Dwivedi Awanindra, Gupta Balram, Tiwari Shalbha, Pratyush Daliparthy D, Singh Saurabh, Singh Surya Kumar
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India.
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, UP, India; Chellaram Diabetes Institute, Pune, India.
Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S373-S375. doi: 10.1016/j.dsx.2017.03.019. Epub 2017 Mar 6.
BACKGROUND/OBJECTIVES: Oral vitamin D supplementation is better than parenteral in improving vitamin D deficiency in individuals with no systemic illness. Our aim was to compare the efficacy of oral and parenteral routes of vitamin D supplementation on circulating serum 25(OH) vitamin D level in patients with type 2 diabetes mellitus.
Total 85 cases of with type 2 diabetes mellitus were screened for vitamin D status of which 71 patients were vitamin D insufficient/deficient. They were randomized into two intent to treat groups with different vitamin D supplementation protocols (a) Oral-60000 IU per day for 5days (group I; n=40) and (b) injectable-300000 IU intramuscularly once (group II; n=31). Baseline and one month post supplementation 25(OH) vitamin D levels were measured in both the groups.
Baseline clinical characteristics and 25(OH) vitamin D levels were comparable in both the groups. Post treatment 25(OH) vitamin D level in group I was 26.06±9.06ng/ml and in group II was 49.69±18.92ng/ml. After one month of vitamin D supplementation, increment in 25(OH) vitamin D level from baseline was significantly higher in group II than group I (p<0.001).
INTERPRETATION & CONCLUSIONS: Injectable method of supplementation was better than oral route in improving serum 25 (OH) vitamin D status in patients with type 2 diabetes. The study suggested impaired absorption of vitamin D from the gastrointestinal tract in patients with type 2 diabetes mellitus and a need for parenteral route of vitamin D supplementation in deficient patients with type 2 diabetes mellitus.
背景/目的：对于无全身性疾病的个体，口服补充维生素D在改善维生素D缺乏方面优于肠道外补充。我们的目的是比较口服和肠道外补充维生素D对2型糖尿病患者循环血清25(OH)维生素D水平的疗效。
共筛查了85例2型糖尿病患者的维生素D状态，其中71例患者维生素D不足/缺乏。他们被随机分为两个按意向性治疗的组，采用不同的维生素D补充方案：(a)口服组——每天60000 IU，共5天（第一组；n = 40）；(b)注射组——肌肉注射300000 IU一次（第二组；n = 31）。两组均测量了基线和补充后1个月时的25(OH)维生素D水平。
两组的基线临床特征和25(OH)维生素D水平具有可比性。第一组治疗后25(OH)维生素D水平为26.06±9.06 ng/ml，第二组为49.69±18.92 ng/ml。补充维生素D 1个月后，第二组25(OH)维生素D水平相对于基线的升高显著高于第一组（p<0.001）。
在改善2型糖尿病患者血清25(OH)维生素D状态方面，注射补充法优于口服途径。该研究提示2型糖尿病患者胃肠道对维生素D的吸收受损，2型糖尿病维生素D缺乏患者需要采用肠道外补充维生素D的途径。
