Vitamin D’s Effect on the Progression of Pre-type 1 Diabetes

Children with different levels of islet autoantibodies studied… 

The objective of this study was to assess the prevalence of vitamin D deficiency in patients with pre-type 1 diabetes and to see whether the progression to type 1 diabetes is faster in those patients with a vitamin D deficiency.

Levels of vitamin D were assessed in 108 children having multiple islet autoantibodies, 406 who remained negative for islet autoantibodies and 244 patients with recently diagnosed type 1 diabetes. In order to monitor the progression of pre-type 1 diabetes, those with multiple islet autoantibodies were followed for a median of 5.8 years (IQR 3.4 – 8.6 years).

In the cross-sectional analysis, vitamin D levels were lower and the prevalence of vitamin D deficiency (<50 nmol/l) was higher in children with prevalent multiple islet autoantibodies than in islet autoantibody-negative children (59.9 ± 3.0 vs 71.9 ± 1.5 nmol/l; p < 0.001; 39.8% vs 28.3%; p = 0.021). The differences in vitamin D levels between the groups were greatest in summer. The cumulative incidence of type 1 diabetes at 10 years after seroconversion was similar between children with vitamin D deficiency and those with sufficient vitamin D levels (51.8% [95% CI 29.3, 74.3] vs 55.4% [95% CI 35.5, 72.3], p = 0.8).

The researchers concluded that Vitamin D levels were lower in children with multiple islet autoantibodies and in children with type 1 diabetes than in autoantibody-negative children. However, vitamin D deficiency was not associated with faster progression to type 1 diabetes in children with multiple islet autoantibodies.

• Vitamin D deficiencies are commonly seen in patients with pre-type 1 diabetes mellitus however the effects of this, in terms of disease progression, are not fully understood
• Although an association exists between diabetes and low levels of vitamin D there is no evidence to suggest that vitamin D can influence the advancement of this disease
• Vitamin D deficiency was not associated with an increased rate of type 1 diabetes progression in children having multiple islet antibodies

Raab J, Giannopoulou EZ, Schneider S, et al. Prevalence of vitamin D deficiency in pre-type 1 diabetes and its association with disease progression. Diabetologia. 2014;