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
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
This is a list of supplementary files associated with this preprint. Click to download.
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.
Posted 31 Dec, 2020
On 15 Jan, 2021
On 09 Jan, 2021
Invitations sent on 06 Jan, 2021
On 25 Dec, 2020
On 25 Dec, 2020
On 25 Dec, 2020
On 22 Dec, 2020
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
Posted 31 Dec, 2020
On 15 Jan, 2021
On 09 Jan, 2021
Invitations sent on 06 Jan, 2021
On 25 Dec, 2020
On 25 Dec, 2020
On 25 Dec, 2020
On 22 Dec, 2020
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