Felício Karem Mileo, de Souza Ana Carolina Contente Braga, Neto Joao Felicio Abrahao, de Melo Franciane Trindade Cunha, Carvalho Carolina Tavares, Arbage Thais Pontes, de Rider Brito Hana Andrade, Peixoto Amanda Soares, de Oliveira Alana Ferreira, de Souza Resende Fabricio, Reis Scarlatt Sousa, Motta Ana Regina, da Costa Miranda Henrique, Janau Luisa Correa, Yamada Elizabeth Sumi, Felicio Joao Soares
University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil.
Curr Diabetes Rev. 2018;14(4):395-403. doi: 10.2174/1573399813666170616075013.
Recent studies suggest that glycemic variability could influence the risk of complications in Type 1 Diabetes Mellitus (T1DM). There are no data about the action of Vitamin D (VD) on glycemic variability. Our pilot study aims to evaluate glycemic variability and insulin needs in patients with T1DM supplemented with VD.
22 Patients received doses of 4000 and 10000 IU/day of cholecalciferol for 12 weeks, according to the patient's baseline VD levels and underwent continuous glucose monitoring system.
Correlations were found between percentage variation (Δ) of glycemia standard deviation (ΔSDG), calculated using continuous glucose monitoring, with Δ of basal (r = 0.6; p <0.01) and total insulin dose (r = 0.6; p <0.01). Correlations between VD status after supplementation and Δ of prandial (r = 0.5; p <0.05) and total insulin dose (r = 0.4; p <0.05) were found, suggesting that the dose of insulin needed by patients is lower when VD status is better. We divided patients in two subgroups: SDG improved (subgroup 1; N = 12 (55%)) and SDG worsened (subgroup 2; N = 10 (45%)). Group 1, compared to subgroup 2, required a lower insulin dose (Δbasal insulin dose = -8.0 vs. 6.3%; p <0.05) and had a lower frequency of hypoglycemia (27% vs. 64%, hypoglycemias/days evaluated; p <0.01).
Our study suggests a relation between VD supplementation, improved glycemic variability, lower insulin needs and lower frequency of hypoglycemia in patients with T1DM.
近期研究表明，血糖变异性可能会影响1型糖尿病（T1DM）患者并发症的风险。目前尚无关于维生素D（VD）对血糖变异性作用的数据。我们的初步研究旨在评估补充VD的T1DM患者的血糖变异性和胰岛素需求。
根据患者的基线VD水平，22例患者接受了每日4000和10000 IU的胆钙化醇剂量，为期12周，并接受了持续葡萄糖监测系统。
使用持续葡萄糖监测计算的血糖标准差百分比变化（Δ）与基础胰岛素剂量变化（r = 0.6；p <0.01）和总胰岛素剂量变化（r = 0.6；p <0.01）之间存在相关性。补充后VD状态与餐时胰岛素剂量变化（r = 0.5；p <0.05）和总胰岛素剂量变化（r = 0.4；p <0.05）之间存在相关性，这表明当VD状态较好时，患者所需的胰岛素剂量较低。我们将患者分为两个亚组：血糖标准差改善组（亚组1；N = 12（55%））和血糖标准差恶化组（亚组2；N = 10（45%））。与亚组2相比，亚组1所需的胰岛素剂量较低（基础胰岛素剂量变化=-8.0%对6.3%；p <0.05），低血糖发生率较低（低血糖事件/评估天数为27%对64%；p <0.01）。
我们的研究表明，补充VD与T1DM患者血糖变异性改善、胰岛素需求降低和低血糖发生率降低之间存在关联。
