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Gestational diabetes treated by Vitamin D plus Omega-3 – RCT Feb 2017


The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes - Feb 2017

Journal of Clinical Lipidology, online 2 Feb 2017, http://dx.doi.org/10.1016/j.jacl.2017.01.011
Mehri Jamilian, MD1, Mansooreh Samimi, MD2, Faraneh Afshar Ebrahimi, MD2, Teibeh Hashemi, MD3, Mohsen Taghizadeh, PhD3, Maryamalsadat Razavi, MD4, , , Marzieh Sanami, BSc3, Zatollah Asemi, PhD3, ,

VitaminDWiki Summary

Trial was only 6 weeks – hardly enough time to get to a good level of vitamin D
Longer trial or starting with loading dose would have had much better results

No Vitamin D
2000mg Omega3
600mg EPA
480mg DHA
50,000 IU Vit D*50,000 IU Vit D*
2000 mg Omega3
No Vitamin D
No Omega-3
fasting plasma glucose-7 -7 -4 +1
serum insulin levels-1-10+3
HOMA-IR -0.7-0.-0.2+0.6
serum triglycerides-8 +8+4 +20
VLDL-cholesterol-2+20`+4

* every 2 weeks, otherwise daily
See also VitaminDWiki
Overview: Omega-3 many benefits include helping vitamin D
Pages listed in BOTH of the categories Diabetes and Pregnancy

Pages listed in BOTH of the categories Omega-3 and Pregnancy

Overview Loading of vitamin D contains the following

If a person is, or is suspected to be, very vitamin D deficient a loading dose is typically given

  • Loading = repletion = quick replacement (previously known as Stoss)
  • Loading doses range in size from 100,000 IU to 1,000,000 IU of Vitamin D3
  • The size of the loading dose is a function of body weight - see below
    Unfortunately, some doctors persist in using Vitamin D2 instead of D3
  • Loading may be done as quickly as a single day, to as slowly as 3 months.
    It appears that spreading the loading dose over 4-20 days is a good compromise
  • Loading is typically oral, but sometimes by injection (I.M,)
  • The loading dose persists in the body for about 3 months
    The loading dose should be followed up with continuing maintenance
    Unfortunately, many doctors fail to follow-up with the maintenance dosing.
  • As about 1 in 300 people have some form of mild allergic reaction to vitamin D supplements,
    it appears prudent to test with a small amount of vitamin D before giving a loading dose
  • The causes of a mild allergic reaction appear to be: (in order of occurance)
    1) lack of magnesium - which can be easily added
    2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
    3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )


Objective
This study was performed to evaluate the effects of vitamin D and omega-3 fatty acids co- supplementation on glucose metabolism and lipid concentrations in gestational diabetes (GDM) patients.

Methods
This randomized double-blind placebo-controlled clinical trial was done among 140 GDM patients. Participants were randomly divided into four groups to receive:

  • 1) 1000 mg omega-3 fatty acids containing 360 mg eicosapentaenoic acid (EPA) and 240 mg docosahexaenoic acid (DHA) twice a day+ vitamin D placebo (n=35);
  • 2) 50,000 IU vitamin D every 2 weeks+ omega-3 fatty acids placebo (n=35);
  • 3) 50,000 IU vitamin D every 2 weeks+1000 mg omega-3 fatty acids twice a day (n=35) and
  • 4) vitamin D placebo+omega-3 fatty acids placebo (n=35) for 6 weeks.

Results
After 6 weeks of intervention, patients who received combined vitamin D and omega-3 fatty acids supplements compared with vitamin D, omega-3 fatty acids and placebo had significantly decreased

  • fasting plasma glucose (FPG) (-7.3±7.8, -6.9±6.6, -4.0±2.5 and +1.0±11.4 mg/dL, respectively, P<0.001),
  • serum insulin levels (-1.9±1.9, -1.3±6.3, -0.4±6.3 and +2.6±6.5 μIU/mL, respectively, P=0.005),
  • homeostatic model of assessment for insulin resistance (HOMA-IR) (-0.7±0.6, -0.5±1.4, -0.2±1.5 and +0.6±1.5, respectively, P<0.001)
  • increased quantitative insulin sensitivity check index (QUICKI) (+0.01±0.01, +0.008±0.02, +0.002±0.02 and -0.005±0.02, respectively, P=0.001). In addition, changes in
  • serum triglycerides (-8.2±41.0, +7.6±31.5, +3.6±29.9 and +20.1±29.6 mg/dL, respectively, P=0.006) and
  • VLDL-cholesterol (-1.6±8.2, +1.5±6.3, +0.8±6.0 and +4.0±5.9 mg/dL, respectively, P=0.006) in the vitamin D plus omega-3 fatty acids group were significantly different from the changes in these indicators in the vitamin D, omega-3 fatty acids and placebo groups.

