Department of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands.
Department of Clinical Chemistry, Medical Center Alkmaar, Alkmaar, the Netherlands.
Diabetes Care. 2015 Aug;38(8):1420-6. doi: 10.2337/dc15-0323. Epub 2015 May 13.
Low vitamin D status has been associated with impaired glycemic control in patients with type 2 diabetes. The purpose of our study was to evaluate the effect of vitamin D supplementation on glycemic control in patients with type 2 diabetes.
This randomized, double-blind, placebo-controlled trial was conducted in 275 adult patients with type 2 diabetes without insulin treatment. Patients were randomly assigned to receive either vitamin D3 (50,000 IU/month) or placebo for 6 months. To assess the primary outcome of the study, change in HbA(1c), we performed a linear regression analysis.
Mean baseline serum 25-hydroxyvitamin D [25(OH)D] increased from 60.6 ± 23.3 to 101.4 ± 27.6 nmol/L and 59.1 ± 23.2 to 59.8 ± 23.2 nmol/L in the vitamin D and placebo group, respectively. Mean baseline HbA(1c) was 6.8 ± 0.5% (51 ± 6 mmol/mol) in both groups. After 6 months, no effect was seen on HbA(1c) (mean difference: β = 0.4 [95% CI -0.6 to 1.5]; P = 0.42) and other indicators of glycemic control (HOMA of insulin resistance, fasting insulin, and glucose) in the entire study population. Subgroup analysis in patients with a serum 25(OH)D <50 nmol/L or an HbA(1c) level >7% (53 mmol/mol) did not differ the results.
In a well-controlled group of patients with type 2 diabetes, intermittent high-dose vitamin D supplementation did not improve glycemic control.
维生素 D 状态低下与 2 型糖尿病患者的血糖控制受损有关。本研究旨在评估维生素 D 补充对 2 型糖尿病患者血糖控制的影响。
这是一项随机、双盲、安慰剂对照试验，在 275 名未接受胰岛素治疗的 2 型糖尿病成年患者中进行。患者被随机分配接受维生素 D3（50,000 IU/月）或安慰剂治疗 6 个月。为了评估研究的主要结局，即 HbA1c 的变化，我们进行了线性回归分析。
平均基线血清 25-羟维生素 D [25(OH)D] 分别从 60.6 ± 23.3 增加到 101.4 ± 27.6 nmol/L 和 59.1 ± 23.2 增加到 59.8 ± 23.2 nmol/L，维生素 D 组和安慰剂组分别增加。两组的平均基线 HbA1c 均为 6.8 ± 0.5%（51 ± 6 mmol/mol）。6 个月后，HbA1c 无变化（平均差异：β=0.4 [95%CI-0.6 至 1.5]；P=0.42），整个研究人群的其他血糖控制指标（胰岛素抵抗的 HOMA、空腹胰岛素和血糖）也无变化。血清 25(OH)D<50 nmol/L 或 HbA1c>7%（53 mmol/mol）的患者亚组分析并未改变结果。
在 2 型糖尿病患者中，间歇性给予高剂量维生素 D 补充并不能改善血糖控制。
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