Abstract:
Diabetes mellitus (DM) is one of the most common non-in-fectious diseases with the tendency to increase.According to the International Diabetes Federation (IDF) data more than 1.1 million of children and adolescents suffer from the DM type 1. More than 128 900 new cases of diabetes in children and adolescents are diagnosed annually in the world.In 2019 almost 300 000 children were known to have type 1 diabetes mellitus in Europe [1]. The main problem of treatment of DM remains optimization of the glycemic control especially in childhood. Thus, the DCCT (Diabetes Control and Complication Trial) study found that normalization of blood glucose levels and disease compensation in adolescents is more difficult than in adult patients [2]. It is also known that in pubertal age there are factors that directly or indirectly can influence the achievement of optimal glycemic control. Such factors include the rapid linear growth of the child that is influenced by the action of sex hormones during puberty , intensive hormonal changes in the body, which leads to increased daily insulin needs.DM type 1 is a result of cell-mediated autoimmune destruction of β - cells of the pancreas. According to the newest data about the effect of vitamin D, as a part of the body’s hormonal system, the authors are interested in the effect of vitamin D on homeostasis not only on calcium- phosphorus metabolism, but also on carbohydrate metabolism [3].
Vitamin D deficiency is common global problem that constantly increases with the level of urbanization. Low vitamin D status effects the skeletal system, plays a significant role in the pathogenesis of diabetes, taking part in the insulin secretion [4,5]. The active metabolites of vitamin D regulate the proliferation and differentiation of cells, synthesis of lipids, proteins, enzymes and the work of organs and systems [6,7].Patients with type 1 and type 2 diabetes mellitus have low levels of vitamin D and low values of 25(OH)D in the blood serum are associated with increased levels of glycated hemoglobin (HbA1C ) [8].The connection between vitamin D intake and a reduced risk of type 1 DM has been demonstrated in a large cohort study in Finland. It was found that the children who received 2,000 IU of cholecalciferol daily had 88% lower risk of the development of DM type 1 compared to children, who did not receive vitamin D [9]. The dose-dependent effect was found: children, who received higher doses of cholecalciferol had a lower risk of developing DM type 1 [10]. According to the published data of cross sectional study in Poland, the lowest levels of 25(OH)D (13,1 ± 4,7 ng/ml) were observed in children aged from 15 to 20 years [11].
