Endocrine Abstracts

JOINT2581

According to the IDF Diabetes Atlas 2021, there were 2,325,000 adult patients with diabetes aged 20-79 years in Ukraine, as well as 920,100 undiagnosed cases. The prevalence of depression in Ukraine civilians reached 30% in 2020 and has been growing since then. Patients with type 2 diabetes mellitus (T2DM) are more sensitive to the stress factor of war, which is added to traditionally common psychopathological disorders. They have a 20% higher prevalence of anxiety compared to those without diabetes. A mutual negative effect between the state of depression and the course of T2DM is well known. According to the results of assessing the vitamin D status of Ukrainian population, an unsatisfactory level was found in 47% of people. The aim of the study was to assess the effect of vitamin D supplementation on metabolic and psychopathological manifestations in patients with T2DM. 164 patients with T2DM aged 19-75 years, in D-deficit status, glycated hemoglobin of 7-8.5%, BMI 30-39 kg/m² were included in the study. Exclusion criteria: CKD, pregnancy, BMI ≥ 40 kg/m², vit D intake 3 months before, insulin therapy, antidepressants, tranquilizers, sedatives usage. Patients were randomized into 2 groups of 82 people in each, comparable by age and gender. Patients received oral antidiabetic agents. Additionally, vitamin D supplementation was used in the main group: 3 months 10,000 IU daily, then 3 months 4000 IU daily; in the control group: 3 months no vitamin D treatment, then 3 months 4000 IU daily. Depression, anxiety and stress grades were evaluated using DASS21 scale.

Results: Patients in the main group showed a statistically significant decrease of salivary cortisol levels, glycated hemoglobin A1c, HOMA index, BMI and levels of depression, anxiety and stress after 3 months of taking vitamin D. The effect was prolonged to 6 months. Among patients in the control group, the levels of glycated hemoglobin A1c and BMI did not significantly improve, psychopathological disorders have been worsened.

Conclusion: Vitamin D supplementation is recommended for patients with type 2 diabetes in chronic stress condition. Vitamin D supplementation for 3 months at a dose of 10,000 IU daily in T2DM patients in D-deficit status improved carbohydrate metabolism, contributed to the normalization of saliva cortisol levels, reduced the levels of depression, anxiety and stress.