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Impact of high-dose vitamin D supplementation initiated shortly after diagnosis on residual beta cell function and partial remission rates in children with type 1 diabetes

  • Chandan Nallapu , Devi Dayal ORCID logo EMAIL logo , Naresh Sachdeva , Mohit Kumar and Savita Verma Attri
Published/Copyright: August 1, 2025
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 10

Abstract

Objectives

We aimed to determine the effect of high-dose cholecalciferol supplementation starting soon after diagnosis on residual β-cell function (RBCF) and partial remission (PR) rates in children with type 1 diabetes (T1D).

Methods

A prospective, randomized, open-label study was conducted in children aged 2–12 years with newly-diagnosed T1D. Cases received additional cholecalciferol (60,000 IU every fortnight) for six months, while age-matched controls received standard care. Primary outcome variables included change in RBCF (measured by stimulated C-peptide, SCP) and the proportion of patients with PR (insulin dose-adjusted HbA1c, IDAA1c ≤9.0 %) at study endpoint. Secondary outcomes included change in mean daily insulin dose (DID) and mean HbA1c levels.

Results

The mean serum vitamin D concentrations achieved in cases (n=32, mean age 7.2 ± 2.8 years) were higher at 6 months (44.91 ± 5.36 vs. 24.87 ± 4.10 ng/mL, p<0.001). Compared to controls (n=31, mean age 6.6 ± 2.5 years), children receiving vitamin D exhibited a slower decline in SCP levels (mean decrease −0.28 ± 0.10 vs. −0.50 ± 0.10 ng/mL, p<0.001). The mean decrease in IDAA1c was higher in cases (−11.1 ± 0.56 %) compared to controls (−10.1 ± 0.52 %), but the difference in mean decrease (−1.1 ± 0.61) did not attain statistical significance (p=0.08). At 6 months, PR rates were significantly higher in cases compared to controls (19, 59.4 % vs. 6, 19.4 %, p<0.001). Regression analysis revealed baseline SCP as strong predictor of SCP at the study endpoint (r=0.92, p<0.001).

Conclusions

High-dose vitamin D supplementation may preserve RBCF and prolong PR in children with newly diagnosed T1D. Large-scale randomized controlled trials are warranted.

Keywords: type 1 diabetes; vitamin D supplementation; residual beta-cell function; partial remission; immunomodulation
Corresponding author: Dr. Devi Dayal, MD, Professor, Department of Pediatrics, Endocrinology and Diabetes Unit, 3110, Level III, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India, E-mail:

  1. Research ethics: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The Institute Ethics Committee approved the study protocol (IEC-INT/2023/MD-1487 dated October 31, 2023).

  2. Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.

  3. Author contributions: CN: Investigation, data collection, formal analysis and writing first draft; DD: Conceptualization, supervision, manuscript reviewing and editing; NS: Investigation, reviewing manuscript; MK: Data analysis and validation; SVA: Investigation, reviewing manuscript. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: The data used in the study is available from the corresponding author upon reasonable request.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2025-0206).

Received: 2025-04-12
Accepted: 2025-07-22
Published Online: 2025-08-01
Published in Print: 2025-10-27

© 2025 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpem-2025-0206
Keywords for this article
type 1 diabetes; vitamin D supplementation; residual beta-cell function; partial remission; immunomodulation

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. A multi-stakeholder perspective on medical devices for children and adolescents with type 1 diabetes: huge unmet needs for the smallest
  4. Original Articles
  5. Concerns for mood disorders in children presenting with early menarche is not an indication for pubertal suppression
  6. Testosterone in Duchenne muscular dystrophy: effects on puberty and growth
  7. First evaluation of fibroblast growth factor 21 levels in patients diagnosed with glycogen storage diseases with liver involvement
  8. Improving cardiometabolic health in children and adolescents with obesity: a comparison between in-person and virtual supervised training
  9. Impact of high-dose vitamin D supplementation initiated shortly after diagnosis on residual beta cell function and partial remission rates in children with type 1 diabetes
  10. Clinical spectrum, imaging characteristics, and treatment outcomes of pediatric adrenocortical tumors: a 24-year experience from Western India
  11. Comparison study of the correlation between free and total 25(OH)D in maternal and umbilical blood and early-life physical development parameters
  12. Hashimoto’s thyroiditis in children and adolescents: analysis of long-term course
  13. Case Reports
  14. 45, X/46, XY mosaicism and gender incongruence: ethical, medical, and psychological considerations
  15. Hormone-active ovarian steroid cell tumor in a 2-year-old girl
  16. Lipoatrophy following weekly growth hormone therapy: a case report
  17. Surgical treatment and somatostatin experience in growth hormone-secreting pituitary macroadenoma due to novel AIP mutation
  18. Letters to the Editor
  19. ANKS1B is a potential candidate gene for short stature and failure to thrive in children
  20. Identification of pathogenic ACAN variants in healthy children with normal height and advanced bone age
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