ROLE OF VITAMIN D ON HbA1c LEVEL, AS AN ADJUVANT TO ORAL HYPOGLYCAEMIC DRUGS IN TYPE 2 DIABETIC PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 53
Abstract
BACKGROUND The incidence of type 2 diabetes mellitus is increasing at an alarming rate both nationally and internationally with more than 1 million new cases diagnosed every year. Diabetes warrants intense lifestyle adaptations, polypharmacy and insulin centred regimens. Conventional oral antidiabetic medications are associated with hypoglycaemias. Besides insulin, treatment has been linked to poor compliance, weight gain and possibly adverse cardiovascular outcomes. (3) The role of vitamin D in the pathogenesis and prevention of diabetes has sparked widespread interest. Vitamin D receptors are present in both pancreatic beta-cells and immune cells. Beside its classical role as the major regulator for calcium absorption, vitamin D mediates the activity of β-cell calcium-dependent endopeptidases, promotes conversion of pro-insulin to insulin and increases insulin output. Objective of this study is to see the effect of vit D on HbA1c level, as an adjuvant to oral hypoglycaemic drugs (of any class) in type 2 diabetic patients. MATERIALS AND METHODS Sixty patients (previously known cases of type 2 DM) aged above 18 years, attending Medicine OPD of Rama Medical College Hospital & Research Centre, Kanpur, over a period of one year were included in the study. The eligible patients (N=60) based on inclusion and exclusion criteria were divided in two groups of 30 patients in each group: group A (control group) on oral hypoglycaemic drugs without vit D supplementation & group B (study group) on oral hypoglycaemic drugs with vit D supplementation. The patients were randomly selected and the vit D supplementation was given on the basis of physician’s direction and the dose of vit D (2000 IU orally) was fixed at the time of the inclusion in the study. Patients were then followed up for a period of 3 months. RESULTS On day 0, mean of fasting blood sugar levels in control group and in study group was 155.17 mg/dL + 9.07 mg/dL and 152.13 mg/dL + 3.45 mg/dL and mean of postprandial blood sugar levels in control group and in study group was 200.07 mg/dL + 12.69 mg/dL and 197.37 mg/dL + 5.40 mg/dL respectively (Table No. 1A) and on day 90, mean of fasting blood sugar levels in control group and in study group was 159.47 mg/dL + 8.90 mg/dL and 120.10 mg/dL + 21.99 mg/dL and mean of postprandial blood sugar levels in control group and in study group was 205.00 mg/dL + 12.09 mg/dL and 160.17 mg/dL + 22.43 mg/dL respectively (Table No. 1B) respectively. Mean HbA1c in control group on day 0 was 6.457 mg/dL + 0.778 mg/dL and on day 90 was 6.873 mg/dL + 0.699 mg/dL and in study group on day 0 was 6.403 mg/dL + 0.65 mg/dL and on day 90 was 5.61 mg/dL + 0.533 mg/dL (Table No. 2). The difference in mean of HbA1c level in both the groups was p <.001 which is highly significant, means that vitamin D therapy has had beneficial effect on the control of blood sugar in diabetic patients. CONCLUSION HbA1c level in patients included in the study was significantly better on day 90 as compared to day 0 & the blood sugar levels (both fasting and postprandial) were improved in the study group significantly
Authors and Affiliations
Shalini Gupta, Nilam Nigam, Sanjay Kumar Nigam, Sunil Kumar, Sugandha Garg
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