Title: A Comparison of Vitamin D Level among the Patients of Gestational Diabetes Mellitus in a Tertiary Care Hospital in North India

Authors: Dr Meenakshi Srivastava, Dr Preeti Bhatnagar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.168

Abstract

Objective: To compare vitamin D level among the patients of gestational diabetes mellitus (GDM) with healthy controls in a tertiary care hospital in north India.

Methods: This was a case-control study. The pregnant women aged between 18-40 years, at 24-28 weeks of gestational age and willing to participate in the study were included in the study. Vitamin D level was measured in both cases and controls. GDM was defined as blood sugar level between 140 -199 mg/dl.

Results: More than half of both cases (55%) and controls (56.7%) were between 20-30 years. The percentage of deficiency was observed in 61.7% of cases and in 15% of controls. The deficiency was found to be 15.17 times significantly higher in cases compared to controls (OR=15.17, 95%CI=5.85-39.32, p=0.0001). A lower BMI was found in vitamin D deficient patients than insufficiency and sufficient, however, the difference was statistically insignificant (p>0.05).

Conclusion: The deficiency of vitamin D was more common among the pregnant women with GDM than without GDM. Informing women of the importance of maintaining adequate vitamin D stores in pregnancy, particularly for those at greatest risk of vitamin D deficiency is required.

Keywords: Pregnant women, Gestational diabetes mellitus, Vitamin D.

References

  1. Karamanou M, Protogerou A, Tsoucalas G, Androutsos G, Poulakou-Rebelakou E. Milestones in the history of diabetes mellitus: Th e main contributors. World J Diabetes 7, 1–7, 2016.
  2. Reyes-Lopez R, Perez-Luque E, Malacara JM. Metabolic, hormonal characteristics and genetic variants of TCF7L2 associated with development of gestational diabetes mellitus in Mexican women. Diabetes Metab Res Rev 30, 701–706, 2014.
  3. Hawryluk J, Grafk a A, Gęca T, Lopucki M. Gestational diabetes in the light of current literature. Pol Merkur Lekarski 38, 344‒347, 2015.
  4. Indian Journal of Endocrinology and Metabolism 2013; 17 (4): 602.
  5. Nagpal S, Na S, Rathachalam R. Non calcemic actions of vitamin D receptor ligands. Endocr Rev 2005; 26:662-87.
  6. Lee S, Clark SA, Gill RK, Christakos S. 1,25-Dihydroxyvitamin D3 and pancreatic beta-cell function: vitamin D receptors, gene expression, and insulin secretion.1994;134(4):1602–1610.
  7. Plum LA, DeLuca HF. Vitamin D, disease and therapeutic opportunities.Nat Rev Drug Discov 2010; 9: 941–55.
  8. Gale CR, Robinson SM, Harvey NC, et al. Maternal vitamin D status during pregnancy and child outcomes.Eur J Clin Nutr. 2008; 62(1):68–77.
  9. Dawodu A, Saadi HF, Bekdache G, Javed Y, Altaye M, Hollis BW. Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin d deficiency.J Clin Endocrinol Metab. 2013.
  10. Seshiah V., Das A. K., Balaji V., Joshi S. R., Parikh M. N., and Gupta S., “Gestational diabetes mellitus-guidelines. Journal of Association of Physicians of India 2006; 54: 622–628.
  11. Zuhur SS, Erol RS, Kuzu I, Altuntas Y. The relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus according to the severity of 25-hydroxyvitamin D deficiency. Clinics 2013; 68(5): 658-664.
  12. Anna Pleskačová, Vendula Bartáková, Lukáš Pácal,  Katarína Kuricová,  Jana Bělobrádková,  Josef Tomandl,  and Kateřina Kaňková. Vitamin D Status in Women with Gestational Diabetes Mellitus during Pregnancy and Postpartum. BioMed Research International Volume 2015.
  13. Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B. Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev 2008; 24: 27–32.
  14. Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal Vitamin D Status in Gestational Diabetes Mellitus. Nutr Clin Pract 2010;25:524–527.
  15. Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal Vitamin D Status in Gestational Diabetes Mellitus. Nutr Clin Pract 2010;25:524–527.

Corresponding Author

Dr Preeti Bhatnagar
Associate Professor, Department of Physiology,

Heritage Institute of Medical Sciences & Research
Varanasi, Uttar Pradesh