Abstract
We assessed the effect of different doses of vitamin D supplementation on microcirculation, signs and symptoms of peripheral neuropathy and inflammatory markers in patients with type 2 diabetes (T2DM). Sixty-seven patients with T2DM and peripheral neuropathy (34 females) were randomized into two treatment groups: Cholecalciferol 5000 IU and 40,000 IU once/week orally for 24 weeks. Severity of neuropathy (NSS, NDS scores, visual analogue scale), cutaneous microcirculation (MC) parameters and inflammatory markers (ILs, CRP, TNFα) were assessed before and after treatment. Vitamin D deficiency/insufficiency was detected in 78% of the 62 completed subjects. Following treatment with cholecalciferol 40,000 IU/week, a significant decrease in neuropathy severity (NSS, p = 0.001; NDS, p = 0.001; VAS, p = 0.001) and improvement of cutaneous MC were observed (p < 0.05). Also, we found a decrease in IL-6 level (2.5 pg/mL vs. 0.6 pg/mL, p < 0.001) and an increase in IL-10 level (2.5 pg/mL vs. 4.5 pg/mL, p < 0.001) after 24 weeks of vitamin D supplementation in this group. No changes were detected in the cholecalciferol 5000 IU/week group. High-dose cholecalciferol supplementation of 40,000 IU/week for 24 weeks was associated with improvement in clinical manifestation, cutaneous microcirculation and inflammatory markers in patients with T2DM and peripheral neuropathy.
Highlights
It is well known that vitamin D deficiency along with type 2 diabetes mellitus (T2DM) is a modern pandemic [1,2]
25(OH)D—17.2 (10.2; 27.9) ng/mL, HbA1c—7.9 (7.2; 8.4)%. Both treatment groups were matched for age, gender, diabetes duration, BMI, HbA1c, neuropathy severity, comorbidities and concomitant medications
Our study revealed a very high prevalence of vitamin D deficiency/insufficiency in patients with T2DM, which is consistent with previously reported data [6,17]
Summary
It is well known that vitamin D deficiency along with type 2 diabetes mellitus (T2DM) is a modern pandemic [1,2]. There is increasing evidence of a possible contribution of vitamin D deficiency to the pathogenesis of diabetes and its complications [3]. Large-scale studies have shown 40% increased risk of developing diabetes in individuals with a reduced 25(OH)D (25-hydroxy vitamin D) level [4], as well as 24% decrease in diabetes risk for every 25 nmol/L increase in 25(OH)D concentration [5]. Some studies found no association between diabetes risk and vitamin D status [6]. A recent interventional prospective study demonstrated no decrease in the risk of T2DM development in patients with prediabetes after two-year treatment with 4000 IU of vitamin D per day [7]
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