Glycemic Variability and Insulin Needs in Patients with Type 1 Diabetes Mellitus Supplemented with Vitamin D: A Pilot Study Using Continuous Glucose Monitoring System

Author(s): Karem Mileo Felício , Ana Carolina Contente Braga de Souza , Joao Felicio Abrahao Neto , Franciane Trindade Cunha de Melo , Carolina Tavares Carvalho , Thais Pontes Arbage , Hana Andrade de Rider Brito , Amanda Soares Peixoto , Alana Ferreira de Oliveira , Fabricio de Souza Resende , Scarlatt Sousa Reis , Ana Regina Motta , Henrique da Costa Miranda , Luisa Correa Janau , Elizabeth Sumi Yamada , Joao Soares Felicio* .

Journal Name: Current Diabetes Reviews

Volume 14 , Issue 4 , 2018

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Abstract:

Background: Recent studies suggest that glycemic variability could influence the risk of complications in Type 1 Diabetes Mellitus (T1DM). There are no data about the action of Vitamin D (VD) on glycemic variability. Our pilot study aims to evaluate glycemic variability and insulin needs in patients with T1DM supplemented with VD.

Methods: 22 Patients received doses of 4000 and 10000 IU/day of cholecalciferol for 12 weeks, according to the patient’s baseline VD levels and underwent continuous glucose monitoring system.

Results: Correlations were found between percentage variation (Δ) of glycemia standard deviation (ΔSDG), calculated using continuous glucose monitoring, with Δ of basal (r = 0.6; p <0.01) and total insulin dose (r = 0.6; p <0.01). Correlations between VD status after supplementation and Δ of prandial (r = 0.5; p <0.05) and total insulin dose (r = 0.4; p <0.05) were found, suggesting that the dose of insulin needed by patients is lower when VD status is better. We divided patients in two subgroups: SDG improved (subgroup 1; N = 12 (55%)) and SDG worsened (subgroup 2; N = 10 (45%)). Group 1, compared to subgroup 2, required a lower insulin dose (Δbasal insulin dose = -8.0 vs. 6.3%; p <0.05) and had a lower frequency of hypoglycemia (27% vs. 64%, hypoglycemias/days evaluated; p <0.01).

Conclusion: Our study suggests a relation between VD supplementation, improved glycemic variability, lower insulin needs and lower frequency of hypoglycemia in patients with T1DM.

Keywords: Type 1 diabetes mellitus, vitamin D supplementation, glycemic variability, insulin resistance, glucose, insulin.

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Article Details

VOLUME: 14
ISSUE: 4
Year: 2018
Page: [395 - 403]
Pages: 9
DOI: 10.2174/1573399813666170616075013
Price: $58

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