Low vitamin D linked with poorer glycaemic control in gestational diabetes

January 01, 0001

Low vitamin D linked with poorer glycaemic control in gestational diabetes

The aim of this retrospective cross-sectional study, in a GDM clinic at a tertiary referral centre by researchers from Australia was to test the hypothesis that lower 25- hydroxyvitamin D (25 OHD) levels in late pregnancy are associated with poorer glucose control in gestational diabetes mellitus (GDM). 147 women with a mean gestational age of 35 plus or minus 2 weeks were included, of whom 41% had insufficient or deficient levels of 25 OHD (less than or equal to 50 nmol/L).

Ethnicity, occupational status and season significantly influenced 25 OHD levels, but BMI did not. 25 OHD levels were inversely associated with fasting and 2-hour blood glucose levels during OGTT and with log HbA1c. BMI and insulin doses were also associated with HbA1c levels. Multivariable analysis identified 25 OHD and blood glucose levels during the OGTT as independent predictors of HbA1c levels.

The researchers concluded: "Lower 25 OHD levels are independently associated with poorer glycaemic control. Future randomised trials are needed to determine whether vitamin D plays a role in glycaemic control in GDM. Regardless, maternal vitamin D insufficiency has adverse effects including neonatal hypocalcaemia and rickets. The 41% prevalence of inadequate 25 OHD levels in the women in our study is unacceptably high. We propose routine 25 OHD testing of all pregnant women at screening for GDM or earlier, and treatment of women who are found to be deficient."

If this proves to be associated with adverse outcomes, it is an impressive figure.

For the full abstract, click here.

MJA 194(7):334-337, 4 April 2011
© The Medical Journal of Australia 2011
Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Sue Lynn Lau, Jenny E Gunton, Neil P Athayde, Karen Byth and N Wah Cheung. Correspondence to Jenny Gunton: [email protected]

Category: T. Endocrine/Metabolic/Nutritional, W. Pregnancy, Family Planning. Keywords: vitamin D, glycated haemoglobin, women, gestational diabetes mellitus, retrospective cross-sectional study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 12 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.