Type 2 Diabetes Mellitus Clinical Trial
Official title:
Can Vitamin D Supplementation Prevent Type 2 Diabetes by Improving Insulin Sensitivity and Secretion in Overweight Humans?
The aim of this study is to determine whether vitamin D supplementation in overweight/obese
individuals with vitamin D deficiency can improve insulin secretion and/or insulin
resistance by decreasing subclinical inflammation.
Results of the present study may help to identify new strategies to prevent type 2 diabetes
in high-risk groups (i.e. overweight and obese individuals, and individuals with a strong
family history of diabetes).
Hypothesis: That increasing plasma 25(OH)D concentrations in healthy individuals at risk for
type 2 diabetes with low vitamin D levels through vitamin D supplementation, will improve
insulin sensitivity and also insulin secretion by reducing the underlying sub-clinical
chronic inflammation.
Aims: To establish whether 16-week vitamin D supplementation given to healthy individuals
with low vitamin D levels will:
1. improve insulin sensitivity (in vivo and tissue) and/or insulin secretory function
2. determine whether this relationship is mediated by a reduced chronic inflammation
Numerous studies documented that low vitamin D levels are a serious health risk. Despite the
sunny climate in Australia, low vitamin D status is becoming increasingly prevalent and
people with vitamin deficiency represent more than 30% of the healthy Australian population.
Although sun exposure can maintain good vitamin D levels, often sun exposure is limited as
people work long hours indoors, and use sunscreen or protective clothing to reduce skin
cancer risk when outdoors. Moreover, it is difficult to obtain sufficient vitamin D from
food alone; few foods are naturally rich in vitamin D and in Australia, few foods are
fortified.
While the importance of vitamin D for bone mineralization is well known, it is less clear
how vitamin D protects against type 2 diabetes and cardiovascular disease. Every day in
Australia around 275 adults develop diabetes and its prevalence continues to rise.
We are therefore arguing for a well-designed intervention trial to define the preventive
potential and physiological mechanisms of the effects of vitamin D supplementation. In
addition, we plan to explore the mechanisms underlying the relationship between vitamin D
deficiency and the risk for type 2 diabetes, via its influence on chronic inflammation. Our
clinical trial will focus on healthy adults with low vitamin D status and will examine the
effects on insulin sensitivity and secretion measured by 'gold standard' methodology when
vitamin D is restored to optimum levels. It is in particularly important to determine
whether vitamin D affects both or only one of these defects because there is evidence from
observational studies that there is a relationship between vitamin D levels and both insulin
sensitivity and secretion.
The proposed intervention study will potentially supply important evidence on how restoring
vitamin D levels may protect against type 2 diabetes. Such findings could have direct
relevance for novel approaches to diabetes prevention.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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