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. 2017 May;6(4):225-231.
doi: 10.1530/EC-17-0045. Epub 2017 Apr 5.

A pilot interventional study to evaluate the impact of cholecalciferol treatment on HbA1c in type 1 diabetes (T1D)

R Perchard  1 , L Magee  1 , A Whatmore  1 , F Ivison  2 , P Murray  1   3 , A Stevens  1 , M Z Mughal  3 , S Ehtisham  3 , J Campbell  3 , S Ainsworth  3 , M Marshall  2 , M Bone  4 , I Doughty  4 , P E Clayton  5   3
Affiliations

A pilot interventional study to evaluate the impact of cholecalciferol treatment on HbA1c in type 1 diabetes (T1D)

R Perchard et al. Endocr Connect. 2017 May.

Abstract

Background: Higher 25(OH)D3 levels are associated with lower HbA1c, but there are limited UK interventional trials assessing the effect of cholecalciferol on HbA1c.

Aims: (1) To assess the baseline 25(OH)D3 status in a Manchester cohort of children with type 1 diabetes (T1D). (2) To determine the effect of cholecalciferol administration on HbA1c.

Methods: Children with T1D attending routine clinic appointments over three months in late winter/early spring had blood samples taken with consent. Participants with a 25(OH)D3 level <50 nmol/L were treated with a one-off cholecalciferol dose of 100,000 (2-10 years) or 160,000 (>10 years) units. HbA1c levels before and after treatment were recorded.

Results: Vitamin D levels were obtained from 51 children. 35 were Caucasian, 11 South Asian and 5 from other ethnic groups. 42 were vitamin D deficient, but 2 were excluded from the analysis. All South Asian children were vitamin D deficient, with mean 25(OH)D3 of 28 nmol/L. In Caucasians, there was a negative relationship between baseline 25(OH)D3 level and HbA1c (r = -0.484, P < 0.01). In treated participants, there was no significant difference in mean HbA1c at 3 months (t = 1.010, P = 0.328) or at 1 year (t = -1.173, P = 0.248) before and after treatment. One-way ANCOVA, controlling for age, gender, ethnicity, BMI and diabetes duration showed no difference in Δ HbA1c level.

Conclusion: We report important findings at baseline, but in children treated with a stat dose of cholecalciferol, there was no effect on HbA1c. Further studies with larger sample sizes and using maintenance therapy are required.

Keywords: HbA1c; bone; diabetes; paediatric endocrinology; vitamin D.

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Figures

Figure 1
Figure 1
Flow diagram to show the recruitment of patients with T1D from the clinic.
Figure 2
Figure 2
Changes in HbA1c levels over time after treatment with cholecalciferol.
See this image and copyright information in PMC

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