title: Differential effects of different vitamin D replacement strategies in patients with diabetes.
abstract: BACKGROUND
  The optimal treatment regimen for correcting vitamin D insufficiency in diabetic patients has not been established.
  
  
  METHODS
  Two hundred and forty four adult diabetic patients with vitamin D insufficiency were enrolled to receive: Ergocalciferol (D2) 50,000 IU daily over 10 days (500,000 IU) followed by Calcichew D3 (calcium carbonate/Cholecalciferol) BID (~24,000 IU cholecalciferol/month) (ECC) (n=53); Cholecalciferol (D3) 40,000 IU daily over 10 days (400,000 IU) followed by Calcichew D3 BID (~24,000 IU cholecalciferol/month) (CCC) (n=94) or Cholecalciferol 40,000 IU daily over 10 days (400,000 IU) followed by Cholecalciferol 40,000 IU monthly (CC) (n=97). The 25(OH)D, HbA1c, lipids, blood pressure and eGFR were assessed at baseline and after a mean follow up of 8.0±4.0 months.
  
  
  RESULTS
  Treatment increased 25(OH)D concentrations significantly in ECC (17.4±13.8 vs 29.9±9.6 ng/ml, P<0.0001), CCC (14.2±6.6 vs 30.9±13.1 ng/ml, p<0.0001) and CC (13.5±8.4 vs 33.9±14.4 ng/ml, P<0.0001). The relative increase in 25(OH)D was significantly lower with ECC compared to CC (+14.6±12.2 vs +20.6±15.0, P=0.01) and the majority of subjects in the ECC group (63%) remained vitamin D deficient (25(OH)D <30 ng/ml) compared to CCC (46%) and CC (36%) (P=0.0005).
  
  
  CONCLUSIONS
  This study demonstrates that relatively aggressive treatment regimens of both vitamin D2 and D3 increase 25(OH)D concentrations in diabetic patients, but the ability to raise 25(OH)D status to 'sufficient' levels is inadequate in a large proportion of individuals.
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK.
authors.forename: Uazman
authors.initials: U
authors.lastname: Alam
authors.affiliation: Barts and The London SMD, London, UK.
authors.forename: Agnes W S
authors.initials: AW
authors.lastname: Chan
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK.
authors.forename: April
authors.initials: A
authors.lastname: Buazon
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Van Zeller
authors.affiliation: Vitamin D Research Group, School of Biomedicine, University of Manchester, UK.
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Berry
authors.affiliation: Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, UK.
authors.forename: Ravinder S
authors.initials: RS
authors.lastname: Jugdey
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK.
authors.forename: Omar
authors.initials: O
authors.lastname: Asghar
authors.affiliation: Department of Diabetes and Nutritional Sciences, King's College and St Thomas' and Guy's Hospitals, UK.
authors.forename: John Kennedy
authors.initials: JK
authors.lastname: Cruickshank
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK.
authors.forename: Ioannis N
authors.initials: IN
authors.lastname: Petropoulos
authors.affiliation: Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Central Manchester University Hospitals Foundation Trust, Manchester, UK. Electronic address: rayaz.a.malik@manchester.ac.uk.
authors.forename: Rayaz A
authors.initials: RA
authors.lastname: Malik
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D048909:Diabetes Complications / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D014807:Vitamin D
keywords: Cholecalciferol; Diabetes; Ergocalciferol; Vitamin D