Abstract
To evaluate the effects of vitamin D supplementation in the postpartum period of women with previous gestational diabetes mellitus (GDM). Randomized clinical trials of pregnant women with GDM of any chronological, gestational age and parity, with no history of previous disease who received vitamin D supplementation in the prenatal and/or postpartum period and were evaluated in the postpartum period were included. The PubMed, EMBASE, Cochrane, and LILACS databases were consulted until July 2019. Serum vitamin D concentration (25-hydroxyvitamin D in nmol/L), fasting blood glucose, glycated hemoglobin, serum calcium concentration, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), parathyroid hormone (PTH) and body mass index (BMI) were evaluated. Similar results in at least two trials were plotted using the RevMan 5; Cochrane Collaboration, Oxford, Reino Unido. The quality of the evidence was generated according to the classification, development, and evaluation of the classification of the recommendations. Four studies were included in the present review (200 women). The findings indicate that there is no difference in the postpartum period in women diagnosed with previous GDM who received vitamin D supplementation in the prenatal and/or in the postpartum period, showing only that there was a significant increase in the concentration of vitamin D (relative risk [RR]: 1.85; 95% confidence interval [CI]: 1.02-2.68). This increase in the concentration of vitamin D should be interpreted with caution, since the assessment of the quality of the evidence was very low. For the other analyzed outcomes, there was no significance between the intervention and control groups, and the outcomes, when analyzed in their strength of evidence, were considered very low and low in their evaluation.
Highlights
Diabetes mellitus (DM) is characterized as a heterogeneous group of metabolic disorders that have hyperglycemia in common, resulting from defects in the action and/or in the secretion of insulin.[1]
The findings indicate that there is no difference in the postpartum period in women diagnosed with previous gestational diabetes mellitus (GDM) who received vitamin D supplementation in the prenatal and/or in the postpartum period, showing only that there was a significant increase in the concentration of vitamin D
A systematic review with meta-analysis performed by at least one research group aimed to assess whether vitamin D supplementation administered to pregnant women with GDM would improve maternal and neonatal outcomes and found no evidence of moderate or high quality indicating that vitamin D supplementation, when compared with placebo, improves glucose metabolism or adverse maternal and neonatal outcomes related to GDM.[19]
Summary
Diabetes mellitus (DM) is characterized as a heterogeneous group of metabolic disorders that have hyperglycemia in common, resulting from defects in the action and/or in the secretion of insulin.[1] Diabetes mellitus can be classified into four general categories: type 1 diabetes, type 2 diabetes, gestational diabetes mellitus (GDM), and other specific types of diabetes.[2]. GDM has been characterized as any degree of glucose intolerance recognized for the first time during pregnancy, regardless of whether the disease started before pregnancy or even persisted after pregnancy. This definition facilitated a uniform tracking strategy but was limited by imprecision.[2]. In Brazil, $ 7% of pregnancies are complicated by gestational hyperglycemia.[1]
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