10 June 2019

vitamin d does not stop diabetes in those with prediabetes

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San Francisco vitamin d3 supplementation in people at high risk of developing diabetes but who did not have vitamin D insufficiency does not reduce the chances of developing the disease compared with placebo the new results of a randomized placebo-controlled trial shows the findings from the vitamin D in type 2 diabetes d2 d trial were presented here at the American Diabetes Association 2019 scientific sessions by Anastasio spitters MD from Tufts Medical Center Boston Massachusetts our study results did not show a statistically significant benefit for vitamin D in decreasing progression to type 2 diabetes and people who have sufficient levels he said however he added that in a post hoc analysis we did see that vitamin D supplementation potentially had a benefit in those with very low vitamin D levels 20% of the study population was deemed at least vitamin being sufficient as opposed to the remainder who were vitamin D sufficient after 2.5 years of follow-up of over 99% of the participants no significant difference was found in the development of diabetes between those taking vitamin D supplementation in those on placebo he

equals 0.12 the study was simultaneously published in the New England Journal of Medicine along with an editorial by Deborah Jay Wexler MD from Massachusetts General Hospital Diabetes Center in Harvard Medical School Boston Wexler notes that d2d is the largest of a number of randomized control trials looking at vitamin D supplementation to prevent progression to type 2 diabetes and as such these results are long awaited but she points out that the findings show that any benefit of vitamin D for diabetes prevention if present is modest and clearly does not pertain to a vitamin D sufficient population whether targeting populations with vitamin D levels below 12 mg/ml many of whom have additional risk factors for diabetes would have an effect on beta cell function and progression to type 2 diabetes remains unresolved trial participants had pre-diabetes but most were not fight being sufficient the d2d multicenter trial aim to test whether vitamin D supplementation reduces the risk of the development of type 2 diabetes among adults at high risk for the disease D

those with pre-diabetes the authors note the biological plausibility of vitamin D status influencing risk for type 2 diabetes highlighting that both impaired pancreatic beta cell function and insulin resistance have been reported with low blood levels of 25 hydroxy vitamin B they and that observational studies suggest a low blood vitamin D level is associated with diabetes risk and this is further supported by mechanistic studies showing that vitamin D supplementation improved pancreatic beta-cell function by 40% in the study a total of 24 23 participants across 22 US cities were randomized 12:11 to the vitamin D group and 12:12 to the placebo group to receive 4000 IU day of vitamin D r placebo regardless of baseline serum 25 hydroxy vitamin D level the 4000 IU day dose was selected to balance safety and efficacy and resulted in a large difference in the serum 25 hydroxy vitamin D level between the trial groups in the first two years effective vitamin D supplementation in those with deficiency unknown in her editorial Wexler remarks that the observed nature of 0.88 for the primary endpoint of the trial does not rule out a modest benefit

of vitamin D a larger and longer trial might be necessary to show a significant benefit in a vitamin D sufficient population she explains Wexler goes on to say that the effect might be greater if vitamin D supplementation was given to people who truly have a vitamin D deficiency in comparison to participants in the D to D trial who largely did not in the US correlates of vitamin D insufficiency include older ages black Asian or Hispanic race and obesity among other factors indeed in the d2d trial a post hoc analysis of data from the 103 participants with vitamin D deficiency 12 mg ml showed an HR for new onset diabetes with vitamin D supplementation of 0.38 95 percent 0.18 0.8 Oh compared with placebo she stresses but Wexler adds that overall in a pre-specified subgroup analysis at those who did not have sufficient levels pH are in participants with a level of vitamin D 20 mg ml was essentially the same as that in participants with a sufficient level of the 20 mg ml or higher 0.87 and 0.89 respectively pedis noted that other large trials from Japan the United States and Norway have shown similar age jars to the D to D trial

with a range of 0.87 to 0.9 88 2019 scientific sessions present a June 7th 2019 and Engel j-man published online June 7th 2019 abstract Pettis has disclosed new relevant financial relationships Wexler has sat on the data monitoring committee for oral soup [Music]