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D for Diabetes: For some young people, correcting vitamin D deficiencies may make diabetes less likely.

DIAGNOSIS OF obesity-related Type 2 diabetes among Americans under age 20 used to be rare. Today it is distressingly common, a consequence, say public health officials, of too many calories and too little exercise.

Most children and adolescents undergoing treatment for diabetes or pre-diabetes — a condition in which blood sugar, or A1c, levels are high enough to signal that diabetes is imminent — will be advised that lifestyle changes are a necessity. They will also be told that controlling insulin levels is imperative.

This typically means a prescription for metformin, the most widely prescribed diabetes treatment in the world. Recent findings by an MU investigation, however, suggest this course of treatment, particularly for young people at the pre-diabetes stage, may not be the end of the story.

Working with young patients at MU’s Adolescent Diabetic Obesity Program, Catherine Peterson, an associate professor of nutrition and exercise physiology, and her team sought to determine whether using supplements to boost levels of vitamin D, deficiencies of which have previously been associated with obesity and diabetes, might also have a positive effect on blood sugar levels.

Vitamin D helps maintain healthy bones, muscles and nerves. Our bodies obtain it through sunlight exposure, diet or supplements. While deficiencies are not uncommon, they can be particularly problematic for those with weight issues.

“What makes vitamin D insufficiency different in obese individuals is that they process vitamin D about half as efficiently as normal-weight people,” Peterson says. “The vitamin gets stored in their fat tissues, which keeps it from being processed. This means obese individuals need to take in about twice as much vitamin D as their lean peers to maintain sufficient levels.”

In the JR Albert Foundation-funded study, published in the April 2013 issue of the American Journal of Clinical Nutrition, Peterson and physician Aneesh Tosh of University Hospital’s Department of Child Health considered the cases of 35 obese, pre-diabetic children and adolescents. All had insufficient or deficient vitamin D levels, and each reported similar diets and activity levels. Study participants were randomly assigned either a high-dose vitamin D supplement or a placebo that they took daily. After six months the scientists tabulated the data. The result? Those who took the supplement became vitamin D sufficient and reduced the amount of insulin in their blood.

“By increasing vitamin D intake alone, we got a response that was nearly as powerful as what we have seen using a prescription drug,” says Peterson. “We saw a decrease in insulin levels, which means better glucose control, despite no changes in body weight, dietary intake or physical activity.”

Adding vitamin D supplements is a natural, inexpensive way to help obese children and teens decrease their odds of developing diabetes and avoid the side effects that might come from taking prescriptions, Peterson adds. She cautions, however, that parents and patients should not take her findings as an invitation to self-medicate. “The vitamin D dosage we gave to the obese adolescents in our study is not something I would recommend for everyone,” Peterson said. “For clinicians, the main message from this research is to check the vitamin D status of their obese patients, because they’re likely to have insufficient amounts. Adding vitamin D supplements to their diets may be an effective addition to treating obesity and its associated insulin resistance.”

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