“Evaluation of Vitamin D Supplementation In Management of Diabetic Retinopathy”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
AIM & OBJECTIVES OF THE STUDY: • To evaluate the role of vitamin-D supplementation in management of diabetic retinopathy. • To assess retinal vascular changes in diabetic retinopathy patients taking vitamin-D supplementation. PATIENTS & METHODS: In the present study, role of vitamin D supplementation in management of diabetic retinopathy was analysed.47 diabetic retinopathy patients were taken according to inclusion criteria. After base line investigations 47 patients of either sex between 35-75 years were enrolled for the study and divided into two groups (group A and B). Patients with normal serum levels of vitamin D were kept under Group A (controls) & patients with low levels were kept under Group B (test subjects). After grouping,25 patients were in group „A‟ and 22 patients were in group‟ B.‟The base line parameters of the study population like age, sex, height,weight,FBS,PLBS,HbA1c and serum vitamin D levels were estimated before initiating the study.Vitamin D supplementation given in group B. Other modalities of treatment for diabetes and diabetic retinopathy maintained constant in both the groups. Parameters like weight,height,FBS,PLBS,HbA1c levels were tested at 0 day,end of 6th and 12th months. Serum vitamin D levels were tested at 0 day and end of 12th month.Results were analysed with p value calculated by t-test and chisquare test. RESULTS: Results of the study demonstrated that BMI varied from 0 day to 12th month in each group but they did not vary much when compared between the two groups,both the therapies are showing similar effect on BMI . The % reduction in BMI was 0.78% in group A and 1.52% in group B . The difference in percentage is 0.74% which is insignificant. The reduction in FBS was significant in Group A and Group B at the end of 12thmonth showing percentage reduction as 9.54% & 15.43% respectively. The difference in the percentage is 5.89%. Vitamin D supplementation is effective upto some extent in reducing FBS as there is little difference in both the groups. The reduction in PLBS was significant in both the test groups showing percentage reduction of 18.79% and 19.74% in Group A & Group B respectively at the end of 12th month. The difference in percentage is 0.95% which is very small. The reduction in HbA1c was insignificant in group A with a % reduction was 16.31% from 0 day to the end of 12th month. But in group B it was showing significant reduction with a % reduction was 13.99% from 0 day to the end of 12th month.The difference in percentage is 2.34% The % increment in serum vitamin D levels in group A was 2.08% at 12th month and in group B it was increased very significantly with a % increment of 58.67% at the end of 12th month.The difference in percentage is 56.59%. Serum levels of vitamin D in all the patients in group B raised above 30ng/ml at the end of 12th month.Above study supported the guidelines of endocrine society i.e.,treatment for vitamin D deficiency is vitamin D supplementation of 50,000IU once a week for 8 weeks to achieve a blood level of 25(OH)D above 30ng/ml,followed by maintenance therapy of 1500IU/day. The progression of disease from mild or moderate or severe NPDR to PDR in group A increased upto 16% at the end of 12th month.But in group B, progression from NPDR to PDR was not seen at the end of 12th month.The difference in percentage is 16%. Conclusion: The results show that supplementation of vitamin D in diabetic retinopathy who are vitamin D deficient,decreases proliferation and neovascularisation in retina,improving glycemic control and also various other benefits without causing any side effects in cost effective manner.
Authors and Affiliations
Mahammad Juber S
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