Joslin research finds nearly three-quarters of youths with diabetes insufficient in vitamin D

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Public release date: 15-Dec-2008

http://www.eurekalert.org/pub_releases/2008-12/jdc-jrf121508.php

Contact: Kira Jastive

kira.jastive@...

Joslin Diabetes Center

Joslin research finds nearly three-quarters of youths with diabetes

insufficient in vitamin D

Study urges supplementation to protect bones later in life

BOSTON – [Dec. 15, 2008] – Three-quarters of youths with type 1 diabetes

were found to have insufficient levels of vitamin D, according to a

study by researchers at the Joslin Diabetes Center – findings that

suggest children with the disease may need vitamin D supplementation to

prevent bone fragility later in life.

" To our surprise, we found extremely high rates of vitamin D

inadequacy, " said Lori Laffel, M.D., M.P.H., Chief of the Pediatric,

Adolescent and Young Adult Section at Joslin, Investigator in the

Section on Genetics and Epidemiology, and senior author of the paper.

" We didn't expect to find that only 24 percent of the study population

would have adequate levels. "

The study, which appears in the January 2009 issue of The Journal of

Pediatrics, measured levels of serum 25-hydroxyvitamin D in 128 youths

with type 1 diabetes ranging in age from 1.5 to 17.5 years. The study

sample included subjects with recent onset of diabetes as well as those

who had long-established diabetes.

It found 24 percent had sufficient levels, 61 percent with insufficient

levels and 15 percent to be deficient or having the lowest levels.

Generally, those with deficient levels were the oldest of the subjects.

In fact, 85 percent of the adolescents in the sample demonstrated

inadequate vitamin D levels.

The paper notes that diabetes itself can negatively impact bone health

and is associated with a modest reduction in bone mineral density and

strength and an increase in fracture risk among those middle-aged and

older. At the same time, vitamin D deficiency in infants and children is

associated with bone deformation, while less severe vitamin D

insufficiency prevents youths from attaining their optimal bone mass and

may contribute to increased fracture risk later in life, the paper adds.

For these reasons, vitamin D deficiency or insufficiency poses an

increased risk for children with diabetes, the paper says. In addition

to reduced sun exposure, diminished milk intake, substituted by intake

of sugar-free beverages among youth with diabetes, may account for

inadequate vitamin D levels.

" In addition to inadequate levels of vitamin D, adolescent patients with

type 1 diabetes potentially possess multiple risk factors for increased

skeletal fragility, " the paper notes.

The researchers were interested in looking at vitamin D levels because

of the vitamin's presumed role in immune modulation and because it is

thought to possibly play a role in the occurrence of type 1 diabetes.

In addition, there has been a rise in vitamin D deficiency among

children in general, mostly among those living in northern climates

where sun exposure is lowest, and also in association with the increased

use of sun block, recommended in efforts to prevent skin cancer.

Protection from over-exposure to sunlight through use of sunscreens

remains an important public health initiative, Laffel stressed.

" We need to make sure all youths in general are getting enough vitamin D

in their diets, " commented Britta Svoren, M.D., the primary author of

the paper and a member of Joslin's Pediatric, Adolescent and Young Adult

Section and the Section on Genetics and Epidemiololgy. " And, we need to

pay particular attention to those with diabetes as they appear to be at

an even higher risk of vitamin D deficiency. For children who are not

drinking sufficient amounts of vitamin D fortified milk, we are

encouraging them to take a vitamin D supplement of 400 IU daily. Many

cereals are fortified with vitamin D as well. "

###

The study was funded by the National Institutes of Health, the

H. Hood Foundation and a Pediatric Fellowship Grant from Eli Lilly and

Company.

Also contributing to the research were K. Volkening, M.A. and

R. Wood, M.D., both of Joslin.

About Joslin Diabetes Center

Joslin Diabetes Center is the world's preeminent diabetes research and

clinical care organization. Joslin is dedicated to ensuring people with

diabetes live long, healthy lives and offers real hope and progress

toward diabetes prevention and a cure for the disease. Founded in 1898

by Elliott P. Joslin, M.D., Joslin is an independent nonprofit

institution affiliated with Harvard Medical School. For more information

about Joslin, call 1-800-JOSLIN-1 or visit www.joslin.org.

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

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