Vitamin D Supplementation as a Therapeutic Strategy in Autoimmune Diabetes: Insights and Implications for LADA Management

Nutrients. 2024 Nov 27;16(23):4072. doi: 10.3390/nu16234072.

Abstract

Latent autoimmune diabetes of adults (LADA) is the most prevalent form of autoimmune diabetes (AI-D) in adulthood; however, its accurate diagnosis and optimal treatment remain challenging. Vitamin D deficiency (VDD) is commonly observed in LADA patients, while increased vitamin D exposure through supplementation and dietary intake is associated with a reduced incidence of LADA. Although limited, case reports, case-control studies, and randomized clinical trials have examined the effects of vitamin D supplementation-alone or combined with dipeptidyl peptidase-4 inhibitors (DPP4-is)-on glucose regulation, residual β-cell function, and glutamic acid decarboxylase antibody (GADA65) levels. Findings, while preliminary, indicate that vitamin D supplementation may enhance glycemic control, preserve β-cell function, and reduce autoimmune activity. Given its accessibility, affordability, and relative safety, vitamin D supplementation presents an attractive adjunct treatment option for LADA patients. This narrative review discusses current evidence on the potential therapeutic benefits of vitamin D supplementation in patients with AI-D, including LADA, who are also vitamin D deficient. Beginning with an exploration of the epidemiological patterns, clinical presentation, and diagnostic framework essential for understanding and identifying LADA, this review then examines the proposed mechanisms through which vitamin D may influence autoimmune modulation of pancreatic β-cells, integrating recent data pertinent to LADA pathology. By distilling and consolidating existing research, we aim to provide a platform for advancing targeted investigations within this distinct patient population.

Keywords: LADA; T1D; autoimmune diabetes; dipeptidyl peptidase-4 inhibitors; vitamin D; vitamin D deficiency.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / diet therapy
  • Diabetes Mellitus, Type 1* / drug therapy
  • Dietary Supplements*
  • Dipeptidyl-Peptidase IV Inhibitors / administration & dosage
  • Female
  • Humans
  • Insulin-Secreting Cells / drug effects
  • Latent Autoimmune Diabetes in Adults* / blood
  • Latent Autoimmune Diabetes in Adults* / diet therapy
  • Latent Autoimmune Diabetes in Adults* / drug therapy
  • Vitamin D Deficiency* / blood
  • Vitamin D Deficiency* / diet therapy
  • Vitamin D* / administration & dosage
  • Vitamin D* / blood

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Vitamin D