Background: Increased frequency of VDD/I has been found in warmer countries over the last years.
Objective and hypotheses: To evaluate the response to vitamin D treatment in VDD/I among children and adolescents with type 1 diabetes.
Method: Total 25OHvitamin D levels (VDL) were measured in 76 consecutive children and adolescents with type 1 diabetes (36 males, mean age (S.D.) 13.6 (5.09) years, median disease duration 5.38 (range 0.1 to 25.3 years)) who were attending the diabetes center. Children who were found to have VDD/I were treated with either high (20002400 units) or low dose (10001200) vitamin D, with/without calcium supplemention according to the dairy product consumption. VDL and PTH levels were frequently monitored during treatment.
Results: Out of 76 patients only 21 (27.6%) were found to have normal VDL, 32 (42.1%) had vitamin D insufficiency and 23 (30.3%) deficiency. PTH levels were significantly lower in patients with normal VDL compared to those with VDD/I (26.1±8.11 vs 31.9±12.9 P=0.28). Patients with VDD/I were consuming significantly less dairy products daily vs those with normal levels (2.09±1.098 vs 3.19±0.96 P=0.011). Out of 55 patients with VDD/I, 47 were treated with vitamin D. VDL increased significantly in those treated vs untreated (78 vs 28% P=0.002). High vs low dose of vitamin D did not succeed in raising significantly its levels to normal within a 3 month period. VDL returned to normal in 42% of patients treated with high dose supplementation after 6.8±5.6 months of treatment and remained in the range of vitamin D insufficiency in 45%. Reduced exposure to sunlight (<30 min/day) prolonged duration of treatment.
Conclusion: VDD/I is found in increased frequency among children and adolescents with type 1 diabetes. Prolonged treatment is necessary even with high dose supplementation to reach normal vitamin D levels.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology