Vitamin D may reduce risk of progression to type 2 diabetes in prediabetics

Vitamin D supplementation is Diabetes A 15% increase, according to an analysis of randomized trials in pre-diabetics.

An analysis of three randomized controlled trials in prediabetics found that study participants assigned to vitamin D supplementation had a 3.3% reduction in absolute 3-year risk of progression to diabetes compared to normal 30 increased likelihood of returning to glycemic control. %.¹

“this [individual participant data] A meta-analysis of three randomized, double-blind, placebo-controlled trials specifically designed for diabetes prevention found that vitamin D in prediabetics reduced the risk of diabetes and the potential for return to normal glycemic control. It was found to be beneficial in increasing signal,” wrote the investigator.¹ “Among cholecalciferol-treated participants, achieving and maintaining higher serum 25-hydroxyvitamin D levels progressively reduced the risk of diabetes.”

Few substances in modern medicine have been studied as extensively as vitamin D. Countless studies in various patient populations have reduced and supported the role of vitamin D many times. Some of these controversies have recently emerged after an analysis of the landmark VITAL study concluded that the potential benefits of vitamin D supplementation in the general population may depend on baseline BMI. has been reactivated.²

In the current study, a team led by Ethan Bork, M.D., M.P.H., Brown University School of Public Health, found that vitamin D could prevent progression to type 2 diabetes in a population considered at risk. tried to evaluate With this in mind, the researcher will collect data from randomized, placebo-controlled trials on the topic published within PubMed, Embase, and ClinicalTrials.gov from database inception to December 9, 2022. We designed a systematic review and meta-analysis of A meta-analysis, a randomized, double-blind, study that should be designed as a placebo-controlled trial, including adults with prediabetes only, assessing oral vitamin D in any formulation, with new onset as the primary outcome At least 2 years with diabetes and an intervention period.¹

The investigator’s initial search returned over 3800 citations and 270 records. Of these, a set of three trials met the eligibility criteria. These trials were the Tromsø Study, the Vitamin D and Type 2 Diabetes (D2d) Study, and the Active Vitamin D for Diabetes Prevention (DPVD) Study. From these three of his trials, the researchers obtained information on her 4,190 participants, of whom 2,097 he was assigned to receive vitamin D and 2,093 to placebo therapy. At baseline, the mean age of the overall population was 61 years, the mean BMI was 30 kg/m2, and the mean 25-hydroxyvitamin D level was 63 nmol/L. The researchers also found that 44% of the population was female, 51% self-identified as Caucasian or European, 33% self-identified as Asian, and 15% were black. I also noticed that I am self-aware.¹

median 3.0 during follow-up (interquartile range [IQR]At age 2.0-3.2), new onset diabetes was observed in 22.7% of the vitamin D group and 25.0% of the placebo group. In an adjusted intention-to-treat analysis, results showed that randomization to vitamin D was associated with a 12% reduction in the relative risk of new-onset diabetes (HR, 0.88 [95% CI, 0.77-0.99]). In analyzes adjusted for age, sex, BMI, race, and HbA1c, this apparent reduction in relative risk was 15% (HR, 0.85 [95% CI, 0.75-0.96]), which the researchers noted was a 3-year absolute risk reduction (ARR) of 3.3% (95% CI, 0.6-6.0) and a need for treatment of 30.¹

In vitamin D-allotted patients who maintained intrastudy mean serum 25-hydroxyvitamin D levels of at least 125 nmol/L compared with 50–74 nmol/L during follow-up, cholecalciferol use Diabetes risk decreased by 76% (HR, 0.24 [CI, 0.16-0.36]) compared with placebo therapy, the 3-year ARR was 18.1% (CI, 11.7% to 24.6%). Further analysis showed that randomized vitamin D was associated with an increased likelihood of return to normal glucose control (Rate ratio). [RR]1.30 [95% CI, 1.16-1.46]). A safety analysis showed no difference in RR for kidney stones (RR, 1.17 [95% CI, 0.69-1.99]), hypercalcemia (RR, 2.34 [95% CI, 0.83-6.66]), hypercalciuria (RR, 1.65 [95% CI, 0.83-3.28]), death (RR, 0.85 [95% CI, 0.31-2.36]).¹

In an editorial, Dr. Malachi McKenna, University College Dublin and Dr. Mary AT Flynn, University of Ulster, RD, noted the growing body of data relating to vitamin D supplementation in a variety of patient populations and the time to do so. suggested it might. We request professional bodies, institutions and governments to provide recommendations for use where evidence exists.³

“What’s next? Professional groups that advise physicians on the benefits and harms of vitamin D therapy have a duty to understand advice from government agencies. There is a need to promote public health recommendations regarding D thresholds, and safety margins, as there are important differences between supplements and treatments,” the pair wrote.³

References

1. Pittas AG, Kawahara T, Jorde R, et al. Vitamin D and the risk of type 2 diabetes in prediabetics. Annals of Internal MedicineFebruary 2023. Doi: 10.7326/m22-3018
2. Campbell P. Study Finds Benefits of Vitamin D Supplementation May Depend on Body Mass Index. HCP Live. https://www.hcplive.com/view/benefits-of-vitamin-d-supplementation-could-depend-on-body-mass-index-study-findsPublished January 17, 2023. Accessed 7 February 2023.
3. McKenna MJ, Flynn MAT. Prevention of type 2 diabetes with vitamin D: treatment and supplementation. Annals of Internal MedicineFebruary 2023. Doi: 10.7326/m23-0220