University Hospital João de Barros Barreto, Federal University of Pará, Endocrinology Division, Mundurucus Street, 4487, Guamá, Belém, Pará,Brazil.
State University of Pará, Platter Perebebuí, 2623, Marco, Belém, Pará,Brazil.
Curr Diabetes Rev. 2022;18(1):e010521189964. doi: 10.2174/1573399817666210106102643.
Some authors evaluated the effect of VD on hyperglycemia in T1DM, but the results remain controversial. This study aims to analyze the effects of high-dose VD supplementation on T1DM patients' glycemic levels, maintaining stable doses of insulin.
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.
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).
Our data suggest that VD is not widely recommended for glycemic control. Nevertheless, specific patients might benefit from this approach.
一些作者评估了 VD 对 1 型糖尿病患者高血糖的影响，但结果仍存在争议。本研究旨在分析高剂量 VD 补充对 1 型糖尿病患者血糖水平的影响，同时维持胰岛素稳定剂量。
前瞻性、为期 12 周的临床试验纳入 67 例 1 型糖尿病患者，根据参与者的 VD 值补充大剂量胆钙化醇。VD 水平低于 30ng/ml 的患者每天接受 10000IU；VD 水平在 30-60ng/ml 的患者每天接受 4000IU。未达到 25(OH)D 水平 > 30ng/ml 或研究期间胰岛素剂量发生变化的患者未进行分析。
仅有 67 例患者中的 46 例在研究结束时达到了标准。VD 补充后，HbA1c 评估的血糖控制总体无改善（9.4 ± 2.4 与 9.4 ± 2.6，p=NS）。然而，根据 HbA1c 变化的事后分析，确定了 HbA1c 至少降低 0.6%的患者（组 1，N=13（28%））。此外，研究结束时观察到 25(OH)D 水平与 HbA1c 和总胰岛素剂量之间存在相关性（r=-0.3，p<0.05；r=-0.4，p<0.05），回归模型表明 25(OH)D 与 BMI、1 型糖尿病持续时间和最终总胰岛素剂量无关，能够确定 HbA1c 最终水平的 9.2%（未标准化 B 系数=-0.033（CI 95%：-0.064 至-0.002），r2=0.1，p<0.05）。
我们的数据表明，VD 不广泛推荐用于血糖控制。然而，特定患者可能会从这种方法中受益。
