High-dose Vitamin D Supplementation on Type 1 Diabetes Mellitus Patients: Is there an Improvement in Glycemic Control?
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de Melo Franciane Trindade Cunha, Felício Karem Mileo, de Queiroz Natércia Neves Marques, de Rider Brito Hana Andrade, Neto João Felício Abrahão, Janaú Luísa Corrêa, de Souza Neto Norberto Jorge Kzan, Silva Ana Luíza Aires, de Lemos Manuela Nascimento, de Oliveira Maria Clara Neres Iunes, de Alcântara Angélica Leite, de Moraes Lorena Vilhena, de Souza Ícaro José Araújo, Said Nivin Mazen, da Silva Wanderson Maia, de Lemos Gabriela Nascimento, Dos Santos Márcia Costa, De Souza D Albuquerque Silva Lilian, Motta Ana Regina Bastos, de Figueiredo Priscila Boaventura Barbosa, de Souza Ana Carolina Contente Braga, Piani Pedro Paulo Freire, Felício João Soares
Аннотация
METHODS: Prospective, 12-week clinical trial including 67 T1DM patients, supplemented with high doses of cholecalciferol according to participants' VD value. Patients with VD levels below 30 ng/mL received 10,000 IU/day; those with levels between 30-60 ng/mL received 4,000 IU/day. Patients who had not achieved 25(OH)D levels > 30 ng/ml or presented insulin dose variation during the study were not analyzed.
RESULTS: Only 46 out of 67 patients accomplished the criteria at the end of the study. There was no general improvement in the glycemic control evaluated by HbA1c (9.4 ± 2.4 vs 9.4 ± 2.6, p=NS) after VD supplementation. However, a post-hoc analysis, based on HbA1c variation, identified patients who had HbA1c reduced at least 0.6% (group 1, N = 13 (28%)). In addition, a correlation between 25(OH)D levels with HbA1c and total insulin dose at the end of the study was observed (r = -0.3, p<0.05; r=-0.4, p<0.05, respectively), and a regression model demonstrated that 25(OH)D was independent of BMI, duration of T1DM and final total insulin dose, being capable of determining 9.2% of HbA1c final levels (Unstandardized B coefficient = -0.033 (CI 95%: -0.064 to -0.002), r2 = 0.1, p <0.05).
CONCLUSION: Our data suggest that VD is not widely recommended for glycemic control. Nevertheless, specific patients might benefit from this approach.