The effect of vitamin D deficiency on the severity and course of manifestation in type 1 diabetes mellitus in children

Abstract

Background. As a hormone, vitamin D is involved in a number of processes (normal brain formation, anticancer effect, cardioprotection effect, immune defense, etc.). In diabetes mellitus type 1 several genetic and epidemiologic factors have been recognized. There is some epidemiologic evidence that decreased vitamin D level in pregnancy or early childhood may be associated with diabetes risk, but the evidence is not yet conclusive. Low level of vitamin D has also been shown to have negative effect in beta-cells function. In our work the influence of vitamin D deficiency on the gravity of manifestation of type 1 diabetes in children was estimated.Aim. To discover vitamin D deficiency and its effect on glycemic control in newly diagnosed type 1 diabetic children in Armenia.Methods. Newly diagnosed type 1 diabetic children were investigated (n=74). In all children the level of vitamin D and glycohemoglobin on the 4th day of diagnosis were evaluated. Vitamin D normal range lies between 13-67ng/L.Results. There were 51,35% (n=38) boys and 48,65% (n=36) girls by sex distribution. Distribution by age groups was as following : 0-4 years, n=14, 5-9 years, n=23, 10-14 years, n=32 and 15-17 years, n=5. Vitamin D deficiency was found in 58,11% patients (n=43). By age groups vitamin D deficiency was as following: 0-4 years - 78,55% (n=9), 5-9 years - 47,83% (n=11), 10-14 years - 62,5% (n=20), 15-17 years -60% (n=3). In 78,38% of cases (n=58) there was ketoacidosis on admission, and in 21,62% (n=16) -only ketosis. Moreover, vitamin D deficiency predominantly was met in the group of ketoacidosis cases (n=39, 67,24%), and in the ketosis group deficiency was seen only in 4 patients (25%). Average HbA1c was almost the same in the group of vitamin D deficiency and without (9,68% and 9,36%respectively).Conclusion. Positive correlation between severity of manifestation of disease and vitamin D deficiency have been revealed, and probably vitamin D deficiency has an impact on the further course of diabetes. Therefore it can be suggested to see the level of 25 OH vit D in all cases of newly diagnosed DMT1, and include the management of vit D deficiency in the protocol of DMT1 treatment.