Impacto da suplementação de vitamina D em adultos com diabetes Mellitus tipo 2.

Abstract

The relationship between diabetes mellitus, its complications and vitamin D deficiency has been shown to be increasingly evident in several recent studies. However, many of these studies are observational and the few intervention studies have short duration or utilize small dosages which turns it difficult to define a causal relationship between these factors. This study aims to evaluate the influence of vitamin D replacement on glycemic control and diabetic complications. Type 2 diabetic patients deficient in vitamin D [25 (OH) vitamin D below 30 ng / ml] were evaluated and randomized in a double-blind fashion concerning to replacement of vitamin D into two groups: group 1 (n = 20) and group 2 (n = 13) that were crossed in the middle of the study. In addition to levels of 25 (OH) vitamin D, plasma concentrations of calcium, phosphorus, magnesium, glycated hemoglobin, fasting glucose, fasting insulin, C-peptide, ultrasensitive PCR, lipid profile and plasma creatinine, along with the albumin / creatinine ratio in spot urine sample were analyzed and calculated HOMA-IR and beta indexes (Homeostasis Model Assessment - Insulin resistance and beta) to determine the degree of insulin resistance and secretion, respectively. The neuropathy was assessed by Neuropathy Symptom Score. Such markers were measured at baseline and after 3 and 6 months of follow-up. At 3 months of follow-up patients had intervention changed (vitamin D3 to placebo and vice versa) featuring a cross-over clinical trial. After data collection and statistical analysis correcting for the intervening sequence or carry-over effect, was observed that none of the variables suffered statistically significant interference by the intervention, including 25-hydroxyvitamin D itself, demonstrating that replacement of vitamin D3 in a dose of 5000 IU per day for three months are not able to lead to changes in the concentration of 25- hydroxyvitamin D, glycemic control parameters, systemic inflammation, lipid profile, the renal function parameters, in albuminuria and Neuropathy Symptom Score. It raises issues about the ideal and proper dosage of vitamin D3 to bring forth a real increase in concentrations of 25-hydroxyvitamin D and thus influence glycemic control nephropathy and neuropathy in type 2 diabetic patients.