Abstract
Vitamin D deficiency may contribute to etiology of type 2 diabetes in Asian Indians. The objectives of this study was to evaluate effect of vitamin D supplementation on glycemic profile and body composition in prediabetic and vitamin D deficient overweight/obese Asian Indian women. In this open-label randomized placebo-controlled trial (78 weeks duration), 121 females (aged 20–60 years) with prediabetes and vitamin D deficiency were randomly allocated in intervention (n, 61) and placebo (n, 60) groups. The primary outcome variables were fasting blood glucose (FBG), 2-h blood glucose post OGTT (2-h BG), hemoglobin A1c (HbA1C), and reversal to normoglycemia. In Intention-to-treat analysis, at the end of intervention, we observed significant decrease in FBG [−5.0 (−12.6–2.4), p = 0.04], 2-h blood glucose post OGTT [−11(−49.3–26.9), p = 0.02], hemoglobin A1c [−0.41 (5.89, 6.55), p = 0.05] and increase in 25(OH) D [7.5 (−6.0–20.9), p = 0.002] levels in intervention as compared to the placebo group. Changes in glycemic category based on FBG were as follows; intervention group: normal FBG, 58.6%; impaired fasting glucose (IFG), 39%; and type 2 diabetes mellitus (T2DM), 2.4%; placebo group: normal FBG, 48.8%; IFG, 46.3%; and T2DM, 4.9%. Changes in category of 2-hour glucose post OGTT after intervention were as follows; intervention group: normal glucose tolerance (NGT) 51.2% and prediabetes, 48.8%; placebo group: NGT, 43.9%; prediabetes, 53.7% and T2DM, 2.4%. After intervention, subscapular skinfold (visit Ist compared to visit IIIrd) and suprailiac skinfold (visit IInd compared to visit IIIrd) were significantly lower in intervention group vs. control group. In conclusion, we observed significant reduction in FBG, 2-hour glucose post OGTT, HbA1c, and truncal subcutaneous fat and reversal to normoglycemia in overweight/obese prediabetic vitamin D deficient Asian Indian women after 78 weeks of vitamin D supplementation.
Highlights
Vitamin D deficiency may contribute to etiology of type 2 diabetes in Asian Indians
Changes in glycemic category based on fasting blood glucose (FBG) were as follows; intervention group: normal FBG, 58.6%; impaired fasting glucose (IFG), 39%; and type 2 diabetes mellitus (T2DM), 2.4%; placebo group: normal FBG, 48.8%; IFG, 46.3%; and T2DM, 4.9%
Prediabetes is an intermediate state of hyperglycemia and gives an opportunity to intervene so that this state could be reverted to normal glucose regulation
Summary
Vitamin D deficiency may contribute to etiology of type 2 diabetes in Asian Indians. The objectives of this study was to evaluate effect of vitamin D supplementation on glycemic profile and body composition in prediabetic and vitamin D deficient overweight/obese Asian Indian women. We observed significant reduction in FBG, 2-hour glucose post OGTT, HbA1c, and truncal subcutaneous fat and reversal to normoglycemia in overweight/obese prediabetic vitamin D deficient Asian Indian women after 78 weeks of vitamin D supplementation. In a cross-sectional study of 488 subjects, those having prediabetes and low circulating 25(OH)D concentration were most insulin resistant and had impaired beta cell function[10] Those with low vitamin D levels showed highest progression to diabetes over 8–10 year period in Swedish population[11]. In former study, which was conducted in women with prediabetes residing in urban New Delhi, lower vitamin D levels are associated with higher fasting blood glucose values (FBG)[15]. We emphasized that, in view of this association, vitamin D intervention studies are needed in Asian Indian women with prediabetes to evaluate if diabetes could be prevented
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