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Effect of 1,25 (OH)2D3 treatment on glucose intolerance in uraemia
1Department of Nephrology, University Hospital, Selçuk University Faculty of Medicine, Konya, Turkey.
Insights
Calcitriol treatment improved glucose intolerance in patients undergoing hemodialysis. This vitamin D therapy enhanced insulin secretion and lowered blood glucose levels, indicating potential benefits for managing diabetes in uremia.
Area of Science:
- Nephrology
- Endocrinology
- Metabolic Disorders
Background:
- Uremia is associated with glucose intolerance and impaired vitamin D metabolism.
- Patients on hemodialysis often exhibit dysregulation of glucose homeostasis.
- Vitamin D deficiency is common in chronic kidney disease patients.
Purpose of the Study:
- To investigate the impact of calcitriol on glucose metabolism in uremic patients undergoing hemodialysis.
- To assess changes in serum glucose, insulin, HbA1c, and fructosamine levels following calcitriol administration.
- To evaluate the effect of calcitriol on pancreatic beta-cell function in the context of uremia.
Main Methods:
- A randomized controlled trial involving 31 hemodialysis patients and 12 healthy controls.
- Uremic patients were assigned to receive either oral calcitriol (0.5 micrograms/day) or placebo for 8 weeks.
- Measurements included serum glucose, insulin, calcium, parathormone (PTH), 1,25(OH)2D3, HbA1c, and fructosamine before and after treatment, along with an oral glucose tolerance test.
Main Results:
- Calcitriol treatment significantly increased baseline and post-glucose load serum insulin levels.
- A significant reduction in blood glucose, HbA1c, and fructosamine was observed in the calcitriol group.
- No significant changes in measured parameters were noted in the placebo or healthy control groups.
Conclusions:
- Calcitriol administration appears to enhance pancreatic beta-cell secretion in uremic patients.
- Vitamin D supplementation with calcitriol may improve glucose intolerance in hemodialysis patients.
- These findings suggest a role for calcitriol in managing glucose metabolism disturbances associated with chronic kidney disease.
Abstract:
The aim of this study was to evaluate the effect of calcitriol treatment on glucose intolerance in uraemia. Thirty one patients on haemodialysis who had never been treated with vitamin D or related drugs, and 12 healthy control subjects with normal renal functions were studied. Uraemic patients were randomly divided into two groups; 16 patients were treated with oral calcitriol (0.5 micrograms/day) for 8 weeks, and 15 uraemic patients and 12 healthy subjects were given a placebo. In all these cases, before and 8 weeks after treatment, baseline serum glucose, insulin, calcium, parathormone (PTH), and 1,25 (OH)2D3 were measured. After an oral load of 75 g glucose, blood glucose and insulin were determined at 30, 60, 90, and 120 min. The same measurements were repeated after 8 weeks. HbA1c and fructosamine were also measured at 0 and 8 weeks. Baseline serum insulin was significantly elevated after calcitriol treatment (7.81 versus 11.63 microIU/ml) there was also a significant increase in insulin following calcitriol treatment at 30, 60, 90, and 120 min. On the other hand, glycosylated haemoglobin (HbA1c) and fructosamine decreased after calcitriol treatment (HbA1c 7.09% versus 5.22% P < 0.01 and fructosamine 2.92 versus 2.50 mmol/l P < 0.01). Blood glucose significantly decreased after calcitriol treatment at 0, 30, 60, 90, and 120 min. In the other two groups there were no significant changes in any parameters. These results seem to confirm that vitamin D influences pancreatic beta (beta) cell secretion and suggest that calcitriol may improve glucose intolerance in uraemic haemodialysis patients.(ABSTRACT TRUNCATED AT 250 WORDS)