P-490: Prevalence of vitamin d deficiency and its association with glycemic control and insulin requirements in children, adolescent and young adult with type 1 diabetes
A Nepal, B BhattaraiAbstract
Introduction
Vitamin D’s immunomodulatory effects have been linked to type 1 diabetes risk and glycemic control, but evidence from prospective studies and trials remains inconsistent. While observational data suggest associations between low vitamin D and poor metabolic outcomes, current guidelines do not recommend routine supplementation absent deficiency.
Objectives
To assess vitamin D deficiency prevalence and its association with glycemic control (HbA1c ≤7% good vs >7% poor) and insulin requirements (TDD, TDD/kg) in children, adolescents, and young adults with type 1 diabetes.
Methods
Cross-sectional analysis of children adolescent and young T1D was performed. Vitamin D was categorized as low (<20 ng/mL), insufficient (20-29 ng/mL), normal (≥30 ng/mL). Glycemic control: good (HbA1c ≤7%) vs poor (>7%). Descriptive analysis along with non- parametric statistics-Mann-Whitney U, Spearman ρ, Fisher’s exact was used for analysis.
Results
The mean age of the population was 15.1 ± 6.0 years; Age range: 2–25 years with 99 males, 98 females. Suboptimal Vitamin D levels were present in 33.5% of the cohort (10.7% Low; 22.8% Insufficiency). The mean HbA1c was 8.77 ± 2.38 with 67.3% of the cohort categorized as having poor control (> 7.0). No significant differences were observed in mean HbA1c (8.76 vs 8.77, p=0.770) or TDD/kg (0.90 vs 0.91 U/kg/day, p=0.684) between the normal and abnormal Vitamin D groups. Spearman correlation showed no significant relationship between Vitamin D concentration and HbA1c (rho=0.056, p=0.436) or insulin requirements (rho=-0.027, p=0.708). Abnormal Vitamin D although had higher odds of poor glycemic control, it was not statistically significantly (OR=1.29, p=0.509).
Conclusions
In this cohort, about one-third had suboptimal vitamin D levels. However, vitamin D status was not independently associated with glycemic control or insulin requirements. Although screening remains important for bone and overall metabolic health, it does not appear to be a major determinant of glycemic outcomes in this group.