Oleh admin kalbemed pada September 13, 2018 06:00

Suplementasi Vitamin D Menurunkan Risiko Diabetes Melitus Masa Kehamilan

Vitamin D merupakan salah satu vitamin larut lemak, yang mempunyai banyak fungsi selain peranannya dalam kesehatan tulang. Kebutuhan vitamin D lebih tinggi pada beberapa tahap kehidupan, meliputi pertumbuhan janin yang cepat dalam fase embrio, bayi, tahap awal masa kanak-kanak, pubertas, dan kehamilan.

Studi menunjukkan bahwa defisiensi vitamin D sering ditemukan pada kehamilan, yang menyebabkan peningkatan frekuensi preeklamsia, persalinan sesar, vaginosis bakterialis neonatus, dan diabetes melitus gestasional (GDM). Sebagai tambahan, hubungan terbalik antara kadar vitamin D dalam serum dengan risiko diabetes tipe II telah terbukti. Vitamin D mempunyai efek langsung pada sel beta pankreas dan metabolisme glukosa, sehingga kadarnya mempunyai kaitan terbalik dengan kadar glycosylated hemoglobin (HbA1C).

Defisiensi vitamin D diketahui berkaitan dengan perubahan kadar glukosa darah dan insulin serta sensitivitas jaringan target terhadap insulin. GDM ditandai dengan intoleransi glukosa pada kehamilan dan patofisiologinya sama dengan diabetes melitus tipe 2, yaitu toleransi insulin dan insufisiensi insulin. Pada sisi lain, GDM dikaitkan dengan komplikasi pada ibu hamil (kelahiran prematur, komplikasi infeksi, hidramnion, komplikasi hipertensi) dan pada janin  (kematian janin, gangguan pertumbuhan janin, gangguan metabolik, sindrom gawat napas, obesitas pada masa kanak-kanak, dan diabetes).

Bukti menunjukkan bahwa vitamin D menyebabkan peningkatan sensitivitas terhadap insulin dan toleransi glukosa, serta banyak peneliti menunjukkan kaitan antara defisiensi vitamin D dengan GM. Selain itu, studi telah menunjukkan bahwa defisiensi vitamin D menyebabkan insufisiensi sekresi insulin dan hormon pankreas lain serta intoleransi glukosa. Suplementasi vitamin D juga telah menunjukkan dapat memperbaiki toleransi glukosa dan sekresi insulin, dan vitamin D menyebabkan kontrol glukosa darah pada GDM.

Suplementasi vitamin D pada trimester pertama dan kedua kehamilan bermanfaat dalam menurunkan risiko diabetes melitus gestasional dan mengontrol GCT (glucose challenge test ) dan GTT (glucose tolerance test). [EKM]



Image: Ilustrasi
Referensi:
1. Shahgheibi S, Farhadifar F, Pouya B. The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial. J Res Med Sci. 2016;21:2. eCollection 2016.
2. Yap C, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M. Vitamin D supplementation and the effects on glucose metabolism during pregnancy: A randomized controlled trial. Diabetes Care. 2014.

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