DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193555

Gestational diabetes mellitus, Vitamin D status and fetomaternal outcome

Rekha T., Shazia Parveen, Nasreen Noor, Seema Hakim, Shagufta Moin

Abstract


Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.

Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.

Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.

Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin.


Keywords


Fetal outcome, Gestational diabetes mellitus, Maternal outcome, Vitamin D

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References


American College of Obstetricians and Gynecologists: Gestational diabetes mellitus. Practice Bulletin No. 180; 2017.

Mohan MA, Chandrakumar A. Evaluation of prevalence and risk factors of gestational diabetes in a tertiary care hospital in Kerala. Diabetes Metab Syndr. 2016;10:68-71.

Anjalakshi C, Balaji V, Balaji MS. Single test procedure to diagnose gestational diabetes mellitus, Acta Diabetol. 2009;46:51.

Abdulrahman Al-Ajlan, Sara Al-Musharaf. Lower vitamin D levels in Saudi pregnant women are associated with higher risk of developing. GDM BMC Pregnancy and Childbirth. 2018:18.

Park S, Kim da S, Kang S. Vitamin D deficiency impairs glucose- stimulated insulin secretion and increases insulin resistance by reducing PPAR-gamma expression in nonobese type 2 diabetic rats. J Nutr Biochem. 2016;27:257-65.

Esteghamati A, Aryan Z, Nakhjavani M. Vitamin D deficiency is associated with insulin resistance in nondiabetics and reduced insulin production in type 2 diabetics. Horm Metab Res. 2015;47(4):273-9.

Grineva EN, Karonova T, Micheeva E, Belyaeva O, Nikitina IL. Vitamin D deficiency is a risk factor for obesity and diabetes type 2 in women at late reproductive age. Aging (Albany NY). 2013;5(7):575-81.

Joergensen JS, Lamont RF, Torloni MR. Vitamin D and gestational diabetes: an update. Curr Opin Clin Nutr Metab Care. 2014;17(4):360-7.

Bourlon PM, Billaudel B, Faure-Dussert A. Influence of vitamin D3 deficiency and 1,25 dihydroxyvitamin D3 on de novo insulin biosynthesis in the islets of the rat endocrine pancreas. J Endocrinol. 1999;160:87-95.

Pittas AG, Lau J, Hu FB. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92:2017-29.

Ferrara A, Kahn HS, Quesenberry CP. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000. Obstet Gynecol. 2004;103:526-33.

Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA. 2001;286:2516-8.

Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes. Diabet Med. 2004;21:103-13.

Dror DK. Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes. Curr Opin Obstet Gynecol. 2011;23:422-6.

Chu SY, Callaghan WM, Kim SY. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30:2070-6.

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-81.

Soheilykhah S, Mojibian M, Rashidi M. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract. 2010;25:524-7.

Clifton-Bligh RJ, McElduff P, McElduff A. Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med. 2008;25:678-84.

Hossein-Nezhad A, Maghbooli Z, Vassigh AR. Prevalence of gestational diabetes mellitus and pregnancy outcomes in Iranian women. Taiwan J Obstet Gynecol. 2007;46:236-41.

Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PloS one. 2008;3(11):e3753.