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 .
A pilot study of active vitamin D administration and insulin resistance in African American patients undergoing chronic hemodialysis.
OBJECTIVE Insulin resistance ( IR ) is associated with increased cardiovascular risk in multiple patient population s , including those undergoing chronic hemodialysis ( CHD ) . Active vitamin D deficiency has been proposed to play a role in the extent of IR observed in patients with CHD . We postulated that administration of paracalcitol , an active vitamin D medication , influences IR in patients with CHD . DESIGN AND METHODS This was a pilot r and omized controlled trial . Ten prevalent CHD patients receiving a stable dose of paracalcitol were recruited .  Paracalcitol was withheld for 8 weeks in all patients ( phase I ) . Parathyroid hormone levels were managed with the calcium-sensing receptor agonist cinacalcet . At week 8 , patients were r and omized to continue cinacalcet or to restart paracalcitol for 8 weeks ( phase II ) . The primary outcome was the change in IR measured by the glucose disposal rate ( GDR ) using hyperinsulinemic euglycemic clamp ( HEGC ) method . Secondary outcomes included changes in IR between groups in indirect indices of IR , biomarkers of inflammation , and adipokine levels . RESULTS The mean age was 49 years ( range , 46 - 57 years ) and 40 % of patients were women . There was no detectable change in the GDR at the end of phase I ( P = .7 ) when compared with baseline values . There was also no statistically significant difference in GDR between groups at the end of phase II ( P = .9 ) . No changes were observed in indirect indices of IR , adipokine levels , or biomarkers of inflammation in either phase . CONCLUSION The results of this pilot study suggest that withdrawal of paracalcitol over 8 to 16 weeks and replacement for 8 weeks after withdrawal does not influence IR measured by HEGC in patients receiving CHD
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 .