Key Global Literature

Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM: Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358:1500–1503, 2001

Findings. All pregnant women (n = 12,055) in northern Finland who were due to give birth in 1966 were enrolled in this birth-cohort study. Data were collected in the first year of life about frequency and dose of vitamin D supplementation, the presence of suspected rickets, and a diagnosis of type 1 diabetes during the first year of life. Of the 10,366 children included in analyses, 81 were diagnosed with diabetes during the study. Vitamin D supplementation was associated with a decreased frequency of type 1 diabetes when adjusted for neonatal, anthropometric, and social characteristics (rate ratio [RR] for supplementation 0.12, 95% CI 0.03–0.51), and irregular versus no supplementation (0.16, 0.04–0.74). Children who regularly took the recommended dose of vitamin D (2,000 IU daily) had an RR of 0.22 (0.05–0.89) compared with those who regularly received less than the recommended amount. Children suspected of having rickets during the first year of life had an RR of 3.0 (1.0–9.0) compared with those without such a suspicion.

Significance. Dietary vitamin D supplementation is associated with reduced risk of type 1 diabetes in animals, and vitamin D has effects on the immune system in humans. Dietary vitamin D supplementation is associated with reduced risk of type 1 diabetes.

Clinical impact. Ensuring adequate vitamin D supplementation for infants in order to prevent rickets is logical. Perhaps it may have the added benefit of reversing the increasing trend in the incidence of type 1 diabetes. With the lack of success of immunological approaches to prevention of type 1 diabetes, clinical trials are in need of such approaches in older children who are identified as being at high risk for the disease. In the meantime, it makes sense to follow appropriate recommendations for vitamin intake for all children.

Collins AC, Vincent J, Newall RG, Mitchell KM, Viberti GC: An aid to the early detection and management of diabetic nephropathy: assessment of a new point of care microalbuminuria system in the diabetic clinic. Diabet Med 18:928–932, 2001

Findings. Collins et al. compared the …