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Title: Vitamin D status in youth with type 1 and type 2 diabetes enrolled in the Pediatric Diabetes Consortium (PDC) is not worse than in youth without diabetes

Author
item WOOD, JAMIE - Children'S Hospital Los Angeles
item CONNOR, CRYSTAL - Jaeb Center For Health Research
item CHENG, PEIYAO - Jaeb Center For Health Research
item RUEDY, KATRINA - Jaeb Center For Health Research
item TAMBORLANE, WILLIAM - Yale University
item KLINGENSMITH, GEORGEANNA - University Of Colorado
item SCHATZ, DESMOND - University Of Florida
item GREGG, BRIGID - University Of Michigan
item CENGIZ, EDA - Yale University
item WILLI, STEVEN - University Of Pennsylvania
item BACHA, FIDA - Children'S Nutrition Research Center (CNRC)
item BECK, ROY - Jaeb Center For Health Research

Submitted to: Pediatric Diabetes
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/23/2015
Publication Date: 11/26/2015
Citation: Wood, J.R., Connor, C.G., Cheng, P., Ruedy, K.J., Tamborlane, W.V., Klingensmith, G., Schatz, D., Gregg, B., Cengiz, E., Willi, S., Bacha, F., Beck, R.W. 2015. Vitamin D status in youth with type 1 and type 2 diabetes enrolled in the Pediatric Diabetes Consortium (PDC) is not worse than in youth without diabetes. Pediatric Diabetes. doi:10.1111/pedi.12340.

Interpretive Summary: The prevalence of vitamin D deficiency in children with type 1 and type 2 diabetes is not well known. We compared the prevalence of vitamin D deficiency/insufficiency in children with diabetes enrolled in the Pediatric Diabetes Consortium (PDC) Consortium to that in a national database of children without diabetes from the National Health and Nutrition Examination (NHANES) Survey. We found that about a third (34%) of children with diabetes had vitamin D insufficiency; another third (36%) had vitamin D deficiency. These rates were similar to those in children without diabetes from NHANES. Vitamin D deficiency was highest in African-American children, intermediate in Hispanics and lowest in Non-Hispanic Whites. More studies are needed to understand the effects of vitamin D deficiency and whether supplementation of vitamin D would be beneficial in children with diabetes.

Technical Abstract: To describe vitamin D levels and prevalence of vitamin D sufficiency, insufficiency and deficiency in a large, ethnically/racially diverse population of youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) in comparison to national data and examine the associations between clinical/demographic factors and vitamin D levels. 25-hydroxy vitamin D (25OHD) levels were measured in 215 youth with T1D and 326 youth with T2D enrolled in the Pediatric Diabetes Consortium (PDC). These levels were compared with those of youth of the same age without diabetes from the 2005-2006 NHANES Survey. Vitamin D deficiency (<21 ng/mL) was present in 36% of PDC participants, and insufficiency (21-29 ng/mL) was present in an additional 34%. About 36% of age-matched youth in the NHANES Survey were vitamin D deficient and an additional 41% were insufficient. Deficiency or insufficiency varied by race/ethnicity, being highest in African-Americans (86%), intermediate in Hispanics (77%), and lowest in non-Hispanic whites (47%). Lower 25OHD levels were observed in African-American and Hispanic youth, during fall and winter, and at sites in the northern United States (all p-values < 0.001). Youth with T2D had significantly lower 25OHD levels than youth with T1D (p < 0.001), but this difference was largely eliminated after adjusting for race/ethnicity and socio-economic status. Vitamin D deficiency/insufficiency is present in a substantial proportion of youth with diabetes, particularly minorities, but the prevalence appears similar to that in youth without diabetes. Further studies are needed to examine whether youth with diabetes would benefit from vitamin D supplementation.