PDF(Pubmed)
Abstract：
The publication of our recent randomized controlled trial (RCT) showing that vitamin D could protect the β-cells during the honeymoon phase of type 1 diabetes (T1D) has led to calls for guidance for vitamin D supplementation during the critical phase of type 1 diabetes. Prolonging the partial clinical remission (PR) phase of TID improves glycemic control and reduces long-term complications of T1D. This RCT randomized 36 children and adolescents to either receive vitamin D2 (ergocalciferol, given as 50,000 international units per week for 2 months and then every other week for 10 months) or a placebo. The results showed that vitamin D significantly decreased the temporal rise in both hemoglobin A1c at a mean rate of changes of 0.14% every 3 months versus 0.46% every 3 months for the placebo group (p=0.044); and in the functional marker of PR, the insulin-dose adjusted A1c at a mean rate of change of 0.30% every 3 months versus 0.77% every 3 months for the placebo group, (p=0.015). We recommend a baseline estimation of 25(OH)D concentration at the time of diagnosis of T1D, and to begin vitamin D supplementation if serum 25(OH)D concentration is <30 ng/mL, to maintain serum 25(OH)D concentrations between 30-60 ng/mL. If serum 25(OH)D concentration is >30 ng/mL, monitor vitamin D status with serial 25(OH)D estimations; and initiate vitamin D supplementation if serum 25(OH)D concentrations drop to <30 ng/mL. Continue vitamin D supplementation for at least one year to ensure optimal benefit from vitamin D supplementation during the partial clinical remission phase of type 1 diabetes.
摘要：
我们最近发表的随机对照试验（RCT）表明维生素D可以在1型糖尿病（T1D）的蜜月期保护β细胞，因此呼吁在1型糖尿病的关键阶段补充维生素D。延长TID的部分临床缓解期（PR）可改善血糖控制并减少T1D的长期并发症。这项RCT随机分配36名儿童和青少年接受维生素D2（麦角钙化醇，每周给予50,000国际单位，持续2个月，然后每隔一周给予10个月）或安慰剂。结果表明，维生素D显着降低了血红蛋白A1c的瞬时升高，平均每3个月变化0.14％，而安慰剂组每3个月变化0.46％（p=0.044）；在PR的功能标志物中，胰岛素剂量调整后的A1c平均变化率为每3个月0.30％，安慰剂组为每3个月0.77％，（p=0.015）。我们建议在诊断T1D时对25（OH）D浓度进行基线估计，如果血清25（OH）D浓度<30ng/mL，则开始补充维生素D，维持血清25（OH）D浓度在30-60ng/mL之间。如果血清25(OH)D浓度>30ng/mL，使用系列25（OH）D估算监测维生素D状态；如果血清25（OH）D浓度降至<30ng/mL，则开始补充维生素D。继续补充维生素D至少一年，以确保在1型糖尿病的部分临床缓解期补充维生素D的最佳益处。
