Date of Graduation

Summer 8-10-2013

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Robert Rosenow

Abstract

Background: The incidence of type one diabetes is increasing. A diagnosis of type one diabetes comes with serious, lifelong implications including the need to inject exogenous insulin multiple times each day. Failure to adhere to a strict treatment regime can lead to microvascular and macrovascular complications involving the cardiovascular, vascular, renal and ocular systems. Current research is focused on the prevention of diabetes. More specifically, recent research addresses how treatment can be offered to slow disease progression and preserve pancreatic beta cell function. Can adjunctive treatment with vitamin D in patients with newly diagnosed type one diabetes preserve pancreatic beta cell function?

Methods: An exhaustive search of medical literature was conducted using Medline-OVID, CINAHL, EBMR Multifile, Web of Science and NIH clinical trials using the keywords: Vitamin D, type 1 diabetes mellitus, and beta cell function. Relevant articles were assessed for quality using GRADE.

Results: Three studies met inclusion criteria and were included in this systematic review. A two-part, randomized, double blind, placebo-controlled trial with 25 subjects showed supplementation with 1 alpha, 25-Dihydroxyvitamin D3 was safe, but showed no difference in stimulated C-peptide levels between treatment patients and placebo. A randomized, double blind, placebo-controlled trial with 34 subjects showed no difference in stimulated C-peptide levels between patients supplemented with calcitriol or placebo. Finally, a randomized, double blind, placebo-controlled trial with 38 patients showed a higher level of residual C-peptide production in patients treated with cholecalciferol versus placebo. This study also demonstrated moderate evidence towards vitamin D supplementation and subsequent immune-protective benefits.

Conclusion: Overall, there isn’t compelling evidence to show that Vitamin D supplementation can preserve pancreatic beta cell function in patients with newly diagnosed type one diabetes. However, it appears that there is modest evidence to show that vitamin D, specifically in the form of cholecalciferol, has the ability to slow the decline of residual beta cell function. Furthermore, it appears that supplementation with vitamin D is safe and could provide immunity benefits that have yet to be proven.

Keywords: Type 1 diabetes mellitus, vitamin D, beta cell function

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