Medically reviewed by Anna Goldman, MD.
Recent research has found that giant doses of vitamin D could lengthen the “honeymoon phase” in children and young adults newly diagnosed with type 1 diabetes (T1D).
Published on March 5, 2024, by JAMA Network Open, the study suggests that this relatively inexpensive intervention could delay the necessity for each day insulin therapy.
“Type 1 diabetes affects tens of millions of individuals and treatment options can often be costly,” said Benjamin Nwosu, MD, chief of endocrinology at Northwell Health and principal writer of the paper. His study shines a light-weight on the potential advantages of vitamin D.
What’s the Honeymoon Phase?
The honeymoon phase describes the sometimes dramatic increase in an individual’s natural insulin production immediately after their diagnosis of type 1 diabetes, after starting each day insulin therapy.
While type 1 diabetes eventually destroys all or nearly all the beta cells — the cells liable for making insulin — this doesn’t occur immediately. Nwosu said that folks newly diagnosed with T1D still retain roughly 30 to 50 percent of beta cell function. Protecting and prolonging that beta cell function is the aim of many clinical trials and investigative therapies.
Vitamin D and T1D
While it isn’t discussed much in patient care, research has focused on vitamin D levels in T1D for a few years.
Past research has suggested that healthy vitamin D levels can improve many facets of diabetes management and progression:
Despite this abundance of research, health authorities have never formally concluded that higher doses of vitamin D must be beneficial to individuals with T1D.
“There’s a ‘vitamin D hypothesis’,” Nwosu explained to Diabetes Each day. “It suggests that the further you progress away from the equator, the upper the prevalence of autoimmune diseases like type 1 diabetes and rheumatoid arthritis are. Once you’re getting enough vitamin D from the sun, it protects you from a few of those autoimmune triggers. We all know vitamin D is an immunomodulator, anti-inflammatory, and helps the body produce functional insulin.”
Routine sun exposure for most individuals all over the world just isn’t enough to lift vitamin D levels to optimal levels. If you happen to’re not living in a tropical climate, or for those who spend relatively little time outdoors, getting more vitamin D through a complement could also be advisable. Nwosu added that supplementing with vitamin D2 or vitamin D3 is equally effective.
The Study: 50,000 IUs per Week
The study enrolled 48 participants between the ages of 10 and 21, all of whom had recently been diagnosed with type 1 diabetes. Researchers followed their progress for a whole yr.
The treated group took a weekly dose of fifty,000 IUs of vitamin D ergocalciferol (vitamin D2) orally for 2 months, then biweekly for 10 months. This amount was inside the range of typical recommendations for vitamin D supplementation. A Cleveland Clinic review (PDF) suggested that folks with demonstrated vitamin D deficiency could take as much as 5,000 IUs per day, and that maintenance doses should start at 2,000 IUs per day.
One other group took a placebo.
Participants underwent glucose tolerance tests before and after the 12 months to check three aspects:
- C-peptide: an amino acid that indicates insulin production levels
- Fasting glucose levels: your blood glucose level within the morning before eating
- Proinsulin: a substance produced by the pancreas that’s converted to insulin
The outcomes revealed that participants receiving vitamin D saw an improved ratio of proinsulin to C-peptide, suggesting increased insulin production. It also delayed the lack of C-peptide, concluding that vitamin D protected the insulin-producing beta cells.
Nwosu conducted past research on the security of taking high doses of vitamin D, all with a transparent conclusion: Vitamin D toxicity isn’t as likely as we’ve been told.
“Our research in 2021 and 2022 showed that even with these high doses of vitamin D, participants’ peak levels didn’t even pass 40 ng/mL,” explained Nwosu, adding that ideal ranges are between 30 to 60 ng/mL. “We monitored participants’ vitamin D levels very closely, however the body has a way of taking what it needs and converting the remaining into inert products.”
Should You Take Vitamin D if You Have T1D?
Nwosu’s evidence suggests that folks with newly diagnosed T1D should consider taking a vitamin D complement. We asked the researcher if he’d go even further: Should everyone with type 1 diabetes be taking vitamin D?
“Yes,” said Nwosu. “Any child or adult newly diagnosed or with longstanding type 1 diabetes can complement with vitamin D. If you happen to get your levels tested and your vitamin D is below 30 ng/mL, it is best to start supplementing. If you happen to’re above 30 ng/mL, you almost certainly don’t must.”
Even in those with longstanding T1D, Nwosu said, vitamin D supplementation could probably still improve glucose metabolism and inflammation.
It’s essential to notice that vitamin D supplementation has not been broadly adopted or emphasized by the diabetes medical field. Nwosu maintains that other past studies that found minimal advantages for vitamin D supplementation weren’t as rigorous as his research.
“All studies are usually not the identical. We used standardized insulin protocols while most studies don’t track proinsulin in any respect. This was also a randomized control study, which most studies are usually not. There are various reasons a study’s results might be negative — you will have to do it thoroughly to get reliable results.”
Nwosu hopes vitamin D supplementation also gains more consideration as a treatment for stopping or delaying T1D.
“It’s exciting to know that vitamin D could protect the beta cells of the pancreas and increase the natural production of fine and functional insulin in these patients. I see vitamin D as a really special molecule that may accomplish that way more than we’ve even been in a position to study yet,” said Nwosu. “If vitamin D can protect your beta cells after you’ve been diagnosed, it should give you the chance to assist before the time of diagnosis, too.”