This is one in an occasional series about children’s health issues. We know that many of our readers are grandparents keenly interested in the health and well-being of grandchildren. We hope this series will provide useful health information you can share with your family.
A recent study from the University of Pennsylvania School of Nursing found that low levels of vitamin D are common in children with Type 1 diabetes.
How this deficiency relates to the cause and/or consequences of the disease is still being sorted out.
Many medical authorities say the precise cause of Type 1 diabetes is unknown, but Colleen Symanski, a registered nurse, health coach and certified diabetes educator, says, “Some studies have shown adequate levels of vitamin D, which is actually a hormone rather than a vitamin, may help regulate the production of insulin in the pancreas, which could in turn help keep blood glucose levels in better control, possibly preventing the development of type 1 diabetes.”
Research conducted at Harvard School of Public Health and published in the American Journal of Epidemiology in 2013 supports Symanski’s statement. A long-term study of more than 900 members of the military found that “having adequate levels of vitamin D during young adulthood may reduce the risk of adult-onset Type 1 diabetes by as much as 50 percent. The findings, if confirmed in future studies, could lead to a role for vitamin D supplementation in preventing this serious autoimmune disease.”
“It is surprising that a serious disease such as Type 1 diabetes could perhaps be prevented by a simple and safe intervention,” said Kassandra Munger, a research associate in the Department of Nutrition at HSPH and the lead author of the Harvard study.
Symanski, co-owner of A Healthier Me, a health and fitness studio on the barrier island, believes vitamin D levels should be monitored in all children.
An earlier study conducted in Great Britain in 2008 found significant evidence that vitamin D supplements were associated with a reduced risk of developing Type 1 diabetes. Lead author Christos Ziptitis, a pediatrician, reviewed five earlier studies and concluded that children who were given vitamin D supplements of roughly 400 IUs per day were 29 percent less likely to develop Type 1 diabetes later in life than those who were not given the supplements.
In the University of Pennsylvania study documenting low levels of vitamin D in children with the disease, researchers analyzed data from 197 children and adolescents from the Diabetes Center for Children at the Children’s Hospital of Philadelphia. Non-fasting blood samples were taken to measure vitamin D (technically called serum concentration of 25-hydroxyvitamin D) and blood glucose levels; other variables were obtained from medical records. The study was published in Diabetes Research and Clinical Practice.
Senior author Terri Lipman, Ph.D., Professor of Nursing of Children and Assistant Dean for Community Engagement at Penn Nursing, says, “To our knowledge this is the first study that has been adequately powered to examine the association between” vitamin D and Type 1 diabetes in children and adolescents. “These data suggest the need for monitoring of vitamin D in all youth with this disorder.”
Type 1 diabetes was previously known as juvenile diabetes, because it is usually diagnosed in children and young adults; however, people of any age can develop the disorder. Only 5 percent of people with diabetes have this form, in which the body does not produce insulin. Insulin is a hormone made by the pancreas; it helps glucose (a type of sugar) enter the body’s cells, where it can be used for energy or stored for future use. Type 1 diabetes is a permanent condition; once the cells of the pancreas that produce insulin are destroyed by the disease, they will never make insulin again.
(In Type 2 diabetes, the body makes insulin, but doesn’t use it the right way. That form of the disease is tied to family history, being overweight, and an inactive lifestyle. It is treated through medication, healthy eating, and exercise; in some cases it can be reversed, meaning medication is no longer needed, as long as lifestyle changes stay in place.)
Most commonly associated with milk and sunlight, vitamin D helps to ensure the body absorbs and retains calcium and phosphorus, both critical for building bone. Vero’s Symanski says that vitamin D is important as we age and helps to prevent or delay the onset of osteoporosis (weakening of the bones) and osteomalacia (softening of the bones). She says “very low levels of vitamin D can cause low levels of calcium in the blood, which can increase the risk of bone fractures, tingling and numbness, and muscle weakness.” There is also scientific evidence that vitamin D plays a role in preventing some later-in-life chronic diseases, including those involving the immune and cardiovascular systems.
In 2008, the American Academy of Pediatrics revised its guidelines on daily vitamin D intake from 200 to 400 IUs; in part due to the prevalence of sunscreens, which prevent the body from making vitamin D when exposed to the sun.
There aren’t many foods in which vitamin D is found naturally, and some aren’t particularly kid-friendly – beef liver, oily fish, cod liver oil, mushrooms – so a chewable supplement is generally recommended. Swiss cheese and egg yolks are a good source of vitamin D, as are foods fortified with vitamin D, such as milk, cereal, orange juice, yogurt and margarine. The National Institutes of Health provides a consumer-friendly Fact Sheet on vitamin D; it includes information on healthful eating and dietary supplements. The Fact Sheet can be found at www.ods.od.nih.gov/factsheets/VitaminD-Consumer.
Symanski urges parents and grandparents to promote healthier eating and more outside playtime. “Let’s un-complicate eating and physical activity through balance; our bodies were meant to move and to eat foods close to their natural source,” she says. “For children with diabetes this is even more important. We have excellent health care professionals, locally grown foods, and outdoor opportunities available to us.”
A Healthier Me is located at 2855 Ocean Drive, Suite C-2 in Vero Beach; Ms. Symanski’s phone number is 772-231-5555.
