高剂量补充维生素D可以帮助防止糖尿病恶化 Vitamin D supplementation may slow diabetes progression

根据发表在《欧洲内分泌学杂志》上的一项研究,新诊断的患者和患有前驱糖尿病的患者,补充维生素D可能会减缓2型糖尿病的进展。 研究结果表明,高剂量补充维生素D可以改善糖代谢,以帮助防止糖尿病的发展和进展。

2型糖尿病是一种日益流行的疾病,对患者和社会造成巨大的负担,可导致严重的健康问题,包括神经损伤,失明和肾衰竭。 人们在高风险的发展2型糖尿病(前驱糖尿病)可以通过几个风险因素,包括肥胖或疾病的家族史来确定。 虽然低维生素D水平以前与发展2型糖尿病的风险增加有关,但一些研究报告没有改善代谢功能。 然而,这些经常有低数量的参与者或包括正常的维生素D水平的个人开始代谢健康,或有长期的2型糖尿病。 维生素D补充对糖尿病前期患者或新诊断的糖尿病患者(特别是低维生素D水平的患者)是否有任何有益的影响,仍然不确定。

在这项研究中,Claudia Gagnon博士和魁北克拉瓦尔大学的同事研究了维生素D补充剂对新诊断为2型糖尿病或确定为高发病风险的患者的葡萄糖代谢的影响。 胰岛素功能和葡萄糖代谢的标志物在高剂量维生素D补充剂(大约推荐剂量的5-10倍)的6个月之前和之后进行测量。 虽然只有46%的研究参与者在研究开始时确定具有低维生素D水平,但维生素D补充剂在六个月后显着改善了参与者肌肉组织中的胰岛素作用。

Claudia Gagnon博士评论说:”我们看到在高危糖尿病患者或新诊断的糖尿病患者中补充维生素D后,葡萄糖代谢改善的原因,而其他研究未能证明长期存在的2型糖尿病患者的效果尚不清楚。 这可能是由于代谢功能的改善在那些长期疾病中难以发现,或者需要更长的治疗时间才能看到好处。”

Gagnon博士建议未来的研究应该评估是否有个人临床或遗传因素影响不同的人对维生素D补充剂的反应,以及是否长期维持对代谢的积极影响。

Claudia Gagnon博士补充说:”2型糖尿病和前糖尿病是一个日益增长的公共卫生关注,虽然我们的结果是有希望的,但需要进一步的研究来证实我们的研究结果,以确定一些人是否可以从这一干预中受益更多,并评估长期高剂量维生素D补充剂的安全性。 在那之前我会建议当前维生素D补充建议被跟随。”

NEWS RELEASE 

Vitamin D supplementation may slow diabetes progression

Peer-reviewed, randomized controlled study, people

EUROPEAN SOCIETY OF ENDOCRINOLOGY

Vitamin D supplementation may slow the progression of type 2 diabetes in newly diagnosed patients and those with prediabetes, according to a study published in the European Journal of Endocrinology. The study findings suggest that high-dose supplementation of vitamin D can improve glucose metabolism to help prevent the development and progression of diabetes.

Type 2 diabetes is an increasingly prevalent disease that places a huge burden on patients and society and can lead to serious health problems including nerve damage, blindness and kidney failure. People at high risk of developing type 2 diabetes (prediabetes) can be identified by several risk factors including obesity or a family history of the disease. Although low vitamin D levels have previously been associated with an increased risk of developing type 2 diabetes, some studies have reported no improvement in metabolic function. However, these often had a low number of participants or included individuals with normal vitamin D levels at the start who were metabolically healthy, or who had long-standing type 2 diabetes. Whether vitamin D supplementation has any beneficial effect in patients with prediabetes or with newly diagnosed diabetes, especially in those who have low vitamin D levels, remains uncertain.

In this study, Dr Claudia Gagnon, and colleagues from Université Laval in Quebec, examined the effect of vitamin D supplementation on glucose metabolism in patients newly diagnosed with type 2 diabetes or identified as at high risk of developing the condition. Markers of insulin function and glucose metabolism were measured before and after six months of high-dose vitamin D supplementation (approximately 5-10 times the recommended dose). Although only 46% of study participants were determined to have low vitamin D levels at the start of the study, supplementation with vitamin D significantly improved the action of insulin in muscle tissue of participants after six months.

Dr Claudia Gagnon comments, “The reason we saw improvements in glucose metabolism following vitamin D supplementation in those at high risk of diabetes, or with newly diagnosed diabetes, while other studies failed to demonstrate an effect in people with long-standing type 2 diabetes is unclear. This could be due to the fact that improvements in metabolic function are harder to detect in those with longer-term disease or that a longer treatment time is needed to see the benefits.”

Dr Gagnon suggests future studies should evaluate whether there are individual clinical or genetic factors that affect how different people respond to vitamin D supplementation and if the positive effect on metabolism is maintained in the longer term.

Dr Claudia Gagnon adds, “Type 2 diabetes and prediabetes are a growing public health concern and although our results are promising, further studies are required to confirm our findings, to identify whether some people may benefit more from this intervention, and to evaluate the safety of high-dose vitamin D supplementation in the long term. Until then I would suggest that current vitamin D supplementation recommendations be followed.”

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