Effect of vitamin D supplement therapy on HbA1C and IGF-1 levels in children with type 1 diabetes mellitus and vitamin D deficiency
More details
Hide details
Department of Pediatric Endocrinology, Child growth and Development Research Center, Research Institute for primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
School of Medicine, Islamic Azad University of Najafabad, Isfahan, Iran
Department of Pediatric Islamic Azad University of Najafabad, Isfahan, Iran
Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Publication date: 2018-07-11
Electron J Gen Med 2018;15(4):em69
Studies indicated higher rate of vitamin D deficiency in Iranian children and also its potential role in both pathogenesis and management of Type 1 diabetes mellitus (T1DM), so we aimed to evaluate the impact of vitamin D supplement therapy on glycemic control and level of Insulin-like growth factor-I (IGF-1) in children with T1DM.

In this cross-sectional study, a total of 30 children with T1DM and serum 25-hydroxyvitamin D levels lower than 29 ng/ml were enrolled. In addition to insulin therapy, the patients underwent treatment with 50,000 units of cholecalciferol (vitamin D3) once a week for a period of 12 weeks. Mean of serum vitamin D, IGF-1 and hemoglobin A1C (HbA1C), before and after treatment were compared.

Serum vitamin D increased significantly after 12 weeks treatment (P<0.001). Mean level of IGF-1 and HbA1c increased and decreased significantly after treatment with vitamin D supplement, respectively (P=0.01 and 0.04). There was a significant negative correlation between HbA1c and IGF-1 (r= -0.69, P<0.001) and 25(OH) D (r= -0.40, P=0.05), 12 weeks after treatment with Vitamin D3 supplement.

Our results indicated that vitamin D treatment enhance level IGF-1 which was accompanied by decreased levels of HbA1c in patients with T1DM. So, developing a proper vitamin D treatment guideline specified in T1DM patients would result in better glycemic control and proper prevention of its related microvascular and macrovascular complication.

Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction. Can J Diabetes. 2013;37 Suppl 1:S1-3.
Gan MJ, Albanese-O’Neill A, Haller MJ. Type 1 diabetes: current concepts in epidemiology, pathophysiology, clinical care, and research. Curr Probl Pediatr Adolesc Health Care. 2012;42(10):269-91. https://doi.org/10.1016/j.cppe....
You WP, Henneberg M. Type 1 diabetes prevalence increasing globally and regionally: the role of natural selection and life expectancy at birth. BMJ Open Diabetes Res Care. 2016;4(1):e000161. https://doi.org/10.1136/bmjdrc....
Teeäär T, Liivak N, Heilman K, Kool P, Sor R, Paal M, Einberg U, Tillmann V. Increasing incidence of childhood-onset type 1 diabetes mellitus among Estonian children in 1999-2006. Time trend analysis 1983-2006. Pediatr Diabetes. 2010;11(2):107-10. https://doi.org/10.1111/j.1399....
Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab. 2016;20(4):546-51. https://doi.org/10.4103/2230-8....
Gunasekara P, Hettiarachchi M, Liyanage C, Lekamwasam S. Effects of zinc and multimineral vitamin supplementation on glycemic and lipid control in adult diabetes. Diabetes Metab Syndr Obes. 2011;4:53-60.
Cazeau RM, Huang H, Bauer JA, Hoffman RP. Effect of Vitamins C and E on Endothelial Function in Type 1 Diabetes Mellitus. J Diabetes Res. 2016;2016:3271293. https://doi.org/10.1155/2016/3....
George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis. Diabet Med. 2012;29(8):e142-50. https://doi.org/10.1111/j.1464....
Hutchinson MS, Figenschau Y, Njølstad I, Schirmer H, Jorde R. Serum 25-hydroxyvitamin D levels are inversely associated with glycated haemoglobin (HbA(1c)). The Tromsø Study. Scand J Clin Lab Invest. 2011;71(5):399-406. https://doi.org/10.3109/003655....
