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Recently, a study published in the journal Journal of the Endocrine Society found that vitamin D2 supplementation can significantly improve insulin sensitivity and slow the rise of HbA1c in children/adolescents with new-onset type 1 diabetes.
It was a randomized, double-blind, parallel, placebo-controlled study that enrolled participants aged 10 to 21 years with a < 3 months of type 1 diabetes (36 in total, with an average age < 15 years). The efficacy of ergocalciferol and placebo in children and adolescents with new-onset type 1 diabetes mellitus was evaluated. Subjects were randomly assigned to a group, and subjects in the ergocalciferol group received 50,000 IU of ergocalciferol per week for the initial 2 months, and then adjusted to use every other week for a period of 10 months.
During the study, HbA1c was elevated in both groups of patients, but there was a significant difference in the rate of elevation:
➤HbA1c in the ergocalciferol group increased by 0.14% every 3 months, significantly lower than the 0.46% in the placebo group (P=0.04);
➤The dose-adjusted HbA1c in the ergocalciferol group increased by 0.3% every 3 months, which was also significantly lower than the 0.77% in the placebo group (P=0.02);
➤At 12 months, serum tumor necrosis factor α in the ergocalciferol group was lower than in the placebo group (1.12 pg/mL vs.1.32 pg/mL; P=0.03).
Figure 1 Changes in serum tumor necrosis factor α levels in the two groups
Figure 2 Changes in 25-hydroxyvitamin D concentrations in two groups
In addition, serum 25-hydroxyvitamin D concentrations were higher in the ergocalciferol group at 6 months (P=0.01) and 9 months (P=0.02) than in the placebo group. There were no significant differences in blood pressure, BMI z-score, waist circumference, fasting C-peptide, and stimulating C-peptide between the two groups.
Study participant Benjamin Udoka Nwosu, a professor of pediatrics at the University of Massachusetts School of Medicine, wrote: "This 12-month randomized controlled trial found that the increase in HbA1c and insulin dose-adjusted HbA1c values in the placebo group was statistically significantly accelerated, indicating that the residual β cell function loss in this group was faster, suggesting that the experimental group played a residual β cell function protection effect by supplementing with high doses of ergocalciferol." ”
In summary, this study found that in newly diagnosed children and adolescents with type 1 diabetes mellitus, high doses of ergocalciferol significantly reduced serum tumor necrosis factor-α concentrations, improved insulin sensitivity, slowed the increase in HbA1c, slowed the increase in insulin demand, and showed a protective effect on residual β cell function. Larger studies are needed in the future to quantify the effects of vitamin D on insulin sensitivity in young people with type 1 diabetes.
Resources:
[1] Michael Monostra. Vitamin D2 supplement may slow progression of new-onset type 1 diabetes in children[EB/OL]. [2022-2-21].https://www.healio.com/news/endocrinology/20220221/vitamin-d2-supplement-may-slow-progression-of-newonset-type-1-diabetes-in-children.
[2] Benjamin Udoka Nwosu, Sadichchha Parajuli, Gabrielle Jasmin, Jody Fleshman, Rohit B Sharma, Laura C Alonso, Austin F Lee, Bruce A Barton, Ergocalciferol in New-onset Type 1 Diabetes: A Randomized Controlled Trial, Journal of the Endocrine Society, Volume 6, Issue 1, January 2022, bvab179, https://doi.org/10.1210/jendso/bvab179