GDM. Mean vitamin D level was lower in GDM group vs control group 32.64 ± 24.33 vs 39.90 ± 21.86 nmol/L (P=.033). Prevalence of severe vitamin D deficiency (<25 nmol/L) was higher in the GDM group vs control group (44 vs 20%; OR, 1.833; P=.010). Women with GDM with BMI >25 kg/m2 had 1.799 times chances to have severe vitamin D deficiency vs those with BMI <25 kg/m2. Mild (>50 but <75 nmol/L) and moderate (>25 but <50 nmol/L) vitamin D deficiency was seen in 6 and 16 women with GDM, respectively. Only 6 women with GDM had sufficient vitamin D level (>75 nmol/L).
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Authors concluded that Severe vitamin D deficiency in the second trimester of pregnancy is significantly associated with elevated risk for GDM. They commented, "Rising trend in the prevalence of GDM has been shown by studies performed in various parts of the world and India. The causes of GDM are an active area of investigation with a growing interest in vitamin D deficiency as a potential cause. Reduced availability of maternal vitamin D level during pregnancy may be a possible mechanism contributing to the development of insulin resistance leading to GDM."