S A Karina, P Winra, S A Nindia


Diabetes mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia due to defect from insulin secretion, insulin action, or both. Despite intensive diabetes management, less than a fifth of diabetic patients achieve the recommended HbA1c target. This cohort prospective design study was conducted in the pediatric endocrinology division of Haji Adam Malik Hospital Medan from March- October 2019.  A total of 14 children were enrolled in this study. This study result showed increase of  25(OH)D level from 18.6±5.6ng/mL to 27.3±5.9ng/mL (p=0.00) and decrease of HbA1c level from 9.8%±1.9 to 7,0%±1.1 (p=0.00). This study found a negative correlation between the HbA1c value and 25(OH)D level (r-0.83;p=0.00). The management of DM with standard medication plus vitamin D supplementation showed a satisfactory result and is expected to become a routine recommendation in the management of children with DM.


diabetes mellitus, children, HbA1c, vitamin D

Full Text:



Rewers, M., Pillay, K., Beafort, C., Craig, M.E., Hanas, R., Acerini, C.L., Maahs, D.M. (2014), “Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD clinical practice consensus guidelines 2014 compendium.” Pediatr Diabetes,15,102-4.

Lachin, J.M., Genuth, S., Nathan, D.M., Zinman, B., Rutledge, B.N. (2008), “Effect of glycemic exposure on the risk of microvascular complications in the Diabetes control and complications trial--revisited.” Diabetes,57, 995–1001.

Watts, W., Lamabadusuriya, H., Edge, J. (2014), “Targeting glycaemic control in children and young people with type 1 diabetes: getting it right from day one.” Diabetes Care for Children and Young People,3;1-7.

Poh, B.K., Rojroongwasinkul, N., Nguyen, B.K., Sandjaja, Ruzita, A.T., Yamborisut U, et al. (2016), “25-hydroxy-vitamin D demography and the risk of vitamin D insuffiency in the South East Asian Nutrition Surveys (SEANUTS).” Asia Pac Clin Nutr,25,538-48.

Nair, R., Maseeh, A. (2012), “Vitamin D: The “sunshine” vitamin.” J Pharmacol Pharmacother,3,118-26.

John, A.N., Jiang, F.X. (2017), “An overview of type 2 diabetes and importance of vitamin D3-vitamin D receptor interaction in pancreatic β-cells.” J Diabetes its Complication,1-53.

Wang, Y., He, D., Ni, C., Zhou, H., Wu, S., Xue, Z., et al. (2016), “Vitamin D inuced autophagy of pancreatic β-cells and enhances insulin secretion.” Mol Med Reports,14,2644-50.

Gao, J., Xiao, Z., Xue, X., Liu, X., Lu, Y., Yin, X., et al. (2003), “25-hydroxyvitamin D is closely related with the function of the pancretic islet β cells.” J Med Sci,29,809-13.

Wulandari, D., Cahyono, H.A., Widjajanto, E., Puryatni, A. (2014), “Low levels of vitamin D correlate with hemoglobin A1c and interleukin-10 levels in pediatric type 1 diabetes mellitus patients.” J Tropical Life Sci,4,182-6.

Dehkordi, E.H., Dehkordi, V.H., Fatemi, S.M., Zolfaghari, M. (2018), “Effect of vitamin D supplement therapy on HbA1c and IGF-1 levels in children with type 1 diabetes mellitus and vitamin D deficiency.” Electron J Gen Med,15;69-75.

George, P.S., Pearson, E.R., Witham, M.D. (2012), “Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis.” Diabetes Med,29:e142-50.

Hutchinson, M.S., Figenschau, Y., Njølstad, I., Schirmer, H., Jorde, R. (2011), “Serum 25-hydroxyvitamin D levels are inversely associated with glycated haemoglobin (HbA1c). The Tromsø Study.” Scand J Clin Lab Invest,71(5),399-406.

Sharma, S., Biswal, N., Bethou, A., Rajappa, M., Kumar, S., Vinayagam, V. (2017), “Does vitamin D supplementatin improve glycemic control in children with type 1 diabetes mellitus? A randomized controlled trial.” J Clin Diagnostic Res,11;15-8.

Madar, A.A., Kirsten, V.K., Stene, L.C., Brekke, M., Meyer, H.M., Lagerlev, P. (2014) “Effect of vitamin D3 supplementation on glycated hemoglobin (HbA1), fructosamine, serum lipids, and body mass index: a randomized, double-blinded, placebo-controlled trial among health immigrants living in Norway.” BMJ Open Diabetes Res Care, l2,1-9.

