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Patterns of vitamin D testing and supplementation for children with inflammatory bowel disease in Australasia
Angharad Vernon-Roberts1, Andrew S Day1,
1Department of Paediatrics University of Otago Christchurch Christchurch New Zealand.
Insights
Optimal vitamin D levels benefit children with inflammatory bowel disease (IBD). Australasian pediatric gastroenterologists need standardized guidelines for vitamin D testing and supplementation in pediatric IBD care.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Nutritional Science
Background:
- Vitamin D plays crucial roles in immune function and has anti-inflammatory properties.
- Optimal vitamin D levels are linked to reduced disease activity, lower postoperative recurrence, and improved quality of life in pediatric inflammatory bowel disease (IBD).
- International guidelines for vitamin D management in IBD lack consistency.
Purpose of the Study:
- To survey Australasian pediatric gastroenterologists regarding their current practices for vitamin D testing and supplementation in children with IBD.
- To identify variations in testing frequency, supplementation protocols, and perceived benefits of vitamin D in pediatric IBD management.
Main Methods:
- An online survey was distributed to members of the Australian Society of Pediatric Gastroenterology, Hepatology and Nutrition.
- Respondents provided data on the frequency of vitamin D testing, supplementation strategies, adherence, and perceived benefits for children with IBD.
Main Results:
- Thirty-two pediatric gastroenterologists participated, with 90% testing vitamin D at diagnosis and follow-up, though frequency varied.
- While most recommended supplementation based on serum levels, inconsistent cutoff values were utilized.
- The majority perceived significant overall benefits of optimal vitamin D levels, with a notable portion also rating benefits to disease activity positively.
Conclusions:
- Standardized guidelines for vitamin D testing and supplementation are necessary for clinicians managing pediatric IBD in Australasia.
- Developing consensus statements can help optimize care for children with IBD across this region.
Background And Aim:
For children with inflammatory bowel disease (IBD), optimal levels of vitamin D are ascribed anti-inflammatory and essential immune system roles that are associated with reduced disease activity, lower postoperative recurrence, and higher quality of life. International guidelines for vitamin D testing and supplementation provide inconsistent recommendations. The aim of this study was to survey Australasian pediatric gastroenterologists to ascertain current practices of vitamin D testing and supplementation for children with IBD.
Methods:
Members of the Australian Society of Pediatric Gastroenterology, Hepatology and Nutrition were invited to complete an online survey. Respondents were asked to provide information on frequency of vitamin D testing and supplementation, adherence, and benefits of vitamin D to children with IBD.
Results:
Thirty-two (54%) pediatric gastroenterologists completed the survey: 27 (84%) from Australia and 5 (16%) from New Zealand. The majority (90%) tested vitamin D levels at diagnosis and follow up, although testing frequency varied (1-3 times/year) and only 8 (28%) tested seasonally. While 28 (88%) recommended supplementation based on serum levels, inconsistent cutoff values were used. Most respondents (n = 27) recommended Stoss (single dose) or vitamin D3 (daily for 8-12 weeks). The majority (84%) rated the overall benefit of optimal vitamin D levels at ≥6/10, although fewer (54%) rated the benefit to disease activity at ≥6/10.
Conclusions:
The results indicate that standardized guidelines for vitamin D testing and supplementation for clinicians caring for children with IBD throughout Australasia are required. Consensus statements may optimize the care of children with IBD in this diverse geographical region.
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