Effect of Three and Six Months of Vitamin D Supplementation on Glycemic Control and Insulin Resistance in Type 2 Diabetes Mellitus: Randomized Placebo-controlled Trial

Alvina Alvina, Suzanna Immanuel, D. Harbuwono, F. Suyatna, A. Harahap, J. Prihartono, Pusparini Pusparini
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Abstract

BACKGROUND: 25(OH)D level is correlated with insulin secretion and tissue sensitivity to insulin. Administration of vitamin D supplements may reduce tissue resistance to insulin in type 2 diabetes mellitus (T2DM), but a number of studies found conflicting results. The present study was to measure the results of administration of vitamin D supplements for 3 and 6 months regarding HbA1c, fasting blood glucose (FBG), insulin and tissue resistance to insulin in T2DM cases.METHODS: A randomized double-blind placebo-controlled trial was conducted in T2DM patients with ≤3 years duration. Subjects were randomly divided into two groups: 47 subjects received daily 5000 IU vitamin D supplementation and 47 subjects received daily placebo as control. After supplementation for 3 and 6 months, homeostatic model assessment for tissue resistance to insulin (HOMA-IR), insulin, HbA1c, and FBG were examined.RESULTS: Supplementation of daily 5000 IU vitamin D for 3 months increased 25(OH)D level in the vitamin D group from 12.50±5.28 to 43.57±17.14 ng/mL, and after 6 months the 25(OH)D level was 38.38±17.64 ng/mL. Both groups showed significant differences after 3 and 6 months regarding HOMA-IR (p=0.033 and p=0.031), insulin (p=0.034 and p=0.013), but not FBG (p=0.296) and HbA1c (p=0.360). In both groups, HOMA-IR and insulin increased although the increase in the control group was greater than in the vitamin D group. The difference between the control and vitamin D groups was significant.CONCLUSION: Vitamin D supplementation for 3 and 6 months may lead to improvement HOMA-IR but not for FBG and HbA1c in the vitamin D group as compared with the control group in T2DM cases.KEYWORDS: vitamin D, T2DM, HbA1c, blood glucose, insulin, tissue resistance to insulin
补充3个月和6个月维生素D对2型糖尿病血糖控制和胰岛素抵抗的影响:随机安慰剂对照试验
背景:25(OH)D水平与胰岛素分泌和组织对胰岛素的敏感性相关。服用维生素D补充剂可能会降低2型糖尿病(T2DM)患者的组织对胰岛素的抵抗力,但许多研究发现了相互矛盾的结果。本研究旨在测量服用维生素D补充剂3个月和6个月对2型糖尿病患者HbA1c、空腹血糖(FBG)、胰岛素和胰岛素组织抵抗的影响。方法:在持续时间≤3年的T2DM患者中进行随机双盲安慰剂对照试验。受试者被随机分为两组:47名受试者每天服用5000 IU维生素D补充剂,47名受试者每天服用安慰剂作为对照。补充3个月和6个月后,检测组织胰岛素抵抗(HOMA-IR)、胰岛素、HbA1c和FBG的稳态模型评估。结果:每日补充5000 IU维生素D 3个月后,维生素D组25(OH)D水平由12.50±5.28 ng/mL提高至43.57±17.14 ng/mL, 6个月后25(OH)D水平为38.38±17.64 ng/mL。3个月和6个月后,两组在HOMA-IR (p=0.033和p=0.031)、胰岛素(p=0.034和p=0.013)、FBG (p=0.296)和HbA1c (p=0.360)方面均有显著差异。在两组中,HOMA-IR和胰岛素增加,尽管对照组的增加大于维生素D组。对照组和维生素D组之间的差异是显著的。结论:与对照组相比,补充维生素D 3个月和6个月可能导致T2DM患者HOMA-IR改善,但维生素D组的FBG和HbA1c没有改善。关键词:维生素D、T2DM、HbA1c、血糖、胰岛素、组织胰岛素抵抗
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