Vitamin D May Prolong ‘Honeymoon Phase’ of Type 1 Diabetes in Patients With Recent Diagnosis

Taking a high-dose vitamin D supplement may improve the function of insulin-producing beta cells in children and young adults who are newly diagnosed with type 1 diabetes (T1D), according to investigators at the Cohen Children’s Medical Center and The Feinstein Institutes for Medical Research at Northwell Health. Findings are published in JAMA Network Open.¹

Preserving the function of insulin-producing cells can extend the “honeymoon phase” of T1D, which can decrease risk of long-term diabetes-associated complications, said principal author Benjamin Nwosu, MD, chief of endocrinology and director of the diabetes center at Cohen Children’s and researcher with the Feinstein Institutes, in the press release.¹

T1D arises when beta cells in the pancreas stop making insulin, a hormone that transports blood sugar into the body’s cells for energy production.^1,2 When blood sugar can’t be transported, it builds up in the bloodstream and can significantly damage the body—this can be fatal for patients.²

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However, beta cells usually retain 30% to 50% of their function when a person is first diagnosed with T1D. They may produce insulin for years after diagnosis, so prolonging this partial remission (PR) phase can reduce long-term complications and improve blood glucose control.³

Investigators with Northwell Health conducted a post hoc secondary analysis of a single-center, double-blind, placebo-controlled, parallel-group randomized clinical trial to evaluate vitamin D supplementation for beta cell production in children aged 10 to 21 years.^1,3

When evaluating ergocalciferol—a form of vitamin D—against placebo, they observed that ergocalciferol decreased the ratio of proinsulin to C-peptide more than placebo (mean [SE], −0.0009 [0.0008] vs 0.0011 [0.0003]; P = .01). It also reduced the area under the curve of C-peptide, meaning it slowed the loss of C-peptide. C-peptide indicates that the body is producing insulin,⁴ and slower loss indicates that the body is still producing insulin.^1,3

“It is exciting to know that vitamin D could protect the β cells of the pancreas and increase the natural production of good and functional insulin in these patients,” said Nwosu in the press release.¹

Nwosu noted that managing the condition can be incredibly costly, and he will conduct future research on the development of more affordable and effective treatment options, according toCharles Schleien, MD, MBA, senior vice president and chair of pediatric services at Northwell Health, and the Philip Lanzkowsky Chair and Professor of Pediatrics at the Zucker School of Medicine at Hofstra/Northwell, in the press release.¹

“Repurposing commonly used supplements such as vitamin D, which is known to be safe and effective for other ailments, presents an opportunity to continue developing other therapies needed to treat T1D,” said Schleien and Lanzkowsky in the press release.

REFERENCES

1. Northwell Health Researcher Shows Vitamin D Could Improve Insulin-producing Cells in Children With Type 1 Diabetes. Northwell Health. News Release. March 5, 2024. Accessed on March 6, 2024. https://www.businesswire.com/news/home/20240305266724/en

2. Definition: Beta Cells. Nemours KidsHealth. https://kidshealth.org/en/parents/beta-cells.html#:~:text=Beta%20cells%20are%20cells%20that,mistakenly%20destroys%20the%20beta%20cells.

3. Nwosu BU, Parajuli S, Sharma RB, et al. Effect of Ergocalciferol on β-Cell Function in New-Onset Type 1 Diabetes. JAMA Netw Open. 2024;7(3):e241155. doi:10.1001/jamanetworkopen.2024.1155

4. Insulin C-peptide test. Mount Sinai. Reference. Accessed on March 6, 2024. https://www.mountsinai.org/health-library/tests/insulin-c-peptide-test#:~:text=C%2Dpeptide%20is%20a%20sign,would%20naturally%20be%20low%20then.