Treating vitamin D deficiency in children with type I diabetes could improve their glycaemic control

Abstract

Background and aimsThe relationship between vitamin D deficiency and type I DM is an ongoing area of interest. The study aims to identify the prevalence of vitamin D deficiency in children and adolescents with T1DM and to assess the impact of treatment of vitamin D deficiency on their glycaemic control.MethodsRetrospective data was collected from 271 children and adolescents with T1DM. The vitamin D deficient (25(OH)D <30 nmol/L) and insufficient (25(OH)D 30–50 nmol/L) patients were treated with 6000 units of cholecalciferol and 400 units of cholecalciferol, once daily for 3 months respectively. HbA1c and 25(OH)D concentrations were measured before and at the end of the vitamin D treatment.Results14.8% from the whole cohort (n = 271) were vitamin D deficient and 31% were insufficient. Among the children included in the final analysis (n = 73), the mean age and plasma 25(OH)D concentration (±SD) were 7.7 years (±4.4) and 32.2 nmol/l (±8.2) respectively. The mean 25(OH)D concentration post-treatment was 65.3 nmol/l (±9.3). The mean HbA1c (±SD) before and after cholecalciferol was 73.5 mmol/mol (±14.9) and 65 mmol/mol (±11.2) respectively (p < 0.001). Children with higher pre-treatment HbA1c had greater reduction in HbA1c (p < 0.001) and those with lower 25(OH)D concentration showed higher reduction in HbA1c (p = 0.004) after treatment.ConclusionsLow 25(OH)D concentrations are fairly prevalent in children and adolescents with T1DM, treatment of which, can potentially improve the glycaemic control.

Acute Responses to Low and High Intensity Exercise in Type 1 Diabetic Adolescents in Relation to Their Level of Serum 25(OH)D

“…Other researchers confirm this assumption and underline in their works the possibility of insulin resistance development in case of severe vitamin D deficiency [11,12,24]. Hitherto, only a sparse number of studies point out the higher risk of diabetic ketoacidosis [13] and the tendency to develop hypoglycaemia [14,24] in the group of T1DM patients with vitamin D deficiency. However, studies regarding the reaction of the organism to glucose concentrations and to glycaemic variability in this group of patients, which take into account the level of vitamin D and the type of performed training (high or low intensity), were not found in the available literature.…”

“…In recent years, few studies focusing on the relationship of vitamin D level in T1DM children with the metabolic control of the disease, insulin sensitivity and development of acute vascular complications including hyperglycaemia and hypoglycaemia, have been published. It has been revealed that adequate vitamin D concentration has a beneficial effect on the reduction of the number of diabetic ketoacidosis [13,24] and hypoglycaemic [12,14] events requiring hospitalization. However, there are no studies regarding vitamin D level in paediatric population with diabetes, that take into account the physical activity and the type of training performed by patients.…”

Sustained serum 25-hydroxyvitamin D concentrations for one year with cholecalciferol supplementation improves glycaemic control and slows the decline of residual β cell function in children with type 1 diabetes

“…Several studies have shown that cholecalciferol supplementation is associated with an improved glycaemic control in T1D [16][17][18][19]. Conversely, VDD is associated with poor control [22].…”

“…Conversely, VDD is associated with poor control [22]. Improvement in vitamin D status improves endogenous insulin secretion and insulin sensitivity of target tissues, thereby contributing to an improved insulin action [17][18][19]. Studies that showed no improvement in glycaemic control were either small [8,9,14] or the vitamin D doses used were unable to achieve the optimal vitamin D concentrations [14,15].…”

“…Studies evaluating the impact of vitamin D supplementation on glycaemic control have also shown variable results. There are almost an equal number of studies showing no improvement [8,9,14,15] as showing improvement [16][17][18][19] in glycaemic control. Nevertheless, the drawbacks of the previous studies related to the dosage, type and duration of vitamin D supplementation, C-peptide concentration at entry into the study, and effect of glycaemic control on RBCF during supplementation could be realised [7].…”