A study of the effects of large dose of parenteral vitamin D (D3) on insulin resistance in type 2 DM patients


  • Vinu Jamwal Department of Medicine, Acharya Shree Chander College of Medical Sciences Jammu, J&K, India
  • Wani Zahid Hussain Department of Medicine, Acharya Shree Chander College of Medical Sciences Jammu, J&K, India
  • Abhinav Gupta Department of Medicine, Acharya Shree Chander College of Medical Sciences Jammu, J&K, India
  • Anil K. Gupta Department of Medicine, Acharya Shree Chander College of Medical Sciences Jammu, J&K, India




Fasting blood sugar, Fasting insulin levels, Homeostatic model for assessment of insulin resistance, Glycosylated hemoglobin, Type 2 diabetes mellitus


Background: Over the past decade, vitamin D is more known as a hormone because of its extra - skeletal outcomes in various disease conditions, including diabetes. Most cells, including the pancreatic β-cells, contain the vitamin D receptor and they also have the capability to produce the biologically active 1,25-dihydroxyvitamin D [1,25(OH)2D3] which allows intracrine and paracrine functions. In vitro studies have shown that the active vitamin D metabolite 1,25(OH)2D stimulated insulin release by the pancreatic β-cells. Vitamin D is known to have immune modulatory and anti-inflammatory effects and reduces peripheral insulin resistance by altering low-grade chronic inflammation. This study was done to assess whether supplementation of vitamin D in type 2 diabetes mellitus (T2DM) patients with Vitamin D deficiency has any favourable effect on insulin resistance.

Methods: It was a short term interventional study conducted at ASCOMS hospital Jammu including a total of 50 vitamin D deficient [25(OH) D <50 nmol/l] T2DM patients with an in-adequate glycemic control (HbA1c > 7.0%). All the 50 study participants completed the study and there were no changes either in anti-hyperglycemic drugs (including insulin) or antihypertensive drugs being used. After supplementation with a single high dose (600000 IU) of parenteral vitamin D3 changes in HOMA-IR (Homeostasis model assessment insulin resistance) were seen on follow up at 3 months.

Results: Vitamin D3 supplementation improved insulin sensitivity, HOMA-IR decreased from 4.05±1.42 to 3.93±1.28 (p =0.011). It decreased equally in males (3.85±1.43 to 3.76±1.30) (p value=0.023) and females (4.24±1.42 to 4.10±1.27) (p value=0.021). HOMA-IR showed negative association with Vitamin D levels both at baseline and after 3 months of follow up.

Conclusions: This improvement in insulin sensitivity is evidenced in our study by decrease in fasting insulin levels (FIL) and improvement in fasting blood sugars (FBS). It is due to both direct and indirect effects of Vitamin D3 on both insulin sensitivity and secretion.


Bikle DD. Vitamin D and immune function: Understanding common pathways. Curr Osteoporos. 2009;7:58-63.

Bland R, Markovic D, Hills CE, Hughes SV, Chan SL, Squires PE, Hewison M. Expression of 25-hydroxyvitamin D3-1 alpha-hydroxylase in pancreatic islets. J Steroid Biochem Mol Biol. 2004;89-90:121-5.

Johnson J, Grande JP, Roche PC, Kumar R. Immunohistochemical localization of the 1,25(OH)2D3 receptor and calbindin D28k in human and rat pancreas. Am J Physiol. 1994;267:E356-360.

Sooy K, Schermerhorn T, Noda M, Surana M, Rhoten WB, Meyer M, et al. Calbindin - D controls Ca induced insulin release. J Biol Chem. 1999;274:34343-9.

Eliades M, Pittas AG. Vitamin D and type 2 diabetes. In Vitamin D Physiology, Molecular Biology and clinical applications ed. Holick M F. Humana press; 2010:895-920.

D'Ambrosio D, Cippitelli M, Cocciolo MG. Inhibition of IL-12 production by 1,25-dihydroxyvitamin D3. Involvement of NF-kappa B downregulation in transcriptional repression of the gene. J Clin Invest. 1998;101:252-62.

Dunlop TW, Väisänen S, Frank C, Molnar F, Sinkkonen L, Carlberg C. The human peroxisome proliferator- activated receptor gene is a primary target of 1 alpha, 25-dihydroxyvitamin D3 and its nuclear receptor. J Mol Biol. 2005;349:248-60.

Lemire JM, Adams JS, Sakai R. 1-alpha,25-dihydroxyvitamin D3 suppresses proliferation and immunoglobulin production by normal human peripheral blood mononuclear cells. J Clin Invest. 1984;74:657-61.

Penna G, Adorini L. 1-Alpha, 25-dihydroxyvitamin D3 inhibits differentiation, maturation, activation, and survival of dendritic cells leading to impaired alloreactive T cell activation. J Immunol. 2000;164:2405-11.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007;92: 2017-2029.

Scragg R, Sowers M, Bell C. Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabet Care. 2004;27:2813-8.

Jehle S, Lardi A, Felix B, Hulter HN, Stettler C, Krapf R. Effect of large doses of parenteral vitamin D on glycaemic control and calcium/phosphate metabolism in patients with stable type 2 diabetes mellitus: a randomised, placebo- controlled, prospective pilot study. Swiss Med Wkly. 2014;144:w13942.

Tabesh M, Azadbakht L, Faghihimani E, Tabesh M, Esmaillzadeh A. Effects of calcium-vitamin D co-supplementation on metabolic profiles in vitamin D insufficient people with type 2 diabetes: a randomised controlled clinical trial. Diabetologia. 2014;57(10):2038-47.

Maestro B, Molero S, Bajo S, Davila N, Calle C. Transcriptional activation of the human insulin receptor gene by 1,25-dihydroxyvitamin D(3). Cell Biochem Funct. 2002;20:227-32.

Short KR, Vittone JL, Bigelow ML, Proctor DN, Rizza RA, Coenen-Schimke JM, et al. Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabet. 2003;52:1888-96.




How to Cite

Jamwal, V., Hussain, W. Z., Gupta, A., & Gupta, A. K. (2017). A study of the effects of large dose of parenteral vitamin D (D3) on insulin resistance in type 2 DM patients. International Journal of Research in Medical Sciences, 5(6), 2338–2342. https://doi.org/10.18203/2320-6012.ijrms20172099



Original Research Articles