A randomised controlled trial of high dose vitamin D in recent-onset type 2 diabetes

作者：Elkassaby Shirley; Harrison Leonard C^*; Mazzitelli Namita; Wentworth John M; Colman Peter G; Spelman Timothy; Fourlanos Spiros

来源：Diabetes Research and Clinical Practice, 2014, 106(3): 576-582.

DOI：10.1016/j.diabres.2014.08.030

• Vitamin D
• Type 2 diabetes
• Beta-cell function
• Glycaemia
• Randomised trial

Aims: Vitamin D insufficiency has been associated with impaired pancreatic beta-cell function. We aimed to determine if high dose oral vitamin D3 (D) improves beta-cell function and glycaemia in type 2 diabetes.
Methods: Fifty adults with type 2 diabetes diagnosed less than 12 months, with normal baseline serum 25-OH D (25D), were randomised to 6000 IU D (n = 26) or placebo (n = 24) daily for 6 months. Beta-cell function was measured by glucagon-stimulated serum C-peptide (delta C-peptide [DCP], nmol/l). Secondary outcome measures were fasting plasma glucose (FPG), post-prandial blood glucose (PPG), HbA1c and insulin resistance (HOMA-IR).
Results: In the D group, median serum 25D (nmol/l) increased from 59 to 150 (3 months) and 128 (6 months) and median serum 1,25D (pmol/l) from 135 to 200 and 190. After 3 months, change in DCP from baseline in D (+0.04) and placebo (-0.08) was not different (P = 0.112). However, change in FPG (mmol/l) was significantly lower in D (-0.40) compared to placebo (+0.1) (P = 0.007), as was the change in PPG in D (-0.30) compared to placebo (+0.8) (P = 0.005). Change in HbA1c (%) between D (-0.20) and placebo (-0.10) was not different (P = 0.459). At 6 months, changes from baseline in DCP, FPG, PPG and HbA1c were not different between groups.
Conclusion: Oral D3 supplementation in type 2 diabetes was associated with transient improvement in glycaemia, but without a measurable change in beta-cell function this effect is unlikely to be biologically significant. High dose D3 therefore appears to offer little or no therapeutic benefit in type 2 diabetes.

• 出版日期2014-12
• 单位河北医科大学