Efficacy of vitamin D supplementation in gestational diabetes mellitus: Systematic review and meta-analysis of randomized trials

Aims: To date, it is largely unknown how body mass index (BMI), gestational weight (GW), and stored vitamin D (25(OH)D) levels change in the vitamin D-supplemented gestational diabetes mellitus (GDM) patients, irrespective of their pre-pregnancy BMI. Therefore, to study this association, a prospective systematic review and meta-analysis protocol is proposed here. Methods: Primarily, different databases (PubMed, Embase and Scopus) will be searched (without any limitation to date or language) for randomised parallel-arm trials comparing GW, BMI and stored vitamin D level in the body among GDM patients who were supplemented and not supplemented with vitamin D, besides their conventional GDM care. The study selection process and the consecutive risk of bias assessment will adhere to the PRISMA 2009 flow chart and the Cochrane collaboration’s guideline, respectively. These interventions’ effect on the respective outcomes will be compared by meta-analysis (along with an assessment of the statistical heterogeneity) when comparable data will be available from at least 4 studies. Subgroup analysis and Egger’s meta-regression will follow if an adequate number of trials are available. Narrative reporting will be considered when a quantitative comparison is not feasible for any of the outcomes. Conclusion: The proposed review aims to compare the BMI, GW, and 25(OH)D levels in the blood between the vitamin D supplemented and not supplemented GDM patients.

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Association between Gene Polymorphisms of Vitamin D Receptor and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010205 ◽

2020 ◽

Vol 18 (1) ◽

pp. 205

Author(s):

Qian Zhou ◽

Shiwu Wen ◽

Miao Liu ◽

Sulei Zhang ◽

Xin Jin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vitamin D Receptor ◽

Odds Ratio ◽

Meta Analysis ◽

Receptor Gene ◽

Vitamin D Receptor Gene

(1) Background: Studies on the association between Vitamin D receptor gene polymorphism and gestational diabetes mellitus have been inconsistent. The aim of this study was to summarize available evidence on the association between polymorphisms of Vitamin D receptor genes and susceptibility to gestational diabetes mellitus. (2) Methods: We searched databases of PubMed, Web of Science, Embase, China national knowledge infrastructure (CNKI), China science and technology journal database (VIP), and Wanfang Data for relevant articles. A systematic review and a meta-analysis were done to compare the distribution of Vitamin D receptor gene polymorphisms in gestational diabetes mellitus patients with those in controls using allelic, codominant, dominant, and recessive models. (3) Results: A total of eight eligible articles were included in the systematic review and of them, six articles were included in the meta-analysis. The vitamin D receptor gene rs7975232 polymorphism was associated with gestational diabetes mellitus under the allelic model (odds ratio = 1.28, 95% confidence interval 1.06–1.56), codominant model (CC vs. AA odds ratio = 1.97, 95% confidence interval 1.28–3.05), and recessive model (odds ratio = 1.83, 95% confidence interval 1.27–2.64) in the case of low heterogeneity. High heterogeneity existed in studies on the association of vitamin D receptor genes rs1544410, rs2228570, and rs731236 with gestational diabetes mellitus, and the most common sources of heterogeneity were the year of publication and matching. (4) Conclusion: Polymorphism of the vitamin D receptor gene rs7975232 may be associated with risk of developing gestational diabetes mellitus. Future studies should be designed to include standardized data collection and matching for important confounding factors such as body mass index, age, and race.

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Maternal vitamin D status and risk of gestational diabetes mellitus: A systematic review and meta-analysis of prospective cohort studies

Clinical Nutrition ◽

10.1016/j.clnu.2021.03.037 ◽

2021 ◽

Vol 40 (5) ◽

pp. 2576-2586

Author(s):

Alireza Milajerdi ◽

Fatemeh Abbasi ◽

Seyed Mohammad Mousavi ◽

Ahmad Esmaillzadeh

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Vitamin D Status ◽

Maternal Vitamin ◽

Prospective Cohort Studies ◽

Maternal Vitamin D Status

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A comparison of the risk of cesarean section in gestational diabetes mellitus patients supplemented antenatally with vitamin D containing supplements versus placebo: A systematic review and meta-analysis of double-blinded randomized controlled trials

Journal of the Turkish-German Gynecological Association ◽

10.4274/jtgga.galenos.2020.2019.0164 ◽

2020 ◽

Vol 21 (3) ◽

pp. 201-212

Author(s):

Sumanta Saha ◽

Sujata Saha

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Vitamin D ◽

Gestational Diabetes ◽

Cesarean Section ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Double Blinded

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Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis

Journal of Diabetes Research ◽

10.1155/2020/6062478 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Shixiao Jin ◽

Liyan Sha ◽

Jianli Dong ◽

Jing Yi ◽

Yang Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Serum Insulin ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Omega 3 ◽

