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High doses of ergocalciferol ( vitamin D analogs) may extend the remission period of type 1 diabetes By maintaining the functionality of (T1D), insulin-Beta cells are generated in newly diagnosed patients.
- Beta cells retain approximately 30% to 50% function at the time of T1D diagnosis and may continue to produce insulin for months or years. Preserving beta cell function early can extend this remission period and improve long-term glycemic control.
- Researchers conducted a second randomized clinical trial examining residual beta function and vitamin D supplementation in 36 young people (aged 10 to 21 years, mean age 13.5 years, 33.3% female) recently diagnosed with T1D. We conducted the following post-hoc analysis.
- Participants were randomly assigned to receive vitamin D (50,000 international units) or a placebo weekly for 2 months and then every other week for 10 months.
- Mixed food tolerance tests were performed after overnight fasting at months 0, 3, 6, 9, and 12, with blood samples taken 30 and 90 minutes after meals. C-peptide and estimation of blood sugar levels.
- To test the effect of vitamin D on β-cell function, we calculated the fasting proinsulin to C-peptide ratio (PI:C) and percent change in area under the C-peptide curve from baseline (%ΔAUC).
- Vitamin D supplementation improved the insulin secretory capacity of beta cells, as observed by a decrease in the mean fasting PI:C ratio compared to placebo (-0.0009 vs 0.0011; P = 0.01).
- The decrease in %ΔAUC of C-peptide was significantly slower with vitamin D than with placebo (-2.8% vs -4.7%; P = 0.03), indicating a longer delay in loss of C-peptide.
“It is interesting to learn that vitamin D may protect the beta cells of the pancreas and increase the natural production of good, functional insulin in these patients. This may help reduce the honeymoon of type 1 diabetes. “This leads to a reduction in long-term diabetes, which is a regular complication of the disease,” lead author Dr. Nwosu said in a press release.
The study was led by Benjamin Udoka Nwosu, M.D., of Northwell Health, Department of Pediatric Endocrinology, Cohen Children’s Medical Center, New Hyde Park, New York. Published online in JAMA network open.
It was a single-center study.
This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. The authors report no conflicts of interest.