Todd JA. Etiology of type 1 diabetes. Immunity. 2010;32(4):457-67. https://doi.org/10.1016/j.immu....
Penna-Martinez M, Badenhoop K. Inherited Variation in Vitamin D Genes and Type 1 Diabetes Predisposition. Genes (Basel). 2017;8(4). pii: E125. https://doi.org/10.3390/genes8....
Dong JY, Zhang WG, Chen JJ, Zhang ZL, Han SF, Qin LQ. Vitamin D intake and risk of type 1 diabetes: a meta-analysis of observational studies. Nutrients. 2013;5(9):3551-62. https://doi.org/10.3390/nu5093....
Mohammadian S, Fatahi N, Zaeri H, Vakili MA. Effect of vitamin d3 supplement in glycemic control of pediatrics with type 1 diabetes mellitus and vitamin d deficiency. J Clin Diagn Res. 2015;9(3):SC05-7. https://doi.org/10.7860/JCDR/2....
Aljabri KS, Bokhari SA, Khan MJ. Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency. Ann Saudi Med. 2010;30(6):454-8. https://doi.org/10.4103/0256-4....
Clemmons DR. Metabolic actions of insulin-like growth factor-I in normal physiology and diabetes. Endocrinol Metab Clin North Am. 2012;41(2):425-43, vii-viii. https://doi.org/10.1016/j.ecl.....
Holt RI, Simpson HL, Sönksen PH. The role of the growth hormone-insulin-like growth factor axis in glucose homeostasis. Diabet Med. 2003;20(1):3-15. https://doi.org/10.1046/j.1464....
Saukkonen T, Shojaee-Moradie F, Williams RM, Amin R, Yuen KC, Watts A, Acerini CL, Umpleby AM, Dunger DB. Effects of recombinant human IGF-1/IGF-binding protein-3 complex on glucose and glycerol metabolism in type 1 diabetes. Diabetes. 2006;55(8):2365-70. https://doi.org/10.2337/db05-1....
McDonald A, Williams RM, Regan FM, Semple RK, Dunger DB. IGF-1 treatment of insulin resistance. Eur J Endocrinol. 2007;157 Suppl 1:S51-6. https://doi.org/10.1530/EJE-07....
Bogazzi F, Rossi G, Lombardi M, Tomisti L, Sardella C, Manetti L, Curzio O, Marcocci C, Grasso L, Gasperi M, Martino E. Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects. J Endocrinol Invest. 2011;34(8):e200-3.
Setoodeh A, Mostafavi F, Hedayat T. Glycemic control in Iranian children with type 1 diabetes mellitus: effect of gender. Indian J Pediatr. 2012;79(7):896-900. https://doi.org/10.1007/s12098....
Bin-Abbas BS, Jabari MA, Issa SD, Al-Fares AH, Al-Muhsen S. Vitamin D levels in Saudi children with type 1 diabetes. Saudi Med J. 2011;32(6):589-92.
Greer RM, Portelli SL, Hung BS, Cleghorn GJ, McMahon SK, Batch JA, Conwell LS. Serum vitamin D levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes. Pediatr Diabetes. 2013;14(1):31-41. https://doi.org/10.1111/j.1399....
Wierzbicka E, Szalecki M, Pludowski P, Jaworski M, Brzozowska A. Vitamin D status, body composition and glycemic control in Polish adolescents with type 1 diabetes. Minerva Endocrinol. 2016;41(4):445-55.
Ordooei M, Shojaoddiny-Ardekani A, Hoseinipoor SH, Miroliai M, Zare-Zardini H. Effect of vitamin D on HbA1c levels of children and adolescents with diabetes mellitus type 1. Minerva Pediatr. 2017;69(5):391-395.
Hafez M, Hassan M, Musa N, Abdel Atty S, Azim SA. Vitamin D status in Egyptian children with type 1 diabetes and the role of vitamin D replacement in glycemic control. J Pediatr Endocrinol Metab. 2017;30(4):389-394. https://doi.org/10.1515/jpem-2....
