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Vitamin D supplementation in patients with diabetes mellitus type 2 on different therapeutic regimens: a one-year prospective study.

Alkharfy KM, Al-Daghri NM, Sabico SB, Al-Othman A, Moharram O, Alokail MS, Al-Saleh Y, Kumar S, Chrousos GP - Cardiovasc Diabetol (2013)

Bottom Line: Also, significant decreases in triglycerides were observed in the rosiglitazone and insulin + oral hypoglycemic agent groups both at 6 and 12 months of supplementation (both p-values <0.001).While in all DMT2 groups circulating levels of 25-OHVitD increased after supplementation, in DMT2 patients on insulin in combination with other drugs benefitted the most in improving cardiovascular risk.Metformin improves 25-hydroxyvitamin D levels but did not seem to confer other added cardiometabolic benefits.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Little or no research has determined the effect of vitamin D3 supplementation in conjunction with pharmacological and non-pharmacological approaches in the diabetes mellitus type 2 (DMT2) patients. The objective of this study was to determine the effect of vitamin D3 supplementation in a cohort of Saudi DMT2 population on diet, insulin and/or different oral hypoglycemic agents and compare them with a non-DMT2 control cohort.

Methods: A total of 499 randomly selected Saudi subjects divided into 8 groups [Non-DMT2 Control = 151; Rosiglitazone alone = 49; Diet = 15; Insulin alone = 55; Insulin + Orals = 12; Metformin alone = 121; Oral agents combination = 37; Sulphonylurea alone = 59] were included in this 12-month interventional study. All DMT2 patients were given 2000 IU vitamin D3 daily, while the control group received none but were advised to increase sun exposure. Anthropometrics, glucose, lipid profile and 25-hydroxyvitamin D (25-OHVitD) were measured at baseline, 6 and 12 months.

Results: Circulating 25-OHVitD concentrations improved in all patient groups. The metformin group showed the highest change in circulating vitamin D levels both at 6 months (62.6%) and 12 months (50.6%) as compared to baseline (p < 0.001). No significant changes were observed in the BMI and glucose in any of the DMT2 groups. In contrast, the insulin + oral agents group showed more significant improvements in the metabolic profile, which included triglycerides and total cholesterol, as well as systolic blood pressure and HDL-cholesterol in males. Also, significant decreases in triglycerides were observed in the rosiglitazone and insulin + oral hypoglycemic agent groups both at 6 and 12 months of supplementation (both p-values <0.001).

Conclusion: While in all DMT2 groups circulating levels of 25-OHVitD increased after supplementation, in DMT2 patients on insulin in combination with other drugs benefitted the most in improving cardiovascular risk. Metformin improves 25-hydroxyvitamin D levels but did not seem to confer other added cardiometabolic benefits.

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Circulating 25-Hydroxyvitamin D Levels in A. DMT2 Males and Females and B. Non-DMT2 Control Males and Females.
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Figure 1: Circulating 25-Hydroxyvitamin D Levels in A. DMT2 Males and Females and B. Non-DMT2 Control Males and Females.

Mentions: With the exception of the diet and oral agents-combination group, all other groups showed a significant increase in serum 25-OHVitD levels as compared with mean baseline status (Table 1). Furthermore, this improvement in 25-OHVitD status was most pronounced after 6 months supplementation, with the 12-month follow-up slightly lower than the 6-month follow-up, but still significantly higher than baseline. This observation remained consistent even after stratifying the groups according to gender. The rosiglitazone and diet groups in females failed to achieve significance possibly because of the small sample size (Table 2). A comparison of 25-OHVitD levels between control and DMT2 groups showed higher baseline 25-OHVitD in males (both control and DMT2) than females (Figure 1).


Vitamin D supplementation in patients with diabetes mellitus type 2 on different therapeutic regimens: a one-year prospective study.

Alkharfy KM, Al-Daghri NM, Sabico SB, Al-Othman A, Moharram O, Alokail MS, Al-Saleh Y, Kumar S, Chrousos GP - Cardiovasc Diabetol (2013)

Circulating 25-Hydroxyvitamin D Levels in A. DMT2 Males and Females and B. Non-DMT2 Control Males and Females.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750473&req=5

Figure 1: Circulating 25-Hydroxyvitamin D Levels in A. DMT2 Males and Females and B. Non-DMT2 Control Males and Females.
Mentions: With the exception of the diet and oral agents-combination group, all other groups showed a significant increase in serum 25-OHVitD levels as compared with mean baseline status (Table 1). Furthermore, this improvement in 25-OHVitD status was most pronounced after 6 months supplementation, with the 12-month follow-up slightly lower than the 6-month follow-up, but still significantly higher than baseline. This observation remained consistent even after stratifying the groups according to gender. The rosiglitazone and diet groups in females failed to achieve significance possibly because of the small sample size (Table 2). A comparison of 25-OHVitD levels between control and DMT2 groups showed higher baseline 25-OHVitD in males (both control and DMT2) than females (Figure 1).

Bottom Line: Also, significant decreases in triglycerides were observed in the rosiglitazone and insulin + oral hypoglycemic agent groups both at 6 and 12 months of supplementation (both p-values <0.001).While in all DMT2 groups circulating levels of 25-OHVitD increased after supplementation, in DMT2 patients on insulin in combination with other drugs benefitted the most in improving cardiovascular risk.Metformin improves 25-hydroxyvitamin D levels but did not seem to confer other added cardiometabolic benefits.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Little or no research has determined the effect of vitamin D3 supplementation in conjunction with pharmacological and non-pharmacological approaches in the diabetes mellitus type 2 (DMT2) patients. The objective of this study was to determine the effect of vitamin D3 supplementation in a cohort of Saudi DMT2 population on diet, insulin and/or different oral hypoglycemic agents and compare them with a non-DMT2 control cohort.

Methods: A total of 499 randomly selected Saudi subjects divided into 8 groups [Non-DMT2 Control = 151; Rosiglitazone alone = 49; Diet = 15; Insulin alone = 55; Insulin + Orals = 12; Metformin alone = 121; Oral agents combination = 37; Sulphonylurea alone = 59] were included in this 12-month interventional study. All DMT2 patients were given 2000 IU vitamin D3 daily, while the control group received none but were advised to increase sun exposure. Anthropometrics, glucose, lipid profile and 25-hydroxyvitamin D (25-OHVitD) were measured at baseline, 6 and 12 months.

Results: Circulating 25-OHVitD concentrations improved in all patient groups. The metformin group showed the highest change in circulating vitamin D levels both at 6 months (62.6%) and 12 months (50.6%) as compared to baseline (p < 0.001). No significant changes were observed in the BMI and glucose in any of the DMT2 groups. In contrast, the insulin + oral agents group showed more significant improvements in the metabolic profile, which included triglycerides and total cholesterol, as well as systolic blood pressure and HDL-cholesterol in males. Also, significant decreases in triglycerides were observed in the rosiglitazone and insulin + oral hypoglycemic agent groups both at 6 and 12 months of supplementation (both p-values <0.001).

Conclusion: While in all DMT2 groups circulating levels of 25-OHVitD increased after supplementation, in DMT2 patients on insulin in combination with other drugs benefitted the most in improving cardiovascular risk. Metformin improves 25-hydroxyvitamin D levels but did not seem to confer other added cardiometabolic benefits.

Show MeSH
Related in: MedlinePlus