The Role of Vitamin D in Children with Type 1 Diabetes

The relevance of studying type 1 diabetes mellitus (DM1) as a multifactorial disease is of general interest not only to endocrinologists, but also to all specialists in the field of pediatrics. In type 1 diabetes, environmental factors and genetic predisposition interact, inducing an autoimmune response against pancreatic β-cells. Moreover, vitamin D promotes the development of immune tolerance through immunomodulatory and anti-inflammatory functions. The aim of the study was to evaluate the vitamin D status and its role in children with type 1 diabetes using data from the National Center for Maternal and Child Health. A prospective cohort study of 89 children with type 1 diabetes was conducted. Statistical processing of the materials was performed using SPSS 23.0 software. The arithmetic mean (M) and standard error of the mean (m) were determined. Vitamin D deficiency was found in 29.8% and insufficiency in 8.0% of children with type 1 diabetes. The concentration of 25(OH)D in the blood of children with vitamin D deficiency (n=7) was 14.56±1.17 ng/ml, while in those with insufficiency (n=26) it was 25.83±0.56 ng/ml. The 25(OH)D level in the blood of 62.2% of children was 40.18±0.99 ng/ml. Statistically significant differences were found between the 25(OH)D levels at the reference level and in children with vitamin D deficiency (t=-16.65; p<0.001). Differences in blood 25(OH)D levels between the groups with and without vitamin D deficiency were also statistically significant (t=-12.54; p<0.001). The Cohen's d effect size of 2.91 indicates a significant difference between the groups. Patients with vitamin D deficiency had a more severe course of type 1 diabetes, with a high rate of decompensation (25%), poor glycemic control (75%), and impaired physical development. Vitamin D metabolism disorders were observed in 37.8% of children with type 1 diabetes. The results of our study suggest that vitamin D deficiency and insufficiency may contribute to the development and complicated course of type 1 diabetes, which warrants further research.