Prospective cohort study of vitamin D deficiency in pregnancy: Prevalence and limited effectiveness of 1000 IU vitamin D supplementation.

BACKGROUND: Vitamin D deficiency is highly prevalent worldwide among pregnant women. Although vitamin D supplementation is effective in improving vitamin D status, the safety and optimal dosing of vitamin D supplementation during pregnancy remain less well understood. OBJECTIVE: This study aimed to investigate the prevalence of vitamin D deficiency among pregnant women and evaluate the effectiveness of vitamin D supplementation in improving vitamin D status during pregnancy. DESIGN: This prospective cohort study assessed the impact of a 16-week daily vitamin D supplementation 1000 IU regimen on vitamin D status among pregnant women. METHODS: A total of 365 pregnant women were recruited, and their baseline total circulating 25-hydroxy vitamin D concentrations were measured. Of these, 249 participants completed the study, which involved oral daily supplementation with 1000 IU of vitamin D and a repeat of total circulating 25-hydroxy vitamin D concentrations after 16 weeks. RESULTS: The study found that 57.7% of the participants had vitamin D deficiency, consistent with the rates reported in other studies. However, vitamin D supplementation at a dose of 1000 IU had a small effect size and was not clinically significant. However, 67% of participants with vitamin D deficiency remained deficient; among participants initially with vitamin D insufficiency, 30% became deficient. Moreover, 26.5% of individuals with sufficient vitamin D status at 12 weeks showed insufficient levels by 28 weeks. CONCLUSION: Vitamin D deficiency is widespread among pregnant women, and vitamin D supplementation at a daily dose of 1000 IU may not adequately address this problem. Although the study has limitations, its results align with previous research and may apply to other populations with a high prevalence of vitamin D deficiency during pregnancy. Further research is necessary to determine the most effective approach for addressing prenatal vitamin D deficiency.

Prevalence and effectiveness of vitamin D supplementation during pregnancyVitamin D deficiency is common among pregnant women and can lead to various health issues. This study aimed to investigate the effectiveness of vitamin D supplementation in improving vitamin D levels during pregnancy. A total of 365 pregnant women were recruited, and their vitamin D levels were measured at the beginning of the study. The participants were given a daily vitamin D supplement of 1000 IU, and their vitamin D levels were measured at 3-month intervals. The study found that more than half of the participants had vitamin D deficiency, which is consistent with the rates reported in other studies. However, vitamin D supplementation at the given dosage had a small effect and did not significantly increase vitamin D levels in pregnant women. Moreover, vitamin D-rich diets had no significant impact on vitamin D levels. The study emphasizes the importance of identifying effective strategies for preventing and treating vitamin D deficiency during pregnancy. The findings suggest that current strategies advised by international and national guidelines may not be sufficient to address the problem. Further research is needed to identify more effective approaches, including screening, higher safe dosages, and monitoring responses after 3 months of treatment. In summary, vitamin D deficiency is common among pregnant women, and current strategies may not be enough to address the issue. The study highlights the need for effective approaches to prevent and treat vitamin D deficiency during pregnancy, and further research is needed to find these strategies.

Risk of Depression and Suicide in Diabetic Patients.

Although mental disorders in diabetics are more prevalent than in the general population, an increased prevalence of depression, frequently leading to suicide, has been reported in individuals with diabetes mellitus. Therefore, the purpose of this review is to assess the risk of depression and suicide in diabetic patients. The prevalence of depression and suicide is high among diabetic individuals. Risk factors including history of depression, presence of comorbidity, younger age, lower education, low social support, presence of diabetic complications, poor glycemic control, and physical impairment, all increase the risk of depression among diabetics. On the other hand, female sex, the intensity of childhood trauma, a history of alcohol misuse, depression, lower level of education, comorbidities, higher blood glucose levels, and previous history of suicide, all increase the risk of suicide among diabetics. Additionally, a bidirectional relationship exists between depression and diabetes. For example, depression can cause diabetes due to the disease's psychological and psychosocial impact, microvascular brain lesions, higher glutamate levels, poor glycemic control, and medication adherence. On the other hand, diabetic patients develop depression due to the stress associated with disease management. This paper concluded that depression and suicide are both prevalent conditions among diabetic patients. The higher risk of depression and suicidality in diabetic patients emphasizes the critical need of integrating depression screening and treatment into primary healthcare settings to avoid fatal conditions in the future. However, more research is required in this area.

The Relationship Between Type 2 Diabetes Mellitus and Related Thyroid Diseases.

Diabetes and thyroid diseases are caused by endocrine dysfunction and both have been demonstrated to mutually impact each other. Variation in thyroid hormone levels, even within the normal range, can trigger the onset of type 2 diabetes mellitus (T2DM), particularly in people with prediabetes. However, the available evidence is contradictory. The purpose of this review is to understand the pathological relationship between thyroid-related disorders and T2DM. T2DM in thyroid dysfunction is thought to be caused by altered gene expression of a group of genes, as well as physiological abnormalities that result in decreased glucose uptake increased, splanchnic glucose absorption, disposal in muscles, increased hepatic glucose output. Additionally, both hyperthyroidism and hypothyroidism can cause insulin resistance. Insulin resistance can develop in subclinical hypothyroidism as a result of a reduced rate of insulin-stimulated glucose transfer caused by a translocation of the glucose transporter type 2 (GLUT 2) gene. On the other hand, novel missense variations in (Thr92Ala) can cause insulin resistance. Furthermore insulin resistance and hyperinsulinemia resulting from diabetes can cause culminate in goitrous transformation of the thyroid gland. Thyroid-related diseases and T2DM are closely linked. Type 2 diabetes can be exacerbated by thyroid disorders, and diabetes can worsen thyroid dysfunction. Insulin resistance has been found to play a crucial role in both T2DM and thyroid dysfunction. Therefore, failure to recognize inadequate thyroid hormone levels in diabetes and insulin resistance in both conditions can lead to poor management of patients.