Evaluation of clinical efficiency of Decap replacement therapy in patients with type 2 diabetes mellitus and concomitant nonalcoholic fatty liver disease in vitamin D deficiency
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Abstract
Background. Recently, vitamin D deficiency has been considered one of the factors in the development of type 2 diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). The purpose was to establish the effectiveness of Decap (cholecalciferol) in patients with its deficiency who suffered from type 2 DM and NAFLD. Materials and methods. Fifty-two people with NAFLD and type 2 DM on the background of established D-deficiency were treated, they were evenly divided into two groups. Patients in the comparison group (n = 26) received only traditional antidiabetic therapy, and the main group (n = 26) additionally took vitamin D — Decap, which was prescribed at a dose of 4,000 IU/day for 6 months. Results. Vitamin D use was associated with a statistically significant reduction in fasting blood glucose after 6 months of treatment — by 4.2 % (p = 0.041). The level of glycated hemoglobin in the main group of patients decreased on average by 0.38 % (p = 0.121) after 3 months, and remained almost at the same level after 6 months — by 0.44 % (p = 0.088). In parallel with the improvement of glycemic control parameters in the main group, there was a tendency to a decrease in the HOMA-2-IR by 0.28 (–0.11; 0.86; p = 0.152) and to a better insulin sensitivity by 1.39 (–10.04; 6.01; p = 0.621) compared to the baseline. The use of vitamin D (Decap) is associated with a decrease in steatosis indices FLI and TyG. The baseline values for FLI was 74.11 ± 18.71 and for TyG — 5.21 ± 0.29, and after a six-month course of vitamin D treatment, they decreased by 4.4 % (p = 0.029) and 2.68 % (p = 0.031), respectively, compared to baseline. Conclusions. It was found that the use of Decap in patients with vitamin D deficiency at a dose of 4,000 IU/day for a course of at least six months improved glycemic control and metabolic profile in those with type 2 DM and NAFLD.
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