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Pediatr Diabetes. 2016 Dec;17(8):592-598. doi: 10.1111/pedi.12342. Epub 2015 Dec 23.

Low vitamin D level in pediatric patients with new onset type 1 diabetes is common, especially if in ketoacidosis.

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Le Bonheur Children's Hospital, Pediatrics, Division of Pediatric Endocrinology, Memphis, TN, USA.
University of Tennessee Health Science Center, Pediatrics Memphis, TN, USA.
University of California San Diego, Pediatrics San Diego, CA, USA.
University of California San Diego, Pediatrics San Diego, CA, USA.
Rady Children's Hospital San Diego, Pediatrics, Division of Pediatric Endocrinology, San Diego, CA, USA.



Vitamin D deficiency (VDD) adversely affects bone health. US data on prevalence of VDD or vitamin D insufficiency (VDI) at diagnosis of type 1 diabetes (T1D) is lacking. Low serum 25-hydroxyvitamin D (25OHD) is speculated to increase the risk of developing T1D.


Assess the prevalence of pediatric VDD and VDI at diagnosis of T1D, and investigate correlations with demographic and clinical parameters.


We performed a retrospective Institutional Review Board (IRB)-approved chart review of all T1D cases diagnosed from January 2011 to August 2012, all having the same 25OHD assay performed at Quest Diagnostics. Definitions for VDD, VDI, and vitamin D sufficiency (VDS) were 25OHD levels (ng/mL) ≤ 20, 21-29, and ≥ 30, respectively. We termed 25OHD <30 ng/mL as Low-D.


We identified 185 autoantibody positive T1D subjects (51% female) with 25OHD measured, 51% Caucasian, 25% Hispanic, 4% mixed-Hispanic, 4% African American, and 16% other/mixed race. Mean age 9.8 yr (0.9-18.6). Most had Low-D (58%), 40% VDI, 18% VDD, and 42% VDS. No gender or age differences among the 25OHD groups. Low-D was more common (p < 0.0001) in Hispanics (81%) vs Caucasians (44%), but VDD rates were similar. Low-D subjects were heavier than VDS (p = 0.018). All four with elevated celiac titers were VDS. Diabetic ketoacidosis was present in 33%, but more common (44%) in Low-D vs. VDS (18%) (p < 0.0001), and trended higher in VDD (61%) vs. VDI (36%). Seventy-seven percentage with DKA had Low-D.


VDD and insufficiency are common, even in Caucasians, at onset of T1D in pediatrics, worse in those with DKA.


diabetic ketoacidosis; pediatric; type 1 diabetes; vitamin D deficiency

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