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- Title
The association between ketoacidosis and 25(OH)-vitamin D<sub>3</sub> levels at presentation in children with type 1 diabetes mellitus.
- Authors
Huynh, Tony; Greer, Ristan M; Nyunt, Ohn; Bowling, Francis; Cowley, David; Leong, Gary M; Cotterill, Andrew M; Harris, Mark
- Abstract
Background: There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus (T1DM). Vitamin D deficiency is also associated with impairment of insulin synthesis and secretion. There have been no formal studies looking at the relationship between 25(OH)-vitamin D3 and the severity of diabetic ketoacidosis (DKA) in children at presentation with T1DM. Objective: To determine the relationship between measured 25(OH)-vitamin D3 levels and the degree of acidosis in children at diagnosis with T1DM. Subjects: Children presenting with new-onset T1DM at a tertiary children’s hospital. Methods: 25(OH)-vitamin D3 and bicarbonate levels were measured in children at presentation with newly diagnosed T1DM. Those with suboptimal 25(OH)-vitamin D3 levels (<50 nmol/L) had repeat measurements performed without interim vitamin D supplementation. Results: Fourteen of the 64 children had low 25(OH)-vitamin D3 levels at presentation, and 12 of these had low bicarbonate levels (<18 mmol/L) (p = 0.001). Bicarbonate explained 20% of the variation in vitamin D level at presentation (partial r2 = 0.20, p < 0.001) and ethnic background a further 10% (partial r2 = 0.10, p = 0.002). The levels of 25(OH)-vitamin D3 increased in 10 of the 11 children with resolution of the acidosis. Conclusions: Acid–base status should be considered when interpreting 25(OH)-vitamin D3 levels in patients with recently diagnosed T1DM. Acidosis may alter vitamin D metabolism, or alternatively, low vitamin D may contribute to a child’s risk of presenting with DKA.
- Subjects
VITAMIN D deficiency; INSULIN synthesis; DIABETIC acidosis; DIABETES in children; JUVENILE diseases; DIAGNOSIS of diabetes; SECRETION
- Publication
Pediatric Diabetes, 2009, Vol 10, Issue 1, p38
- ISSN
1399-543X
- Publication type
Article
- DOI
10.1111/j.1399-5448.2008.00439.x