The administration of vitamin D safe, economical and easy to introduce in the treatment of children newly diagnosed with type 1 diabetes promises to improve disease progression measures. this is demonstrated by the results of a randomized clinical trial comparing ergocalciferol supplementation with placebo, conducted by Benjamin Udoka Nwosu, dell’University of Massachusetts Medical School.
The results of the Research have been published in the scientific journal Journal of the Endocrine Society.
Vitamin D and children with type 1 diabetes: here’s what the research says
“There are new findings of clinical significance in this study“Said Dr. Nwosu, professor of pediatrics. “The ergocalciferol protected the beta cell mass and was useful for maintaining better glycemic control during the honeymoon phase ”.
Type 1 diabetes occurs when insulin-producing beta cells stop working over time. During partial clinical remission, known as the “honeymoon phase” that can follow the start of insulin therapy, the surviving beta cells continue to produce some insulin – the longer the better.
Patients who do not have partial clinical remission require higher doses of insulin and are more likely to suffer from severe diabetes-related complications later in life.
In the randomized, double-blind, placebo-controlled, 12-month study, 18 patients aged 10 to 21 years, who were three months or less after being diagnosed with type 1 diabetes, received 50,000 IU ergocalciferol. per week for two months, then once every two weeks for 10 months, while the 18 members of the control group received a placebo. All participants followed a strictly controlled insulin treatment plan.
Trends for increasing mean blood glucose levels over several months (HbA1c) and dose-adjusted blood glucose levels of insulin (IDAA1c), a measure of beta cell function, were significantly attenuated in the group that took ergocalciferol. These results suggest that adding vitamin D to insulin therapy may further extend the duration of partial clinical remission.
“Our study is the first to demonstrate significant functional and dynamic differences between ergocalciferol and placebo“, Said Nwosu. “It is also the longest of such studies in an exclusive pediatric population with type 1 diabetes using a standardized insulin regimen and high-dose ergocalciferol. “
Subsequently, Nwosu is initiating a long-term study to clearly delineate the impact of vitamin D on partial clinical remission, which has not been fully demonstrated in this short-term study.
It is estimated that around 652,000 children with type 1 diabetes are diagnosed annually worldwide. Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a condition in which the body cannot produce insulin, requiring people with the condition to take artificial insulin to stay alive.
Unlike type 2 diabetes, the development of type 1 diabetes is not associated with being overweight or obese. The exact cause of type 1 diabetes is not known, but genetics and exposure to viruses and other environmental factors are thought to play a role. Cases of type 2 diabetes account for the vast majority of diabetes cases.
The countries with the highest rates of type 1 diabetes among children and adolescents are the Finland, Sweden and Kuwait. Treatment for type 1 diabetes includes healthy eating, exercise, blood sugar monitoring, and insulin intake.
There are several types of insulin that can be injected or delivered through a pump. The world market for insulin treatment is large and growing. By 2027, the insulin pen market alone is expected to be worth approximately US $ 8.3 billion.
In countries where the provision of health services is inadequate and access limited to essential drugs for diabetes like the insulin , children and adolescents with type 1 diabetes develop serious complications and die at a young age.
Type 2 diabetes also in children and adolescents it is increasingly common in some countries, but reliable data are scarce. With increasing levels of overweight and obesity Among children and adolescents in many countries, type 2 diabetes in this age group has the potential to become a global public health problem leading to serious health outcomes.
Living with type 1 diabetes remains a challenge for the child and the entire family even in countries with access to multiple daily injections or an insulin pump, glucose monitoring, diabetes education, and specialist medical care. Poor metabolic control can cause acute complications of hypoglycemia and ketoacidosis, chronic microvascular and macrovascular complications, and death.
Children are more sensitive to insulin deficiency than adults and are more at risk for the rapid and dramatic development of diabetic ketoacidosis. Episodes of severe hypoglycemia or ketoacidosis, especially in young children, are risk factors for structural brain abnormalities and impaired cognitive function, which can cause academic difficulties and limit future career choices.
Many children and adolescents find it difficult to emotionally cope with their condition. Diabetes causes them embarrassment, causes discrimination and limits social relationships. It can have an impact on academic performance and family functioning. Many schools and daycare centers are reluctant to take children with diabetes.
The incidence of childhood-onset diabetes is increasing in many countries. There are clear indications of geographical differences in trends, but the overall annual increase is estimated at around 3%. There are some indications that incidence is increasing more rapidly in some of the low prevalence European countries and also that in some high incidence European countries the trend of increasing incidence is stabilizing.