Research has linked higher doses of
vitamin D to an extended honeymoon phase in diabetes.
- Type 1 diabetes occurs when β cells in
the pancreas stop producing insulin, the hormone that controls blood
glucose.
- This autoimmune condition may develop at
any age but commonly starts during childhood and adolescence.
- Following diagnosis, people often
experience a ‘honeymoon phase’, during which some β cells continue to
function and produce insulin.
- A study has now found that high doses of
vitamin D2 may extend this honeymoon phase and delay the symptoms of
diabetes.
Type 1 diabetes is an autoimmune disorder in which β cells in the pancreas are destroyed
and stop producing insulin. A person who is diagnosed with
type 1 diabetes must take insulin for the rest of their life to control
their blood glucose levels and
prevent complications.
The condition often develops in childhood or early
adulthood, although it can occur later in life. Symptoms that
indicate type 1 diabetes may include:- increased
thirst and urination
Soon after diagnosis, people with type 1 diabetes will
often experience a lessening of symptoms, known as the honeymoon phase, or partial clinical remission.
This occurs in around 50% of children who are diagnosed with type 1 diabetes.
In the honeymoon phase, people often have an
increase in insulin production, and become less reliant on insulin therapy,
because some β cells continue to function and produce insulin. Around 50% of
children and 60% of adults experience this after
diagnosis, and it generally lasts 3-12 months, although some β cells may keep
functioning for more than 5 years.
The
longer the honeymoon phase, the lower the likelihood of developing
complications from type 1 diabetes.
Now, a study has found that vitamin D2 can help
maintain the functioning of β cells, which could extend the honeymoon phase.
The findings are published in JAMA Network Open.
“The study suggests that vitamin D2 may help preserve
beta cell function, which are the cells responsible for insulin production. The
exact mechanisms aren’t fully understood, but vitamin D2 may play a role in
regulating the immune system and reducing inflammation, which could contribute
to beta cell health.”
— Dr. Daniel Ganjian,
board certified pediatrician at Providence Saint John’s Health Center in Santa
Monica, CA, speaking to Medical
News Today, welcomed the findings.
However, Dr. Robert Gabbay, M.D., Ph.D., chief
scientific and medical officer at the American Diabetes Association, cautioned:
“The
study is a secondary analysis of another study, and it has some limitations as
a result of that.”
Health effects of vitamin D
Vitamin D is
essential for good health, as it helps the body absorb calcium, which is
used for building, maintaining and repairing bones. It is also vital for muscle movement, and for the
functioning of the nervous system and the immune system.
There are two forms of vitamin D — D2, also known
as ergocalciferol, and
D3, or cholecalciferol. We
make vitamin D when we expose our skin to the sun, but can also get it in some
foods or take it as a supplement. Both forms have the same effect on the body,
although there is some evidence that D3 may be
slightly more effective in raising levels of vitamin D in the blood.
Most vitamin D2 is made by sun exposure, but mushrooms and yeast also make D2 when
exposed to the sun, so keeping your mushrooms somewhere sunny before eating
them will increase their D2 content. Some manufacturers fortify products such
as dairy and plant milks, orange
juice and cereals with vitamin D2.
Oily fish, such as trout, salmon, tuna, and mackerel, and fish oils are
the best sources of vitamin D3, so people who do not eat fish must get it from
fortified foods or supplements.
Testing vitamin D2 in
children and adolescents
In this trial, the researchers recruited 48 children
and adolescents, aged between 10 and 21 years, who had been diagnosed with type
1 diabetes no more than 3 months before the start of the trial. After initial
testing, they excluded 12 children from the trial.
They then randomly allocated the remaining 36 to two
groups of 18. By dividing each group into those of normal-weight (BMI below
85th centile) and overweight/obese (BMI on or above 85th centile), they created
4 groups of 9 participants.
For the double-blind trial, they gave one group (9
normal-weight and 9 overweight/obese) 50 000 international units (IU) of
ergocalciferol orally once weekly for 2 months, and then once every other week
for 10 months. They gave the control group similar-appearing placebo pills and
pill-counting dosettes.
Vitamin D2 extends the
activity of β cells
The researchers carried out a number of tests at
three, six, nine, and 12 months after the participants had fasted overnight.
From
these, they calculated proinsulin to C-peptide (PI:C) ratio.
This ratio increases as β cells stop functioning. In the treatment group, PI:C
decreased significantly compared with the placebo group.
For the first 3 months, both groups had similar
percent change from baseline in the area under the curve (%∆AUC) of C-peptide — the gold
standard measure of β cell loss in Type 1 diabetes — but this decreased slower
in the vitamin D2 group than the placebo group over the following 9 months,
showing that they retained more active β cells.
Both measures showed that vitamin D2 was extending the
activity of β cells compared with placebo, as Dr. Ganjian explained to Medical News Today:
“The
study observed an improvement in the proinsulin-to-C-peptide ratio (PI:C) in
the vitamin D2 group. PI:C is an indicator of beta cell function. A lower ratio
suggests more efficient insulin production.”
“Vitamin D2 supplementation shows promise in extending
the honeymoon phase and potentially benefiting beta cell function in newly
diagnosed T1D patients,” he added.
What might this mean
for people with type 1 diabetes?
“This adds to the body of evidence of agents that may
preserve beta cell function in early type 1 diabetes. It is an encouraging
initial study, and we look forward to further research in the area.”— Dr.
Robert Gabbay
Preserving β cell function for as long as possible is
a key goal in treating type 1 diabetes, and this research indicates another
potential way of doing this, as Dr. Gabbay told MNT:
“This is early evidence suggesting that vitamin D may
be effective in preserving beta cell function in early type I diabetes. This
comes on the heels of other agents showing similar effects.”
“What would be really exciting is to see some
combination of these agents dramatically affect and prolong the period of time
in early type 1 diabetes during which insulin is still produced,” he added.
https://www.medicalnewstoday.com/articles/vitamin-d2-may-help-delay-symptoms-extend-honeymoon-phase-type-1-diabetes
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