Abstract
Vitamin D and omega 3 fatty acid (ω-3) co-supplementation potentially improves type 1 diabetes (T1D) by attenuating autoimmunity and counteracting inflammation. This cohort study, preliminary to a randomized control trial (RCT), is aimed at evaluating, in a series of T1D children assuming Mediterranean diet and an intake of cholecalciferol of 1000U/day from T1D onset, if ω-3 co-supplementation preserves the residual endogen insulin secretion (REIS). Therefore, the cohort of 22 “new onsets” of 2017 received ω-3 (eicosapentenoic acid (EPA) plus docosahexaenoic acid (DHA), 60 mg/kg/day), and were compared retrospectively vs. the 37 “previous onsets” without ω-3 supplementation. Glicosilated hemoglobin (HbA1c%), the daily insulin demand (IU/Kg/day) and IDAA1c, a composite index (calculated as IU/Kg/day × 4 + HbA1c%), as surrogates of REIS, were evaluated at recruitment (T0) and 12 months later (T12). In the ω-3 supplemented group, dietary intakes were evaluated at T0 and T12. As an outcome, a decreased insulin demand (p < 0.01), particularly as pre-meal boluses (p < 0.01), and IDAA1c (p < 0.01), were found in the ω-3 supplemented group, while HbA1c% was not significantly different. Diet analysis in the ω-3 supplemented group, at T12 vs. T0, highlighted that the intake of arachidonic acid (AA) decreased (p < 0.01). At T0, the AA intake was inversely correlated with HbA1c% (p < 0.05; r;. 0.411). In conclusion, the results suggest that vitamin D plus ω-3 co-supplementation as well as AA reduction in the Mediterranean diet display benefits for T1D children at onset and deserve further investigation.
Highlights
Nutraceutic is a neologism made up of the words “nutrition” and “pharmaceutical” which was coined in 1989 by Stephen de Felice to label the science that focuses on nutritional principles contained in foods and their beneficial effects on health
Since anecdotal cases have suggested that this co-supplementation may prolong residual endogen insulin secretion (REIS) [15,16,17], we looked at the introduction, in a series of type 1 diabetes (T1D) children already assuming
A recent systematic review of vitamin D supplementation at the onset of T1D concluded that alphacalcidole and cholecalciferol supplementations have beneficial effects on daily insulin doses, HbA1c%, fasting C-peptide (FCP), and SCP
Summary
Nutraceutic is a neologism made up of the words “nutrition” and “pharmaceutical” which was coined in 1989 by Stephen de Felice to label the science that focuses on nutritional principles contained in foods and their beneficial effects on health This discipline has its roots in the not-so-recent past, but it has taken on scientific value over the last fifty years. It faces inherent difficulties in the assessment of clinical outcomes for a specific nutrient outside of the whole nutrition [1], which would be relevant for management of specific diseases. The rise in incidences of T1D in most developed countries, and its shift towards younger ages of life, implies that a genetic predisposition must be associated with environmental factors, including nutrients or other potentially reversible causative agents
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