Does high-dose vitamin D supplementation impact insulin resistance and risk of development of diabetes in patients with pre-diabetes? A double-blind randomized clinical trial

Niroomand, Mahtab; Fotouhi, Akbar; Irannejad, Navid; Hosseinpanah, Farhad

doi:10.1016/j.diabres.2018.12.008

Cited by 93 publications

(67 citation statements)

References 31 publications

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“…Eight trials that have reported data on the effect of vitamin D supplementation and incident diabetes included persons with prediabetes ( 12–19 ). Five of these trials have major limitations, including a small sample size (109–205 participants) ( 12–15 , 18 ), not being designed for incident diabetes as the primary outcome ( 12 , 14 , 15 , 18 ), a short duration (≤1 year) ( 12 , 14 , 15 , 18 ), and open-label study design ( 13 , 15 ). Therefore, results from these 5 trials ( 12–15 , 18 ) and the 2 large trials where incident diabetes was a post-hoc outcome ( 38 , 39 ) are not informative in our understanding of the role of vitamin D supplementation for diabetes prevention in the clinical setting.…”

Section: Review Strategy and Literature Searchmentioning

confidence: 99%

Vitamin D Supplementation for Prevention of Type 2 Diabetes Mellitus: To D or Not to D?

Pittas

Jorde

Kawahara³

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Over the last decade, vitamin D has emerged as a risk determinant for type 2 diabetes and vitamin D supplementation has been hypothesized as a potential intervention to lower diabetes risk. Recently, several trials have reported on the effect of vitamin D supplementation on diabetes prevention in people with prediabetes. Evidence Acquisition A comprehensive literature review was performed using PubMed, Embase, and ClinicalTrials.gov to identify: 1) recent meta-analyses of longitudinal observational studies that report on the association between blood 25(OH)D level and incident diabetes and 2) clinical trials of adults with prediabetes that have reported on the effect of vitamin D supplementation on incident diabetes. Evidence Synthesis Longitudinal observational studies report highly consistent associations between higher blood 25(OH)D levels and lower risk of incident diabetes in diverse populations, including populations with prediabetes. Trials in persons with prediabetes show risk reduction in new-onset diabetes with vitamin D supplementation. In the three large trials that were specifically designed and conducted for prevention of diabetes, vitamin D supplementation when compared with placebo, reduced risk of diabetes by 10 to 13% in persons with prediabetes not selected for vitamin D deficiency. Conclusions Results from recent trials are congruent with a large body of evidence from observational studies indicating that vitamin D has a role in modulating diabetes risk. Participant-level meta-analysis of the three largest trials should provide a more refined estimate of risk reduction and identify patient populations likely to benefit the most.

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Section: Review Strategy and Literature Searchmentioning

confidence: 99%

Vitamin D Supplementation for Prevention of Type 2 Diabetes Mellitus: To D or Not to D?

Pittas

Jorde

Kawahara³

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Nine of 17 studies which investigated various dietary supplements used vitamin D as the intervention [ 36 , 37 , 42 , 68 , 69 , 83 , 91 , 92 , 94 ]. Most showed an increase in serum 25-hydroxyvitamin D levels but failed to demonstrate improvements in FPG, insulin sensitivity, insulin resistance and lipid status.…”

Section: Resultsmentioning

confidence: 99%

“…Most showed an increase in serum 25-hydroxyvitamin D levels but failed to demonstrate improvements in FPG, insulin sensitivity, insulin resistance and lipid status. Results for rates of progression to T2DM [ 36 , 91 ] and β-cell function [ 42 , 69 , 92 ] in the vitamin D group were particularly confounding, as contradicting outcomes were reported.…”

Section: Resultsmentioning

confidence: 99%

Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

Yau¹,

Thor²,

Ramadas³

2020

Nutrients

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Nutritional therapy has been conventionally recommended for people with prediabetes as a method to delay or halt progression to type 2 diabetes. However, recommended nutritional strategies evolve over time. Hence, we performed a scoping review on recently reported nutritional interventions for individuals with prediabetes. Ovid MEDLINE, PubMed, Embase, Scopus, CINAHL and PsycINFO databases were searched to identify relevant research articles published within the past 10 years. Ninety-five articles involving a total of 11,211 participants were included in this review. Nutritional strategies were broadly classified into four groups: low calorie diet, low glycemic index diet, specific foods, and a combination of diet and exercise. The most frequently assessed outcomes were plasma glucose, serum insulin, serum lipid profile, body mass index and body weight. More than 50% of reported interventions resulted in significant improvements in these parameters. Nutritional interventions have demonstrated feasibility and practicality as an effective option for prediabetes management. However, the intervention variability demonstrates the challenges of a ‘one-size-fits-all’ approach. Investigations in genetically diverse populations and objective assessment of progression rate to diabetes are necessary to better comprehend the impact of these nutritional strategies in prediabetes.