Conclusion
Overall, vitamin D and omega-3 fatty acids co-supplementation for 6 weeks among GDM patients had beneficial effects on FPG, serum insulin levels, HOMA-IR, QUICKI, serum triglycerides and VLDL-cholesterol levels.

Publisher wants $36 for the PDF


The effects of vitamin D and omega-3 fatty acids co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in patients with gestational diabetes - Dec 2017

It appears the same RCT was re-published with free PDF later in 2017
Nutrition & Metabolism201714:80, https://doi.org/10.1186/s12986-017-0236-9. Dec 2017
Maryamalsadat Razavi, Mehri Jamilian, Mansooreh Samimi, Faraneh Afshar Ebrahimi, Mohsen Taghizadeh, Reza Bekhradi, Elahe Seyed Hosseini, Hamed Haddad Kashani, Maryam Karamali and Zatollah Asemi
 Download the PDF from VitaminDWiki
Image
Nice outcome trends for this short small study
Anticipate that a long study with more mothers would get many statistically significant results

Image

Background
This study was carried out to determine the effects of vitamin D and omega-3 fatty acids co- supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes (GDM) patients.

METHODS:
This randomized, double-blind, placebo-controlled trial was conducted among 120 GDM women.
Participants were randomly divided into four groups to receive:

  • 1) 1000 mg omega-3 fatty acids containing 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA) twice a day + vitamin D placebo (n = 30);
  • 2) 50,000 IU vitamin D every 2 weeks + omega-3 fatty acids placebo (n = 30);
  • 3) 50,000 IU vitamin D every 2 weeks + 1000 mg omega-3 fatty acids twice a day (n = 30) and
  • 4) vitamin D placebo + omega-3 fatty acids placebo (n = 30) for 6 weeks.

Results
Subjects who received vitamin D plus omega-3 fatty acids supplements compared with vitamin D, omega-3 fatty acids and placebo had significantly decreased high-sensitivity C-reactive protein (−2.0 ± 3.3 vs. -0.8 ± 4.4, −1.3 ± 2.4 and +0.9 ± 2.7 mg/L, respectively, P = 0.008), malondialdehyde (−0.5 ± 0.5 vs. −0.2 ± 0.5, −0.3 ± 0.9 and +0.5 ± 1.4 μmol/L, respectively, P < 0.001), and increased total antioxidant capacity (+92.1 ± 70.1 vs. +55.1 ± 123.6, +88.4 ± 95.2 and +1.0 ± 90.8 mmol/L, respectively, P = 0.001) and glutathione (+95.7 ± 86.7 vs. +23.0 ± 62.3, +30.0 ± 66.5 and −7.8 ± 126.5 μmol/L, respectively, P = 0.001). In addition, vitamin D and omega-3 fatty acids co-supplementation, compared with vitamin D, omega-3 fatty acids and placebo, resulted in lower incidences of newborns’ hyperbilirubinemiain (P = 0.037) and newborns’ hospitalization (P = 0.037).

Conclusion
Overall, vitamin D and omega-3 fatty acids co-supplementation for 6 weeks among GDM women had beneficial effects on some biomarkers of inflammation, oxidative stress and pregnancy outcomes.

Attached files

ID Name Comment Uploaded Size Downloads
9099 Vit D O-3 outcomes.jpg admin 02 Jan, 2018 12:04 69.31 Kb 11
9098 GD with Vit D and O-3.jpg admin 02 Jan, 2018 12:04 37.66 Kb 10
9097 D3 + Omega-3 during pregnancy.pdf admin 02 Jan, 2018 11:48 1.09 Mb 4
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