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

Autor: Felício KM; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., de Souza ACCB; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Neto JFA; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., de Melo FTC; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Carvalho CT; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Arbage TP; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., de Rider Brito HA; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Peixoto AS; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., de Oliveira AF; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., de Souza Resende F; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Reis SS; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Motta AR; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., da Costa Miranda H; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Janau LC; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Yamada ES; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil., Felicio JS; University Hospital Joao de Barros Barreto, Federal University of Para, Endocrinology Division, Mundurucus Street, 4487, Guama, Belem, Para, 66073-000, Brazil.
Jazyk: angličtina
Zdroj: Current diabetes reviews [Curr Diabetes Rev] 2018; Vol. 14 (4), pp. 395-403.
DOI: 10.2174/1573399813666170616075013
Abstrakt: 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.
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Databáze: MEDLINE