Aljabri Khalid S, Bokhari Somoa A, Khan Murtadha J
Division of Endocrinology, Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Ann Saudi Med. 2010 Nov-Dec;30(6):454-8. doi: 10.4103/0256-4947.72265.
A prospective, nonblinded and nonrandomized controlled trial was conducted to test the hypothesis that vitamin D supplementation would improve glycemic control in patients with type 1 diabetes mellitus who have vitamin D deficiency.
Eighty patients with type 1 diabetes mellitus who had 25-hydroxyvitamin D levels less than 50 nmol/L were assigned to receive 4000 IU of vitamin D3. Calcium supplements were provided to ensure a total calcium intake of 1200 mg/d. Glycosylated hemoglobin and 25-hydroxyvitamin D levels were measured at baseline and at 12 weeks.
There was a significant difference in mean (SD) glycosylated hemoglobin level (%) between the groups that achieved 25-hydroxyvitamin D levels of <35.4 nmol/L, 35.4-51 nmol/L and >51 nmol/L at 12 weeks (P=.02). There was a significant difference in glycosylated hemoglobin change from baseline between the groups that achieved 25-hydroxyvitamin D levels of <35.4 nmol/L, 35.4-51 nmol/L and >51 nmol/L at 12 weeks (P=.04). There was a significant difference in 25-hydroxyvitamin D level between the groups that achieved glycosylated hemoglobin levels of <7.8, 7.8-9.9 and >9.9 at 12 weeks (P=.001). Patients were more likely to achieve lower glycosylated hemoglobin levels at 12 weeks if they had higher 25-hydroxyvitamin D levels at 12 weeks (r=-0.4, P=.001).
There was an observed effect of vitamin D supplementation on glycemic control in vitamin D-replete, type 1 diabetes mellitus patients. Further studies are needed to determine if these findings are applicable.
开展了一项前瞻性、非盲法且非随机对照试验,以检验补充维生素D可改善维生素D缺乏的1型糖尿病患者血糖控制这一假设。
80例25-羟维生素D水平低于50 nmol/L的1型糖尿病患者被分配接受4000 IU维生素D3。提供钙补充剂以确保每日总钙摄入量为1200 mg。在基线和12周时测量糖化血红蛋白和25-羟维生素D水平。
在12周时25-羟维生素D水平<35.4 nmol/L、35.4 - 51 nmol/L和>51 nmol/L的组间,平均(标准差)糖化血红蛋白水平(%)存在显著差异(P = 0.02)。在12周时25-羟维生素D水平<35.4 nmol/L、35.4 - 51 nmol/L和>51 nmol/L的组间,糖化血红蛋白自基线的变化存在显著差异(P = 0.04)。在12周时糖化血红蛋白水平<7.8、7.8 - 9.9和>9.9的组间,25-羟维生素D水平存在显著差异(P = 0.001)。如果患者在12周时25-羟维生素D水平较高,则更有可能在12周时达到较低的糖化血红蛋白水平(r = -0.4,P = 0.001)。
在维生素D充足的1型糖尿病患者中,观察到补充维生素D对血糖控制有影响。需要进一步研究以确定这些发现是否适用。