Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: Randomized, double-blind, placebo-controlled trial

Objective: To our knowledge, no reports are available indicating the effects of selenium supplementation on metabolic parameters, inflammatory factors, and oxidative stress in gestational diabetes mellitus (GDM). The aim of this study was to assess the effects of selenium supplementation on metabolic status in pregnant women with GDM who were not on oral hypoglycemic agents. Methods: This randomized, double-blind, placebo-controlled clinical trial was performed with 70 women with GDM. Patients were randomly assigned to receive either 200 jig selenium supplements as tablet (n = 35) or placebo (n = 35) for 6 wk from weeks 24 to 28 of gestation. Fasting plasma samples were taken at study baseline and after 6 wk of intervention to quantify related variables. Results: Selenium supplementation, compared with placebo, resulted in a significant reduction in fasting plasma glucose (-10.5 +/- 11.9 versus +4.5 +/- 12.9 mg/dL; P < 0.001), serum insulin levels (-1.98 +/- 11.25 versus +5.26 +/- 9.33 mu lU/mL; P = 0.005), homeostasis model of assessment (HOMA)-insulin resistance (-0.84 +/- 2.76 versus +1.47 +/- 2.46; P < 0.001) and a significant increase in quantitative insulin sensitivity check index (+0.008 +/- 0.03 versus 0.01 +/- 0.01; P = 0.009). Additionally, a significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) levels (-791.8 +/- 2271.8 versus +500.5 +/- 2563.3 ng/mL; P = 0.02) was seen after the administration of selenium supplements compared with placebo. Additionally, we observed a significant elevation in plasma glutathione (+52.14 +/- 58.31 versus -39.93 +/- 153.52 mu mol/L; P = 0.002) and a significant reduction in plasma malondialdehyde levels (-0.01 +/- 0.36 versus +0.67 +/- 1.90 mu mol/L; P = 0.04) after consumption of selenium supplements compared with placebo. We did not find any significant effect of taking selenium supplements on HOMA beta-cell function, lipid profiles, plasma nitric oxide, or total antioxidant capacity concentrations. Conclusion: Selenium supplementation in pregnant women with GDM demonstrated beneficial effects on glucose metabolism, hs-CRP levels, and biomarkers of oxidative stress. (C) 2015 Elsevier Inc. All rights reserved.