Therapeutic benefits of vitamin A for Type 1 Diabetics: A case of Gondar University Hospital Diabetic Center

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Date

2011

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Addis Ababa University

Abstract

The incidence of diabetes mellitus has soared to epidemic proportions worldwide. The debilitating chronic hyperglycemia is caused by either lack of insulin as in diabetes type 1 or its ineffectiveness as in diabetes type 2. Frequent replacement of insulin with or without insulin analogs for optimum glycemic control is the conventional cumbersome therapy. The quest to find a cure for diabetes has led scientists to think new therapeutic strategies like re-educating the immune system, β-cell transplantation and rejuvenating β-cells of the pancreas in an attempt to restore β-cell function and resume physiologic glucose homeostasis. There are in vitro and animal studies suggesting that Retinoic acid (Vitamin A) induces differentiation of pancreatic ductal epithelial cells to insulin secreting cells and also plays an immunomodulatory role in the progression of the autoimmune process in Type 1 diabetes. Moreover, majority of diabetic patients have Vitamin A deficiency. However, there was inadequate information regarding in vivo effects of retinoic acid in diabetic patients and hence the need for this study. This study was an interventional study on 24 Type 1 Diabetic patients attending the chronic illness clinic at Gondar University Hospital. The patients were randomly divided in to two groups; treatment and control. The treatment group received vitamin A supplementation in addition to the conventional insulin therapy where as the control group continued with their conventional insulin therapy alone. Both groups were followed for 6 weeks and treatment effect compared across them in terms of glycemic control, C-peptide levels and lipid profile over the treatment period and both groups were comparable with regard to Age, sex, BMI, duration of disease, dosage of insulin therapy and other baseline biochemical parameters. Results showed a remarkable clinical benefit in the vitamin A treated group with HbA1c levels of 6.7% versus 8.44% for the control group though it was not statistically significant(P = 0.165). Furthermore, the mean C-peptide level among the treated group was raised to 1.06ng/ml from a baseline level of 0.48ng/ml (a 55% increase in endogenous insulin secretion) indicating the potential therapeutic benefits of vitamin A supplementation in Type 1 diabetics and obviating the need for further research preferably using a bigger sample size and a well-designed clinical trial. Besides, Vitamin A could protect or delay the onset of diabetes in high risk groups.

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Keywords

Vitamin A , Type 1 Diabetes

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