Abstract

Luay Farhood Jumaah, Baha D. Moohy Alosy, Hind Mutar Ibrahim, Emad Maaroof Thskir

Background: Vitamin D3 can adjust glycemic control and spot to their etiological factor on type 1 diabetes (T1D), increased transcription of insulin receptor genes by 1, 25 (OH) D. types 1 diabetes is associated with magnesium deficiency. Antibody against Zn-transport 8 has been well documented as a diagnostic consideration for T1D Objective: Evaluate efficacy of Vitamin D3 plus magnesium and zinc for tight glycemic control and decrement in symptoms and sign of type 1 diabetes (T1D) and/or diabetic ketoacidosis in pediatric age group. Patients and Methods: doubleâ€�blind placeboâ€�controlled Fifty patient type 1 diabetes (T1D) child under 16 years from outpatient clinic of pediatrics department in Tikrit teaching and /or salahaldeen teaching Hospital were collected and admitted as inpatient from 2 January 2012 to 2 June 2019. 25 Child ((vitamin D3 magnesium, zinc)) group were take regime as (800 IU/day of vitamin D3, Magnesium 3 mg/kg/d and zinc 2 mg per day) for 180 day, oral capsule prior to meal once daily. 25 Child were received (placebo capsule) as control group for 180 days. Both groups receive recommended dose of insulin twice daily. Results : The Decrement in rate, mean ± SD of symptoms and sign of type 1 diabetes (T1D) at 4 month of ((vitamin D3 magnesium, zinc)) group for Polydipsia11 9.5 (1.4), Glycosuria10 9.2(1.1), Hyperglycemia 108.2 (1.8), were significantly less than rate, mean ± SD of symptoms and sign of type 1 diabetes (T1D) at 4 month of Placebo group for Polydipsia23 20.0(2.5),Glycosuria 2119.52(1.48), Hyperglycemia 24 20.74 (3.26). The Decrement in rate, mean ± SD of Symptoms and sign of diabetic ketoacidosis at 4 month of ((vitamin D3 magnesium, zinc)) group for Acidotic breathing11 10.9(1.3),blood sugar <350 10 8.93 (2.3), Drowsiness11 9.9(1.1),coma12 10.8(1.2),were significantly less than rate , mean,SD of Symptoms and sign of diabetic ketoacidosis at 4 month of Placebo group for Acidotic breathing2422.7(2.25),blood sugar<350 2522.85 (2.15), Drowsiness 23 20.55 (2.45), coma 2420.74 (3.26) and other result can be seen in table 1-2.The Decrement in rate, mean ± SD of symptoms and sign of type 1 diabetes (T1D) at 8month of ((vitamin D3 magnesium, zinc))group for Polydipsia 5 3.2(1.8),Glycosuria5 4.0(1.0),Hyperglycemia64.9(1.3),glycosylated hemoglobin < 7 5 3.2(1.8),were significantly less than rate, mean ± SD of symptoms and sign of type 1 diabetes (T1D) at 8month of Placebo group for Polydipsia 25 22.55 (2.45), Glycosuria 23 20.5 (2.5) ,Hyperglycemia24 21.75(2.25),glycosylated hemoglobin < 7 25 22.65 (2.35). The Decrement in rate, mean ± SD of Symptoms and sign of diabetic ketoacidosis at 8 month of ((vitamin D3 magnesium, zinc)) group for severe dehydration 4 3.8 (0.2) , blood sugar <350 4 2.8 (1.2) , Drowsiness 42.7 (1.3), coma 2 1.7(0.3), were significantly less than rate, mean ± SD of Symptoms and sign of diabetic ketoacidosis at 8 month of Placebo group for Severe dehydration 21 18.22 (2.82), , blood sugar <350 25 22.85 (2.15) , Drowsiness 23 20.5 (2.5), coma 2420 74 (3.26) and other result can be seen in table 3-4. The 12 month mean±SD overall reduction in symptoms and sign of type 1 diabetes (T1D) of (Vitamin D3) plus magnesium and zinc group was (92.84%) (23.21 ±1.56) which is more than in Placebo group (14.56%) (3.64±2.19) (P= 0.01) Additionally, the 12 month mean±SD overall reduction in symptoms and sign of diabetic ketoacidosis of (Vitamin D3) plus magnesium and zinc group was (90.88%) (22.72±1. 40) which is more than in Placebo group (9.76%) (11.44±2.81) (P= 0.01). As in Table (5) & Figure (1).Conclusion: Cholecalciferol (Vitamin D3) plus magnesium and zinc can be safe and effective used for tight glycemic control and decrement in symptoms and sign of type 1 diabetes (T1D) and/or diabetic ketoacidosis in pediatric age group.