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“…Interventional trials also have conflicting results. Two recent prospective studies showed improvement in glucose metabolism after vitamin D supplementation was applied [67,68]. Unfortunately, the studies did not evaluate patients with renal disease.…”

Section: Vd and Diabetes Mellitusmentioning

confidence: 99%

Vitamin D Deficiency in Renal Disease

Filipov¹,

Dimitrov²

2020

Vitamin D Deficiency

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Vitamin D deficiency is highly prevalent in patients with renal disease. The abnormal vitamin D (VD) metabolism in chronic kidney disease (CKD) is a key factor for developing CKD-related mineral bone disease (CKD-MBD), which directly influences the survival of the CKD patients. The importance of VD is perhaps of greater value due to its pleiotropic effects that span beyond calcium-phosphorus metabolism (cancer protection, diabetes prevention, and renal protection). The aim of our chapter is to depict the clinical implications of VD deficiency in the setting of CKD, including VD pleiotropy in renal disease, and to propose the most adequate treatment suggested in the literature. Keywords: vitamin D deficiency, chronic kidney disease, mineral bone disease, vitamin D pleiotropy, vitamin D supplementationVitamin D Deficiency 2 the ratio between free and total 25VD remained unchained; therefore, total 25VD is the indicator of VD status in CKD [3].Generally, 25VD level has reverse association with parathyroid hormone (PTH) levels. In addition, higher 25VD is associated with higher calcium intestinal reabsorption. However, at 25VD ≥ 75 nmol/l, no reduction in PTH levels and no increase in calcium intestinal reabsorption occurs [4, 5]. Therefore, 25VD ≥ 75 nmol/l is regarded as a cut-off value for vitamin D sufficiency.No generally accepted definition for VD deficiency exists, as authors choose cut-off value either serum 25VD of 25 nmol/L [6] or serum 25VD of 50 nmol/L [7]. However, target levels of 75 nmol/L are recommended, taking into consideration the clinical importance of mild VD insufficiency (25VD between 50 and 74.9 nmol/L) [7,8].Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for more than 3 months, with implications for health [one of the following: estimated glomerular filtration rate (eGFR) less than 60 ml/ min/1.73 m 2 ,presence of proteinuria, structural abnormalities of the kidney detected on imaging, pathological findings detected on kidney biopsy, urine sediment pathology, electrolyte abnormalities due to tubular disorders, history of kidney transplantation] [9]. CKD patients are at increased risk for VD deficiency; therefore, they require VD screening [7]. Vitamin D metabolism in health and renal disease VD metabolism in healthy subjectsVD is synthesized predominantly endogenously (approx. to 90% of the total VD in human body). In the skin, the ultraviolet light transforms 7-dehydroxycholesterol (provitamin D) to pre-vitamin D, which under the influence of body temperature spontaneously isomerizes to cholecalciferol (vitamin D3). Approximately, 10% of total body VD is taken orally (vitamin D2, ergocalciferol, and cholecalciferol). VD is transported via VD-binding protein to the liver, where it is hydroxylated to 25VD. The next step in VD activation is hydroxylation of 25VD by the enzyme 1α-hydroxylase (CYP27B1) to 1,25VD, which is the active VD metabolite. The process occurs predominantly in the renal tubules. In addition, non-renal CYP27B1 was detected...

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Does high-dose vitamin D supplementation impact insulin resistance and risk of development of diabetes in patients with pre-diabetes? A double-blind randomized clinical trial

Cited by 93 publications

References 31 publications

Vitamin D Supplementation for Prevention of Type 2 Diabetes Mellitus: To D or Not to D?

Vitamin D Supplementation for Prevention of Type 2 Diabetes Mellitus: To D or Not to D?

Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

Vitamin D Deficiency in Renal Disease

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