ESPE Abstracts

Background: Many epidemiological studies have found high prevalence of vitamin D deficiency in children with type 1-diabetes mellitus (T1D). 1,25(OH)2D is a potent immune-modulator that also enhances the production and secretion of several hormones, including insulin. The association of low serum 1,25(OH)2D levels with high glucose level and diminished insulin sensitivity suggests that vitamin D may modulate insulin metabolism.

Aim and objectives: To screen for vitamin D deficiency in paediatric patients with T1D and to study the effect of vitamin D supplementation on glycaemic control and insulin requirements in those patients.

Methods: Our study was a prospective cohort study that included 50 patients with T1D above 5 years of age with onset of T1D >1 year, with no hepatic or renal problems or any drugs that may affect vitamin D metabolism. 25-hydroxyvitamin D (25(OH)D) level was assessed initially and after 3 months of vitamin D supplementation (in those with vitamin D deficiency). Glycaemic control (HbA1c) and insulin requirements were studied at 0 and 3 months of vitamin D therapy.

Results: Thirty-five patients (70%) had vitamin D deficiency, 33 of them received vitamin D supplementation for 3 months (two were non-compliant). 25(OH)D levels improved after therapy (from a mean of 11.2+5.7 to 31.4+11.5). Mean HbA1c at 0 and 3 months of therapy was 9.4+1.9 and 8.7+1.5 respectively. However, mean insulin requirements were not reduced after therapy (1.13+0.3 and 1.18+0.4 at 0 and 3 months respectively).

Conclusion: Checking the serum 25(OH)D levels in children and adolescents with T1D and providing replacement for children with low levels improved glycaemic control at 3 months after therapy with no reduction in insulin requirements.