Abstract
Objective: Vitamin D has a role in the regulation of pancreatic β-cell function and insulin sensitivity. Accordingly, Vitamin D deficiency is considered to be a risk factor for the development of type 2 diabetes mellitus (T2DM) and its complications. Therefore, the aim of the study was to assess and compare the effect of different regimens of Vitamin D3 on glucose homeostasis in patients with T2DM.
 Methods: The study included 80 patients with T2DM taking oral antidiabetic drugs. The patients were randomized to receive antidiabetic drugs alone or with different regimens of Vitamin D3 for 3 months. Vitamin D3-treated patients were supplemented by either daily oral 4000 IU Vitamin D3, weekly oral 50,000 IU Vitamin D3, or a single parenteral dose of 300,000 IU Vitamin D3. In addition to the assessment of patient characteristics, laboratory measurements of serum creatinine, blood urea, total and ionized calcium, serum phosphorus, fasting blood glucose, fasting serum insulin, homeostasis model assessment of insulin resistance, hemoglobin A1c, and 25(OH) Vitamin D levels were measured at the beginning and after 3 months.
 Results: After 3 months, the increased Vitamin D levels resulting from the daily and weekly oral doses of Vitamin D3 caused a significant decrease in metabolic parameters, whereas the parenteral dose demonstrated a non-significant decrease.
 Conclusion: Oral daily and weekly doses of Vitamin D3 could improve glucose homeostasis equally in patients with T2DM and better than a single parenteral dose of Vitamin D3.
Highlights
The management of type 2 diabetes mellitus (T2DM) has been improved over the past few decades, it remains a worldwide healthcare problem [1,2,3]
Five of 85 patients withdrew from the study; 20 patients (5 men and 15 women) in the control group and 60 patients in the Vitamin D3-treated groups completed the study (21 men and 39 women) (Fig. 1)
Regarding the change from baseline values, 25(OH)D3 levels increased significantly less in patients treated with a single parenteral dose of Vitamin D3 compared with patients treated with daily or weekly oral doses
Summary
The management of type 2 diabetes mellitus (T2DM) has been improved over the past few decades, it remains a worldwide healthcare problem [1,2,3]. Further efforts in developing measures for the management and prevention of T2DM and its complications are required. Vitamin D regulates pancreatic β-cell function and insulin sensitivity through several potential mechanisms. The pancreatic β-cells contain VDR and 1-α-hydroxylase enzyme, which allow direct stimulation of insulin secretion [11]. Vitamin D can regulate the Ca pool of β cells, decrease reactive oxygen species formation, and modulate chronic inflammation to further control insulin secretion and decrease insulin resistance [10,12,13,14]
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