Disclosures: The authors report no relevant financial disclosures.
February 21, 2022
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Vitamin D2 supplement may slow progression of new-onset type 1 diabetes in children

Disclosures: The authors report no relevant financial disclosures.
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A supplement of Vitamin D2 may improve insulin sensitivity and slow the increase of HbA1c for children and adolescents with new-onset type 1 diabetes, according to study findings published in the Journal of the Endocrine Society.

In findings from a randomized controlled trial, youths with type 1 diabetes randomly assigned 50,000 IU of adjunctive ergocalciferol weekly for 2 months and then biweekly for 10 months had lower serum tumor necrosis factor-alpha levels at 12 months and slower increases in both HbA1c and insulin dose-adjusted HbA1c compared with placebo.

HbA1c in newly-diagnosed type 1 diabetes with Vitamin D supplement
Children and adolescents newly diagnosed with type 1 diabetes had a slower increase in HbA1c with vitamin D2 supplementation compared with placebo. Data were derived from Nwosu BU, et al. J Endocr Soc. 2021;doi:10.1210/jendso/bvab179.

“This 12-month randomized controlled trial found no statistically significant differences between the groups for the duration of partial clinical remission, magnitude of residual beta-cell function, insulin dose-adjusted HbA1c and glycemia,” Benjamin Udoka Nwosu, MD, professor of pediatrics at the University of Massachusetts Medical School, and colleagues wrote. “However, a statistically significantly faster rate of increase of HbA1c and insulin dose-adjusted HbA1c values in the placebo group suggested a faster rate of loss of residual beta-cell function in that group, which indicates protection of residual beta-cell function by high-dose ergocalciferol supplementation in the experimental group.”

Researchers conducted a randomized, double-blind, placebo-controlled trial comparing the effects of ergocalciferol vs. placebo in children and adolescents with new-onset type 1 diabetes. Individuals aged 10 to 21 years with type 1 diabetes duration of less than 3 months were recruited to participate. Following a run-in phase where a treat-to-target insulin regimen was implemented for 1 to 2 months, 36 participants were randomly assigned to a treatment group receiving 50,000 IU of ergocalciferol once per week for 2 months followed by every other week for 10 months, or placebo. Follow-up visits were conducted at 3, 6, 9 and 12 months. Visits took place between 8 and 10:30 a.m. following an overnight fast. Researchers collected anthropometrics, HbA1c, proinflammatory and anti-inflammatory cytokine levels, and glucose data.

The ergocalciferol group had higher concentrations of serum 25-hydroxyvitamin D at 6 months (P = .01) and 9 months (P = .02) compared with placebo. No differences were observed between the two groups in blood pressure, BMI z score, waist circumference, fasting C-peptide and stimulated C-peptide.

Both groups had an increase in HbA1c during the study in trend analysis. The ergocalciferol group had an increase in HbA1c of 0.14% every 3 months, lower than the placebo’s mean increase of 0.46% (P = .04). Insulin dose-adjusted HbA1c was higher in the treatment group at 3 months compared with placebo (P = .05). The ergocalciferol group had an increase in insulin dose-adjusted HbA1c of 0.3% every 3 months compared with a 0.77% increase in placebo (P = .02). At 12 months, serum tumor necrosis factor-alpha was lower in the ergocalciferol group compared with placebo (1.12 pg/mL vs. 1.32 pg/mL; P = .03).

“Adjunctive ergocalciferol supplementation statistically significantly reduced serum tumor necrosis factor-alpha concentration and significantly blunted the rates of increase both in HbA1c and insulin dose-adjusted HbA1c, suggesting a protection of residual beta-cell function and partial remission in youth with newly diagnosed type 1 diabetes,” the researchers wrote. “This suggests that ergocalciferol slowed the rise in insulin requirements by improving insulin sensitivity in youth with newly diagnosed type 1 diabetes. Larger studies are needed to quantify the effect of vitamin D on insulin sensitivity in youth with type 1 diabetes.”