Magnesium Supplementation ◽

Nutritional Strategies

Background. Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and nutritional therapy is the basis of GDM treatment. However, the effects of different forms of nutritional supplementation on improving gestational diabetes are uncertain. Objective. We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. Methods. We conducted a literature search using PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the differences between different nutritional strategies in women with GDM. The Cochrane tool was used to assess the risk of bias. Pairwise meta-analysis and network meta-analysis were used to compare and rank the effects of nutritional strategies for the improvement of fasting plasma glucose (FPG), serum insulin, and homeostasis model assessment-insulin resistance (HOMA-IR). Results. We included thirteen RCTs with a total of 754 participants. Compared with placebo, omega-3, magnesium, vitamin D, zinc, and probiotics were more beneficial for improving FPG, serum insulin, and HOMA-IR. Network analysis showed that vitamin D supplementation was superior to omega-3 (-3.64 mg/dL, 95% CI: -5.77 to -1.51), zinc (-5.71 mg/dL, 95% CI: -10.19 to -1.23), probiotics (-6.76 mg/dL, 95% CI: -10.02 to -3.50), and placebo (-12.13 mg/dL, 95% CI: -14.55 to -9.70) for improving FPG. Magnesium supplementation was more beneficial for decreasing serum insulin compared with probiotics (-5.10 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL; 95% CI-11.95, -3.65). Vitamin D was more effective than probiotics (-0.99, 95% CI: -1.84 to -0.14) and placebo (-1.80, 95% CI: -2.45 to -1.16) for improving HOMA-IR. Conclusion. Vitamin D supplementation significantly reduced FPG and regulated HOMA-IR. Magnesium supplementation was superior in decreasing serum insulin than supplementation with other nutrients. Nutrient supplementation seemed to have an effect on glucose homeostasis maintenance in patients with GDM and may be considered an adjunctive therapy.

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Maternal and Neonatal Metabolic Outcomes of Vitamin D Supplementation in Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Annals of Nutrition and Metabolism ◽

10.1159/000491643 ◽

2018 ◽

Vol 73 (2) ◽

pp. 145-159 ◽

Cited By ~ 4

Author(s):

Fatemeh Jahanjoo ◽

Azizeh Farshbaf-Khalili ◽

Seyed Kazem Shakouri ◽

Neda Dolatkhah

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Density Lipoprotein ◽

Vitamin D Supplementation ◽

Controlled Trials ◽

Cochrane Central Register ◽

Hs Crp

Introduction: Many scientists have revealed the association between vitamin D deficiency and gestational diabetes mellitus (GDM). The purpose of this review was to evaluate the impact of vitamin D supplementation on maternal and neonatal health measures in GDM. Methods: A comprehensive systematic literature search in the electronic databases including Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Scopus, Web of Sciences, EMBASE, Google Scholar, Clininaltrial.gov, and ProQuest as well as SID, Magiran, Irandoc, and Iranmedex for Persian literature review carried out up to January 2018. All RCTs and quasi-experimental studies that compared vitamin D supplementation with placebo or without supplementation on GDM women were included in this review. Results: Five randomized controlled trials involving 310 women were included in the meta-analysis. There were significant differences in fasting Plasma Glucose (FPG; mean difference [MD] –12.54, 95% CI –15.03 to –10.05; 3 trials, 223 participants); total cholesterol (TC; MD –24.77, 95% CI –32.57 to –16.98; 3 trials, 223 participants); low-density lipoprotein (LDL) cholesterol (MD –18.92, 95% CI –24.97 to –12.88; 3 trials, 223 participants); high-density lipoprotein (HDL) cholesterol (MD, 3.87, 95% CI 1.20–6.55; 3 trials, 223 participants); high sensitivity C-reactive protein (hs-CRP; MD –1.35, 95% CI –2.41 to –0.28; 2 trials, 126 participants); and Newborns’ hyperbilirubinemia (OR 0.33, 95% CI 0.13–0.80; 2 trials, 129 participants). Conclusions: Supplementation of GDM women with vitamin D may lead to an improvement in FPG, TC, LDL, HDL, hs-CRP serum levels as well as in newborns’ hyperbilirubinemia.

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Impact of missingness on clinical trials on the effectiveness of antenatal vitamin D supplementation in gestational diabetes mellitus patients

Journal of Ideas in Health ◽

10.47108/jidhealth.vol3.iss1.47 ◽

2020 ◽

Vol 3 (1) ◽

pp. 138-139

Author(s):

Sumanta Saha

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Clinical Trials ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Medical Complication ◽

Maternal And Neonatal Outcomes ◽

Cautious Interpretation

Gestational diabetes mellitus (GDM) is a vital medical complication of pregnancy in which glucose intolerance is first detected or develops during gestation. GDM is associated with adverse maternal and neonatal outcomes, and contemporarily, several clinical trials have tested their incidence in antenatal vitamin D receiving GDM patients. Considering their clinical significance, these trials' findings pertaining to the above outcomes require cautious interpretation, in terms of the risk of bias due to missingness. Any such bias in randomized controlled trials (RCT) can contaminate the results of a meta-analysis that extracts data from these RCTs.

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