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Research article
Effect of Vitamin D3 Supplementation Combined with Exercise Training on Glycemic Control and Bone Health in Patients with Type 2 Diabetes: A Randomized, Placebo-Controlled Trial
Xiaomin Sun
Xi'an Jiaotong University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6473-6311
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aims
This study aimed to examine the effect of a 12-week vitamin D supplementation and exercise training alone and in combination on glycemic control and bone health in Chinese type 2 diabetes patients.
Methods
Sixty-one type 2 diabetes patients (age, 33–65 years; 72.0% men) with non-insulin dependence were randomized into the 12-week vitamin D group (1000 IU/day), exercise group (60%–80% of maximal heart rate, 1 h/time, 2–3 times/week), vitamin D combined with exercise group, and control group. A 75-g oral glucose tolerance test was used to estimate glycemic control. Dual X-ray absorptiometry was used to examine bone health (bone mass content and bone mass density) and body fat percentage (%).
Results
During the 75-g oral glucose tolerance test, lower glucose and higher insulin levels were found in the vitamin D combined with exercise group, vitamin D group, and exercise group after intervention than before intervention, although the differences were not statistically significant. A significant exercise and vitamin D interaction for the insulinogenic index (P = 0.032) and a borderline interaction for the glucose disposition index (P = 0.051) were observed, while no further independent effect was observed. Compared with non-vitamin D supplementation, vitamin D supplementation significantly alleviated the loss of total bone mass content (95% CI: -29.9–19.4 vs. -74.9–-24.7), trunk bone mass content (95% CI: -24.1–19.5 vs. -56.1–-11.7), and spine bone mass density (95% CI: -0.03–0.03 vs. -0.07–-0.01).
Conclusions
The findings suggest that 12-week combined vitamin D and exercise intervention has a potentially positive effect on glycemic control, and vitamin D supplementation plays an important role in the prevention of bone loss, which was identified in the exercise alone group. Further studies are needed to elucidate the long-term effect of combined vitamin D and exercise intervention in type 2 diabetes patients.
The study was registered in the Chinese Clinical Trial System (No. ChiCTR1800015383).
Keywords
bone mass, diabetes, exercise training, glycemic control, vitamin D supplementation
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Supplemental figure 1 Blood glucose and insulin during oral glucose tolerance test according to treatment group before and after the intervention in 55 T2DM patients# The values are expressed as means of blood glucose and insulin at 30min, 60min, 90min, and 120min during OGTT. #, VEG, n=15; VDG, n=13; EG, n=14; CG, n=13. *, P<0.05 compared with the values at the same time points using paired-t test.
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CURRENT STATUS: Under Review
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On 15 Jan, 2021
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On 09 Jan, 2021
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This preprint is under consideration at Journal of the International Society of Sports Nutrition. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Effect of Vitamin D3 Supplementation Combined with Exercise Training on Glycemic Control and Bone Health in Patients with Type 2 Diabetes: A Randomized, Placebo-Controlled Trial
Xiaomin Sun
Xi'an Jiaotong University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6473-6311
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 31 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 15 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Reviewers invited
Invitations sent on 06 Jan, 2021
Editor assigned
On 25 Dec, 2020
Submission checks complete
On 25 Dec, 2020
Editor invited
On 25 Dec, 2020
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nutrition & Dietetics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aims
This study aimed to examine the effect of a 12-week vitamin D supplementation and exercise training alone and in combination on glycemic control and bone health in Chinese type 2 diabetes patients.
Methods
Sixty-one type 2 diabetes patients (age, 33–65 years; 72.0% men) with non-insulin dependence were randomized into the 12-week vitamin D group (1000 IU/day), exercise group (60%–80% of maximal heart rate, 1 h/time, 2–3 times/week), vitamin D combined with exercise group, and control group. A 75-g oral glucose tolerance test was used to estimate glycemic control. Dual X-ray absorptiometry was used to examine bone health (bone mass content and bone mass density) and body fat percentage (%).
Results
During the 75-g oral glucose tolerance test, lower glucose and higher insulin levels were found in the vitamin D combined with exercise group, vitamin D group, and exercise group after intervention than before intervention, although the differences were not statistically significant. A significant exercise and vitamin D interaction for the insulinogenic index (P = 0.032) and a borderline interaction for the glucose disposition index (P = 0.051) were observed, while no further independent effect was observed. Compared with non-vitamin D supplementation, vitamin D supplementation significantly alleviated the loss of total bone mass content (95% CI: -29.9–19.4 vs. -74.9–-24.7), trunk bone mass content (95% CI: -24.1–19.5 vs. -56.1–-11.7), and spine bone mass density (95% CI: -0.03–0.03 vs. -0.07–-0.01).
Conclusions
The findings suggest that 12-week combined vitamin D and exercise intervention has a potentially positive effect on glycemic control, and vitamin D supplementation plays an important role in the prevention of bone loss, which was identified in the exercise alone group. Further studies are needed to elucidate the long-term effect of combined vitamin D and exercise intervention in type 2 diabetes patients.
The study was registered in the Chinese Clinical Trial System (No. ChiCTR1800015383).
Figure 1
Figure 2
Figure 3
Figure 4