Conclusions Short-term ( 4–12 weeks ) supplementation with vitamin D is associated with lower fasting glucose levels in ESRD with no change in fasting insulin levels .
Abstract Purpose We tested whether short-term vitamin D supplementation improves insulin resistance in patients with kidney disease , a condition with little intrinsic vitamin D activity .
Intravenous 1,25 dihydroxycholecalciferol corrects glucose intolerance in hemodialysis patients.
The effects of intravenous 1,25 dihydroxycholecalciferol [ (OH)2D3 ] on glucose tolerance and insulin secretion were studied in eleven uremic patients on regular hemodialysis and compared with eleven healthy controls . Intravenous glucose tolerance tests ( IVGTT ) were used to assess glucose tolerance , and the hyperglycemic clamp technique was used to quantitate endogenous insulin secretion . Three days after they had discontinued oral 1,25(OH)2D3 , the dialysis patients were then studied with ( + D ) and without ( -D ) a single intravenous dose of 1,25(OH)2D3 at 2 micrograms/m2 , given two hours before the IVGTT or clamp studies . During the -D studies , the uremic patients were glucose intolerant but not hyperinsulinemic . Intravenous 1,25(OH)2D3 in dialysis patients increased glucose uptake ( K values ) during IVGTT by 38 % ( P less than 0.02 ) and increased early component of insulin secretion during hyperglycemic clamps by 48 % ( P less than 0.01 ) and the late component by 32 % ( P less than 0.01 ) . After intravenous 1,25(OH)2D3 , the dialysis patients became hyperinsulinemic and regained glucose tolerance . Intravenous 1,25(OH)2D3 did not change the K values during IVGTT nor the insulin secretion during hyperglycemic clamps in the control subjects . During the -D studies , serum concentrations of 1,25(OH)2D3 were significantly lower in uremic patients compared with controls . Serum 1,25(OH)2D3 during the + D studies increased to supraphysiological levels in both uremic patients and controls . Serum concentrations of intact parathyroid hormone , total and ionized calcium , magnesium , potassium , urea nitrogen and creatinine were not different between the + D and -D studies in neither the uremic patients nor the controls . These results suggest that 1,25(OH)2D3 deficiency , independent of parathyroid hormone and calcium , may contribute to the abnormalities in glucose tolerance and insulin secretion in dialysis patients
Conclusions Short-term ( 4–12 weeks ) supplementation with vitamin D is associated with lower fasting glucose levels in ESRD with no change in fasting insulin levels .
Abstract Purpose We tested whether short-term vitamin D supplementation improves insulin resistance in patients with kidney disease , a condition with little intrinsic vitamin D activity .