Bogdanou D, Penna-Martinez M, Filmann N, Chung TL, Moran-Auth Y, Wehrle J, Cappel C, Huenecke S, Herrmann E, Koehl U, Badenhoop K. T-lymphocyte and glycemic status after vitamin D treatment in type 1 diabetes: A randomized controlled trial with sequential crossover. Diabetes Metab Res Rev. 2017;33(3). https://doi.org/10.1002/dmrr.2....
Savastio S, Cadario F, Genoni G, Bellomo G, Bagnati M, Secco G, Picchi R, Giglione E, Bona G. Vitamin D Deficiency and Glycemic Status in Children and Adolescents with Type 1 Diabetes Mellitus. PLoS One. 2016;11(9):e0162554. https://doi.org/10.1371/journa....
Nwosu BU, Maranda L. The effects of vitamin D supplementation on hepatic dysfunction, vitamin D status, and glycemic control in children and adolescents with vitamin D deficiency and either type 1 or type 2 diabetes mellitus. PLoS One. 2014 Jun 11;9(6):e99646. https://doi.org/10.1371/journa....
Bizzarri C, Pitocco D, Napoli N, Di Stasio E, Maggi D, Manfrini S, Suraci C, Cavallo MG, Cappa M, Ghirlanda G, Pozzilli P. IMDIAB Group: No protective effect of calcitriol on beta-cell function in recent-onset type 1 diabetes: the IMDIAB XIII trial. Diabetes Care. 2010;33(9):1962-3. https://doi.org/10.2337/dc10-0....
Friedrich N, Thuesen B, Jørgensen T, Juul A, Spielhagen C, Wallaschofksi H, Linneberg A. The association between IGF-1 and insulin resistance: a general population study in Danish adults. Diabetes Care. 2012;35(4):768-73. https://doi.org/10.2337/dc11-1....
Kabir G, Hossain M, Faruque MO, Hassan N, Hassan Z, Nahar Q, Shefin SM, Alauddin M, Ali L. Association of serum free IGF-1 and IGFBP-1 with insulin sensitivity in impaired glucose tolerance (IGT). Int J Diabetes Mellit. 2010;2(3):144-7. https://doi.org/10.1016/j.ijdm....
Simpson HL, Jackson NC, Shojaee-Moradie F, Jones RH, Russell-Jones DL, Sönksen PH, Dunger DB, Umpleby AM. Insulin-like growth factor I has a direct effect on glucose and protein metabolism, but no effect on lipid metabolism in type 1 diabetes. J Clin Endocrinol Metab. 2004;89(1):425-32. https://doi.org/10.1210/jc.200....
Færch L, Juul A, Pedersen-Bjergaard U, Thorsteinsson B. Association of IGF1 with glycemic control and occurrence of severe hypoglycemia in patients with type 1 diabetes mellitus. Endocrine Connections. Endocr Connect. 2012;1(1):31-6. https://doi.org/10.1530/EC-12-....
Shiva S, Behbod H, Ghergherechi R. Effect of insulin therapy on IGF-1 level in children with new-onset type 1 diabetes mellitus: a comparison between DKA and non-DKA. J Pediatr Endocrinol Metab. 2013;26(9-10):883-6. https://doi.org/10.1515/jpem-2....
Carroll PV, Christ ER, Umpleby AM, Gowrie I, Jackson N, Bowes SB, HovorkaR, Croos P, Sönksen PH, Russell-Jones DL. IGF-1 treatment in adults with type 1diabetes: effects on glucose and protein metabolism in the fasting state and during a hyper insulinemic-euglycemic amino acid clamp. Diabetes. 2000;49(5):789-96. https://doi.org/10.2337/diabet....
Ameri P, Giusti A, Boschetti M, Bovio M, Teti C, Leoncini G, Ferone D, Murialdo G, Minuto F. Vitamin D increases circulating IGF-1 in adults: potential implication for the treatment of GH deficiency. Eur J Endocrinol. 2013;169(6):767-72. https://doi.org/10.1530/EJE-13....
Journals System - logo
Scroll to top