Rustama, D.S., Yati, N.P., Andriana, N., Pulungan, A.B. (2018), “Diabetes Melitus. In: Buku Ajar Endokrinologi Anak. Editor Batubara JR, Tridjaja B, Pulungan AB. Edisi ke-2.” IDAI:Jakarta. Pp.146-7.

Lubis, S.M., Julia, M., Soesanti, F. (2018), “Diabetes melitus tipe 2. Dalam Buku Ajar Endokrinologi Anak. Editor Batubara JR, Tridjaja B, Pulungan AB. Edisi ke-2.” IDAI: Jakarta, Pp. 156

Ludvigsson, J., Carlsson, A., Forsander, G., Ivarsson, S., Kockum, I., Lernmark, A., et al. (2012), “C-peptide in the classification of diabetes in children and adolescents.” Pediatr Diabetes,13, 45–50.

NICE. 2019. Blood glucose control in children and young people with type 1 diabetes. Diabetes Care for Children and Young People, pp1-11.

Mayer-Davis, E.J., Kahkoska, A.R., Jefferies, C., Dabelea, D., Balde, N., Gong, C.X., et al. (2018), “ISPAD clinical practice consensus guidelines 2018: Definition, epidemiology, and classification of diabetes in children and adolescents.” Pediatr Diabetes,19; pp7-19

Holick, M.F., Binklet, N.C., Bischoff-Ferrari, H.A., Gordon, C.M., Hanley, D.A., Heany, R.P., et al. (2011), “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab, 96;1911-30.

Busta, A., Alfonso, B., Poretsky, L. (2011), “Role of vitamin D in the pathogenesis and therapy of type 1 diabetes mellitus. In: Liu CP. Type 1 Diabetes - Complications, Pathogenesis, and Alternative Treatments.” InTech, pp403-426.

Savastio, S., Cadario, F., Genoni, G., Bellomo, G., Bagnati, M., Secco, G., et al. (2016), “Vitamin D Deficiency and Glycemic Status in Children and Adolescents with Type 1 Diabetes Mellitus. PLOS,1,1-13.

Elsayed, A.M., Mohamed, G.A. (2016), “Vitamin D deficiency and its correlation to hemoglobin A1c in adolescent and young adult type 1 diabetes mellitus patients.” Al Azhar Med J,14,pp.76-9.

Al-Sawah, S.A., Compher, C.W., Hanlon, A.L., Lipman, T.H. (2016), “25-hydroxyvitamin D and glycemic control: a cross-sectional study of children and adolescents with type 1 diabetes.” Diabetes Res Clin Practice, pp1-23.

Alkhatatbeh, M.J., Abdul-Razak, K.K. (2018), “Association between serum 25-hydroxyvitamin D, hemoglobin A1c and fasting blood glucose levels in adults with diabetes mellitus.” Biomedical Reports,9;pp523-30.

Buhary, B.M., Almohareb, O., Aljohani, N., Alrajhi, S., Elkassi, S., Sherbeeni, S., et al. (2017), “Association of glycosylated hemoglobin levels with vitamin D status.” J Clin Med Res,9;pp1013-8.

Mehta, N., Shah, S., Shah, P.P., Prjapati, V. (2016), “Correlation between vitamin D and HbA1c in type 2 diabetic patients.” GCSMC J Med Sci,5;pp1-5.

Kanakaraju, K., Ranganathan, R.S., Shankar, R. (2017), “Correlation of vitamin D3 levels and the blood sugar parameters among the patients with type 2 diabetes mellitus.” Int J Contemporary Med Res,4;pp.844-8.

Giri, D., Pintus, D., Burnside, G., Ghatak, A., Mehta, F., Paul, P., et al. (2017), “Treating vitamin D deficiency in children with type 1 diabetes could improve their glycaemic control.” BMC Res Notes,10;465-70.

Randhawa, F.A., Msutafa, S., Khan, D.M., Hamid, S. (2017), “Effect of vitamin D supplementation on reduction in levels of HbA1c in patients recently diagnosed with type 2 diabetes mellitus having asymptomatic vitamin D deficiency.” Pakistan J Med Sci, 33;pp.881-6.


  • There are currently no refbacks.