ISSN:
1432-0428
Keywords:
Key words Non-insulin-dependent diabetes mellitus
;
vitamin D
;
vitamin D deficiency
;
total insulin
;
specific insulin
;
proinsulin
;
32
;
33 split proinsulin
;
C-peptide
;
glucose intolerance.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Vitamin D deficiency reduces insulin secretion and still occurs in East London Asians in whom the prevalence of diabetes mellitus is at least four times that of Caucasians. Vitamin D status was assessed in 44 of 65 non-diabetic subjects ’at risk' of diabetes (spot blood glucose level 〉 6.0 mmol/l 〈 2 h post cibum, or 〉 4.6 mmol/l 〉 2 h post cibum on two separate occasions) and in 15 of 60 age and sex-matched ’low-risk' control subjects who attended for oral glucose tolerance test (OGTT) after screening of 877 omnivorous subjects not known to have diabetes. It was found that 95 % of at-risk and 80 % of low-risk subjects were vitamin D deficient (serum 25-hydroxy-vitamin D 〈 11 ng/ml). Diabetes was present in 16, impaired glucose tolerance in 12 and normoglycaemia in 19 at-risk subjects, impaired glucose tolerance in 2, and normoglycaemia in 13 low-risk subjects. Correlations of 30-min OGTT blood glucose, specific insulin and C-peptide levels with 25-hydroxy-vitamin D concentrations in 44 at-risk subjects were −0.31 (p = 0.04), 0.59 (p = 0.0001) and 0.44 (p = 0.006). In 15 ’not-at-risk' subjects 30-min OGTT specific insulin and C-peptide levels correlated with 25-hydroxy-vitamin D, r = 0.39 (p = 0.04) and 0.16 (p = 0.43), respectively. Serum alkaline phosphatase concentration was higher in at-risk than not-at-risk subjects (59.6 vs 46.5 IU/l, p = 0.012); corrected calcium concentrations were comparable (2.38 vs 2.39 mmol/l, p = 0.7). Following treatment with 100,000 IU vitamin D by i. m. injection, specific insulin, C-peptide [30 min on OGTT] and 25-hydroxy-vitamin D concentrations had risen 8–12 weeks later [means ± SD] from 57 ± 62 to 96.2 ± 82.4 mU/l [p = 0.0017], 1.0 ± 0.4 to 1.7 ± 0.8 pmol/ml [p = 0.0001] and 3.6 ± 1.8 to 13.5 ± 7.4 ng/ml [p = 0.0001], (but not to low-risk group values of 179 ± 89 mU/l, 2.7 ± 1.14 pmol/ml and 8.16 ± 6.4 ng/ml), respectively. Both total serum alkaline phosphatase and corrected calcium concentrations rose following vitamin D treatment in the at-risk subjects by 11.1 ± 8.22 (from 44 to 55 IU/l) and 0.15 ± 0.18, (2.43 to 2.57 mmol/l), respectively (p = 0.004). Abnormal glucose tolerance was unchanged by vitamin D treatment. The value of early and sustained repletion with vitamin D in diabetes prophylaxis should be examined in communities where vitamin D depletion is common. [Diabetologia (1995) 38: 1239–1245]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00422375
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