Vitamin D and ω-3 Supplementations in Mediterranean Diet During the 1st Year of Overt Type 1 Diabetes: A Cohort Study

Vitamin D and omega 3 fatty acid (&omega
3) co-supplementation potentially improves type 1 diabetes (T1D) by attenuating autoimmunity and counteracting inflammation. This cohort study, preliminary to a randomized control trial (RCT), is aimed at evaluating, in a series of T1D children assuming Mediterranean diet and an intake of cholecalciferol of 1000U/day from T1D onset, if &omega
3 co-supplementation preserves the residual endogen insulin secretion (REIS). Therefore, the cohort of 22 &ldquo
new onsets&rdquo
of 2017 received &omega
3 (eicosapentenoic acid (EPA) plus docosahexaenoic acid (DHA), 60 mg/kg/day), and were compared retrospectively vs. the 37 &ldquo
previous onsets&rdquo
without &omega
3 supplementation. Glicosilated hemoglobin (HbA1c%), the daily insulin demand (IU/Kg/day) and IDAA1c, a composite index (calculated as IU/Kg/day &times
4 + HbA1c%), as surrogates of REIS, were evaluated at recruitment (T0) and 12 months later (T12). In the &omega
3 supplemented group, dietary intakes were evaluated at T0 and T12. As an outcome, a decreased insulin demand (p &lt
0.01), particularly as pre-meal boluses (p &lt
0.01), and IDAA1c (p &lt
0.05), were found in the &omega
3 supplemented group, while HbA1c% was not significantly different. Diet analysis in the &omega
3 supplemented group, at T12 vs. T0, highlighted that the intake of arachidonic acid (AA) decreased (p &lt
0.01). At T0, the AA intake was inversely correlated with HbA1c% (p &lt
0.05
r
0.411). In conclusion, the results suggest that vitamin D plus &omega
3 co-supplementation as well as AA reduction in the Mediterranean diet display benefits for T1D children at onset and deserve further investigation.