ASSESSMENT OF VITAMIN D IN EGYPTIAN PATIENTS WITH TYPE 1 DIABETES MELLITUS

Objective: To study vitamin D status in patients with type 1 diabetes mellitus (T1DM) and to investigate any factors associated with vitamin D deficiency in these patients. Patients and Methods: This study included 130 patients with T1DM diagnosed according to American Diabetes Association (ADA) criteria, and 40 healthy non-diabetic. Age and sex matched subjects served as a control group. All participants were subjected to full history taking, thorough clinical examination and laboratory investigations including fasting and 2-hour postprandial plasma glucose, HbA1c, serum calcium, inorganic phosphorus, magnesium, total alkaline phosphatase, liver and kidney function tests, and urinary albumin to creatinine excretion ratio. Serum parathormone (PTH) and 25-hydoxyvitamin D levels were also measured. Results: Serum level of 25(OH) vit D (25-hydroxyvitamin D) was significantly lower in T1DM patients than controls (23.8 ± 13.4 vs 32.9 ± 15.7 ng/mL). Also, diabetics had significantly higher serum PTH than controls (54.7 ± 26.5 vs 41-9 ± 24.5 pg/mL). The association between vitamin D status and HbA1c was significant (P <0.05) with HbA1c levels of 7.9 ±2.2, 9.3±2.3, and 10.7±2.8 for categories of vitamin D sufficiency, insufficiency, and deficiency respectively. There were more cases with vitamin D deficiency and insufficiency amongst patients with diabetes-related complications, but the association was not significant (P >0.05). Conclusion: Vitamin D deficiency and insufficiency are common in T1DM and are associated with worse glycemic control. Therefore, assessment of vitamin D status in all patients with T1DM is recommended.