Effect of vitamin D supplementation in type 2 diabetes patients with pulmonary tuberculosis.
OBJECTIVE
Diabetes and vitamin D deficiency are widely prevalent in India. Studies have proven correlation between low vitamin D levels and pulmonary tuberculosis (PTB) and low vitamin D levels and insulin resistance. We evaluated the effects of vitamin D supplementation on type 2 diabetes mellitus patients with pulmonary tuberculosis (PTB).


METHODS
Forty-five subjects (M:F=34:11) were screened. Inclusion criteria were age >15 years, newly diagnosed PTB cases with uncontrolled diabetes, serum vitamin D<20 ng/ml. The patients with vitamin D level<20 ng/ml were randomly assigned to 2 groups. Group 1 subjects received oral cholecalceferol (60,000 units/week) and calcium carbonate (1g/day) along with anti tubercular treatment (ATT), while group 2 subjects did not. Sputum was checked at interval of 2 weeks for 12 weeks. Primary end point was time to achieve sputum smear conversion.


RESULTS
Fifteen patients having vitamin D>20 ng/ml were excluded. Age of the patients was 42.9±13.2 years and serum vitamin D levels were 18.4±15.3 ng/ml. Sputum smear conversion was 6 weeks in group 1 versus 8 weeks in group 2 (p=0.067). Glycated hemoglobin levels reduced from 11.1±1.3 to 7.7±0.9 in group 1 versus 10.3±1.2 to 7.8±1.1 (p>0.1).


CONCLUSIONS
Vitamin D can serve as adjuvant treatment of tuberculosis in diabetics with vitamin D deficiency. Further studies are required to validate this observation and define a cut off for vitamin D level to prevent immunological alterations.
Department of Endocrinology, Medwin Hospitals, Hyderabad, Andhra Pradesh, India. hidocsunil@ibibo.com
Sunil Kumar
SK
Kota
Sruti
S
Jammula
Siva Krishna
SK
Kota
Prabhas Ranjan
PR
Tripathy
Sandip
S
Panda
Kirtikumar D
KD
Modi
D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D014807:Vitamin D