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November 13, 2007

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Question from Homer, Alaska, USA:

My 12-year-old daughter, who was diagnosed with type 1 diabetes two years ago, controls her blood sugars with the use of an insulin pump. A year ago, I read about the possible benefits of Vitamin D so her physician put her on Vitamin D 1000 IU daily. One year later, her Vitamin D level is 30 with a recommended level of 50 to 55. We crush the pill and give it to her every morning with breakfast. What is a safe amount of Vitamin D for a 12-year-old? Should we be giving it differently to increase absorption? Are there other tests into which we should be looking?

Answer:

First of all, the issue with Vitamin D and type 1 diabetes is not clear cut. Therefore, the optimal dosing is not known. The current recommendations for Vitamin D (25-hydroxy Vitamin D) concentrations in serum is more than 30 ng/mL. But, these are values to optimize calcium absorption and prevent thinned out bones. It is NOT based on any sort of treatment for type 1 diabetes.

The previously touted (and still current) Recommended Daily Allowance (RDA) for Vitamin D has been about 400 units. This is probably too small, especially in a society that drinks less milk, etc.

Your doctor might want to consider increasing the dose to 2000 units daily (I would not recommend more without more testing), but the serum calcium (and Vitamin D) and urine calcium and creatinine values should be assessed periodically so as to look for side effects such as kidney stones. But, again, this has essentially no basis in regards to her type 1 diabetes.

DS