Gestational Diabetes and the Role of Vitamin D with Omega-3s

Gestational diabetes describes a condition during pregnancy when women experience high blood glucose (sugar) levels. The condition occurs in around 5 percent of UK pregnancies (1). Gestational diabetes can give rise to a number of complications, including premature birth, stillbirth, neonatal hypoglycaemia (low blood sugar after giving birth), pre-eclampsia (high blood pressure), macrosomia (where the baby grows larger than normal, which may lead to complications during delivery), and hyperbilirubinemia (neonatal jaundice) (2). After the birth, the condition puts the mother at increased risk of developing Type 2 Diabetes, the increased level of risk is thought to be three to sevenfold in the period of 5 to 10 years after the pregnancy (3).

A meta-analysis conducted in 2015 of 20 studies comprising 9,209 participants clearly demonstrated that low vitamin D status increased the risk of gestational diabetes (4) and administration with marine omega-3s EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) may improve insulin sensitivity. However, other intervention studies using EPA and DHA in gestational diabetes patients have been conducted and the results have been inconclusive (5).

A new paper explores the idea that a combined intervention of vitamin D and marine omega-3s could be effective in mitigating the risk of negative outcomes associated with gestational diabetes (6). A double-blinded, placebo controlled RCT was conducted with 120 Iranian women with gestational diabetes (four arms, 30 in each test arm: 1) placebo, 2) DHA plus EPA, 3) vitamin D, and 4) DHA plus EPA and vitamin D combined) receiving interventions of 180 mg EPA and 120 mg DHA per day and/or 50,000 IU of Vitamin D every 2 weeks over a six-week period. Biomarkers of inflammation, oxidative stress and pregnancy outcomes were determined. The infants of mothers in the combined Vitamin D and omega-3 treatment group had lower incidence of hospitalization and jaundice (hyperbilirubinemia). Furthermore, the mothers had decreased levels of high sensitivity C-reactive protein, which may reduce the risk of the baby developing jaundice and respiratory distress syndrome, and increased total anti-oxidant capacity.

Co-administration of vitamin D and omega-3s for pregnant women with gestational diabetes for six weeks may be beneficial to the health of both mother and baby.

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1. www.gestationaldiabetes.co.uk accessed 10.1.18.
   
2. https://www.tommys.org/pregnancy-information/pregnancy-complications/gestational-diabetes/what-are-risks-gestational-diabetes
3. Curry A; “Exploring why Gestational Diabetes Leads to Type 2”; Diabetes Forecast Jan/Feb 2015.
   
4. Zhang M-X, Pan G-T, Guo J-F et al.; “Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A meta-analysis of Observational Studies”; Nutrients 2015; 7: 8366-8375.
   
5. Ostadrahimi A, Mohammed-Alizadeh S, Mirgafourvand M et al.; “Effects of Fish Oil Supplementation on Gestational Diabetes Mellitus (GDM): A Systematic Review”; Iran Red Crescent Med J; 2016 Nov, 18(11): e24690.
   
6. Razavi M, Jamilian M, Samimi M et al, “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”; Nutr Metab (Lond). 2017; 14: 80. 
   
   Published online 2017 Dec 28. doi:  10.1186/s12986-017-0236-9