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The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency

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  • Rosa Corcoy
  • Lilian C Mendoza
  • David Simmons
  • Gernot Desoye
  • J M Adelantado
  • Ana Chico
  • Roland Devlieger
  • Andre van Assche
  • Sander Galjaard
  • Dirk Timmerman
  • Annunziata Lapolla
  • Maria G Dalfra
  • Alessandra Bertolotto
  • Jürgen Harreiter
  • Ewa Wender-Ozegowska
  • Agnieszka Zawiejska
  • Alexandra Kautzky-Willer
  • Fidelma P Dunne
  • Peter Damm
  • Elisabeth R Mathiesen
  • Dorte M Jensen
  • Lise Lotte T Andersen
  • Mette Tanvig
  • David J Hill
  • Judith G Jelsma
  • Frank J Snoek
  • Harald Köfeler
  • Martin Trötzmüller
  • Paul Lips
  • Mireille N M van Poppel
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Background & aims: As vitamin D deficiency is associated with an increased risk of gestational diabetes mellitus (GDM), we aimed to test vitamin D supplementation as a strategy to reduce GDM risk (evaluated after fasting plasma glucose (FPG), insulin resistance and weight gain) in pregnant overweight/obese women. Methods: The DALI vitamin D multicenter study enrolled women with prepregnancy body mass index (BMI) ≥ 29 kg/m 2 , ≤19 + 6 weeks of gestation and without GDM. Participants were randomized to receive 1600 IU/day vitamin D3 or placebo (each with or without lifestyle intervention) on top of (multi)vitamins supplements. Women were assessed for vitamin D status (sufficiency defined as serum 25-hydroxyvitamin D (25(OH)D) ≥ 50 nmol/l), FPG, insulin resistance and weight at baseline, 24–28 and 35–37 weeks. Linear or logistic regression analyses were performed to assess intervention effects. Results: Average baseline serum 25(OH)D was ≥50 nmol/l across all study sites. In the vitamin D intervention arm (n = 79), 97% of participants achieved target serum vitamin 25(OH)D (≥50 nmol/l) at 24–28 weeks and 98% at 35–37 weeks vs 74% and 78% respectively in the placebo arm (n = 75, p < 0.001). A small but significantly lower FPG (−0.14 mmol/l; CI95 −0.28, −0.00) was observed at 35–37 weeks with the vitamin D intervention without any additional difference in metabolic status, perinatal outcomes or adverse event rates. Conclusion: In the DALI vitamin D trial, supplementation with 1600 IU vitamin D3/day achieved vitamin D sufficiency in virtually all pregnant women and a small effect in FPG at 35–37 weeks. The potential of vitamin D supplementation for GDM prevention in vitamin D sufficient populations appears to be limited. Trial registration number: ISRCTN70595832

Original languageEnglish
JournalClinical nutrition (Edinburgh, Scotland)
Volume39
Issue number3
Pages (from-to)976-984
Number of pages9
ISSN0261-5614
DOIs
Publication statusPublished - Mar 2020

    Research areas

  • Fasting plasma glucose, Fasting plasma insulin, Gestational diabetes mellitus, Pregnancy, Vitamin D sufficiency, Vitamin D supplementation

ID: 57341251