Influência da suplementação de altas doses de vitamina D no controle glicêmico em pacientes com diabetes mellitus tipo 1

Abstract

Although the intensive glycemic control of Diabetes Mellitus (DM) with insulin has reduced the incidence of microvascular and macrovascular complications, most patients still develop these injuries with high morbidity and mortality. It has been suggested that low levels of vitamin D (VD) may be associated with the development of Type 1 diabetes mellitus (DM1) and poor glycemic control. As a therapeutic potential, the use of VD in patients with DM1 has presented controversial results regarding the reduction of glucose levels. The objective of this study is to analyze the effects of high-dose vitamin D supplementation on glycemic control of patients with DM1, assessed through glycated hemoglobin levels (HbA1c). A prospective, 12week clinical trial including 52 patients with DM1, which were supplemented with high doses of cholecalciferol, was performed. The dose used for this vitamin was according to the participant's VD value. Patients with VD levels below 30 ng / mL received 10,000 IU / day, and when 30-60 ng / mL, they used 4,000 IU / day. The levels of VD and HbA1c were evaluated before and after 3 months of vitamin supplementation. When we analyzed the total number of patients (N = 52), there was no improvement in the glycemic control evaluated by HbA1c ((9.3 ± 2.3 vs 9.5 ± 2.4, p=NS). To better study the effects of VD on HbA1c, patients were divided into 3 groups according to HbA1c variation: those whose HbA1c reduced ≥ 0.5% (group 1, N = 14); those with no variation in HbA1c (group 2, N = 19) and those with ≥ 0.5% increase in HbA1c (group 3, N = 24). There was a decrease in HbA1c in only one specific group (N = 14). In addition, there was no reduction in prandial basal insulin needs or full dose after three months of VD supplementation. Thus, our data suggest that there is no additional benefit of VD supplementation in the optimization of glycemic control evaluated by HbA1C in patients with DM1.