The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes

Randomized, double-blind, placebo-controlled trial conducted at a single center in Arak, Iran, in 60 pregnant women with gestational diabetes, aged 18–40, not on oral hypoglycemic agents.

100 mg magnesium + 4 mg zinc + 400 mg calcium + 200 IU vitamin D per dose, taken twice daily for 6 weeks.

Co-supplementation for 6 weeks reduced inflammation and oxidative stress biomarkers and improved metabolic parameters versus placebo. Key changes: FPG −4.3 vs −0.9 mg/dL (P=0.008); hs-CRP −1.2 vs +0.8 mg/L (P=0.01); MDA −0.3 vs +0.3 μmol/L (P=0.003); TAC +38.2 vs −16.3 mmol/L (P=0.01); magnesium +0.1 mg/dL; zinc +4.1 mg/dL; calcium +0.3 mg/dL; 25-OH vitamin D +6.1 ng/mL (P≤0.001 for all). Newborn weight 3089.8 g vs 3346.3 g (P=0.05); macrosomia 3.3% vs 16.7% (P=0.08). Authors conclude that magnesium-zinc-calcium-vitamin D co-supplementation for 6 weeks may reduce inflammation and oxidative stress in GDM and could improve birth outcomes; larger, longer trials are needed to confirm these findings.

Small sample size (n=60); single-center; short duration (6 weeks); not all pregnancy outcomes assessed; did not measure intracellular magnesium; reliance on serum magnesium; potential compliance measurement limitations; no long-term follow-up; macrosomia outcome not statistically significant.