Endocrine Abstracts

Background: The prevalence of type 2 diabetes mellitus is very high among elderly people and can faster the cognitive decline and the loss of independence, if not treated adequately. Another topic not clearly explained yet is the relationship between vitamin D and type 2 diabetes mellitus.

Objective: The aim of our work is to reveal relationship between diabetes control and self-sufficiency and to determine the possible impact of the current levels of vitamin D in elderly hospitalized patients.

Methods: We studied retrospectively the group of hospitalized patients of age 65+ with type 2 diabetes mellitus. Each patient included into our study was assessed according to Comprehensive Geriatric Assessment tool. The serum levels of glycated hemoglobin (HbA1c), C-peptid fasting and after breakfest and vitamin D were determined. Data were analyzed by descriptive statistical methods, Student’s T-Test and regression analysis.

Results: Alltogether 77 patients (average age 82.7+7.08 years, median 84 years, 56 women, 21 men) fulfilled the inclusion criteria. The average HbA1c serum concentration was 50.5+12.5, median 47 mmol/mol and decreased with age. The average fasting and after breakfest C-peptid serum level was 1222.1+997.1 resp. 2340.0+1535.3 pmol/l. Vitamin D serum levels ranged from unmeasurable values to 100 nmol/l with average 23.3+19.7 nmol/l and median 17 nmol/l and decreased with age. Seniors with vitamin D serum level below 10 nmol/l showed significantly lower C-peptid serum levels – fasting and after breakfest (P=0.033; P=0.027). Despite it we have found significant positive correlation between vitamin D serum level and HbA1c (r=0.257, P=0.05). The curve of HbA1c and parameters of self-sufficiency dependence was “J” shaped with optimal HbA1c levels between 50 and 70 mmol/mol.

Conclusions: Sufficient vitamin D serum levels were connected with higher insulin secretion and better self-sufficiency parameters. Optimal HbA1c serum concentration was between 50 and 70 mmol/l from self-sufficiency parameters point of view.