Loading...
 
Toggle Health Problems and D

Diabetes prevented by 50,000 IU vitamin D monthly (Iran) – Jan 2022

Economic evaluation of a national vitamin D supplementation program among Iranian adolescents for the prevention of adulthood type 2 diabetes mellitus

BMC Complement Med Ther. 2022 Jan 3;22(1):1. doi: 10.1186/s12906-021-03474-0.
Narges Zandieh 1, Mohsen Rezaei Hemami 2, Ali Darvishi 3, Seyed Mohammad Hasheminejad 4, Zahra Abdollahi 5, Maryam Zarei 5, Ramin Heshmat 6

Background: This study aimed to evaluate the cost-effectiveness of vitamin D supplementation in preventing type 2 diabetes mellitus (T2DM) among Iranian adolescents.

Methods: This analytical observational study was conducted, using the decision tree model constructed in TreeAge Pro to assess the cost per quality-adjusted life-year (QALY) of monthly intake vitamin D supplements to prevent T2DM compared to no intervention from the viewpoint of Iran's Ministry of Health and through an one-year horizon. In the national program of vitamin D supplementation, 1,185,211 Iranian high-school students received 50,000 IU vitamin D supplements monthly for nine months. The costs-related data were modified to 2018. The average cost and effectiveness were compared based on the Incremental Cost-Effectiveness Ratio (ICER).

Results: Our analytical analysis estimated the 4071.25 (USD / QALY) cost per AQALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the ICER threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood T2DM. It means that vitamin D supplementation costs were substantially less than the costs of T2DM treatments than the no intervention.

Conclusions: Based on the findings, the national vitamin D supplementation program for Iranian adolescents could be a cost-effective strategy to reduce the risk of diabetes in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.
 Download the PDF from VitaminDWiki

Appears: $250 cost of annual supplementation for 200 people would eliminate 1 person getting diabetes

Study does not appear to measure the vitamin D levels actually achieved

Previous study in Iran by the same authors with 50K/month focused on a different health problem
Giving free vitamin D to every Iranian would pay for itself by just reducing CVD – Oct 2021

References
  • 1. Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: prospective analysis from first nationwide diabetes report of National Program for prevention and control of diabetes (NPPCD-2016). Sci Rep. 2017;7(1):1-10.
  • 2. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the international diabetes federation diabetes atlas. Diabetes Res Clin Pract. 2019;157:107843. in VitaminDWiki
  • 3. Orkaby AR, Djousse L, Manson JE. Vitamin D supplements and prevention of cardiovascular disease. Curr Opin Cardiol. 2019;34(6):700-5.
  • 4. Cashman KD. Vitamin D in childhood and adolescence. Postgrad Med J. 2007;83(978):230-5.
  • 5. Bacon C, Gamble G, Horne A, Scott M, Reid I. High-dose oral vitamin D 3 supplementation in the elderly. Osteoporos Int. 2009;20(8):1407-15.
  • 6. Grimnes G, Emaus N, Joakimsen R, Figenschau Y, Jenssen T, Njolstad I, et al. Baseline serum 25-hydroxyvitamin D concentrations in the Tromso study 1994-95 and risk of developing type 2 diabetes mellitus during 11 years of follow-up. Diabet Med. 2010;27(10):1107-15.
  • 7. Grimnes G, Figenschau Y, Almas B, Jorde R, Vitamin D. Insulin secretion, sensitivity, and lipids: results from a case-control study and a randomized controlled trial using hyperglycemic clamp technique. Diabetes. 2011;60(11):2748-57.
  • 8. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity. Diabetes Care. 2006;29(10):2244-6.
  • 9. Knekt P, Laaksonen M, Mattila C, Harkanen T, Marniemi J, Heliovaara M, Rissanen H, Montonen J, Reunanen A. Serum vitamin D and subsequent occurrence of type 2 diabetes. Epidemiology. 2008;19(5):666-71. https:// doi.org/10.1097/EDE.0b013e318176b8ad.
  • 10. Mitri J, Dawson-Hughes B, Hu FB, Pittas AG. Effects of vitamin D and calcium supplementation on pancreatic (3 cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the calcium and Vitamin D for diabetes mellitus (CaDDM) randomized controlled trial. Am J Clin Nutr. 2011;94(2):486-94.
  • 11. Oosterwerff MM, Eekhoff EM, Heymans MW, Lips P van Schoor NM.Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons: a population-based study. Clin Endocrinol. 2011;75(5):608-13.
  • 12. El-Hajj Fuleihan G, Baddoura R, Habib RH, Halaby G, Arabi A, Rahme M, et al. Effect of vitamin D replacement on indexes of insulin resistance in overweight elderly individuals: a randomized controlled trial. Am J Clin Nutr. 2016;104(2):315-23.
  • 13. Oosterwerff MM, Eekhoff EM, Van Schoor NM, Boeke AJP Nanayakkara P Meijnen R, et al. Effect of moderate-dose vitamin D supplementation on insulin sensitivity in vitamin D-deficient non-Western immigrants in the Netherlands: a randomized placebo-controlled trial. Am J Clin Nutr. 2014;100(1):152-60.
  • 14. Sollid ST, Hutchinson MY, Fuskevag OM, Figenschau Y, Joakimsen RM, Schirmer H, et al. No effect of high-dose vitamin D supplementation on glycemic status or cardiovascular risk factors in subjects with prediabetes. Diabetes Care. 2014;37(8):2123-31.
  • 15. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third National Health and nutrition examination survey. Diabetes Care. 2004;27(12):2813-8.
  • 16. Heshmat R, Mohammad K, Majdzadeh S, Forouzanfar M, Bahrami A, Ranjbar Omrani G, et al. Vitamin D deficiency in Iran: a multi-center study among different urban areas. Iran J Public Health. 2008;37(1):72-8.
  • 17. Goudarzi R, Zeraati H, Akbari Sari A, Rashidian A, Mohammad K. Population-Based Preference Weights for the EQ-5D Health States Using the Visual Analogue Scale (VAS) in Iran. Iran Red Crescent Med J. 2016;18(2):e21584. https://doi.org/10.5812/ircmj.21584.
  • 18. Sanabria Á, Domínguez LC, Vega V, Osorio C, Duarte D. Cost-effectiveness analysis regarding postoperative administration of vitamin-D and calcium after thyroidectomy to prevent hypocalcaemia. Revista de Salud Pública. 2011;13:804-13.
  • 19. Neumann PJ, Sanders GD, Russell LB, Siegel JE, Ganiats TG. Cost-effectiveness in health and medicine: Oxford University Press; 2016.
  • 20. Weinstein MC, Torrance G, McGuire A. QALYs: the basics. Value Health. 2009;12:S5-9.
  • 21. Al Shaikh AM, Abaalkhail B, Soliman A, Kaddam I, Aseri K, Al Saleh Y, et al. Prevalence of Vitamin D deficiency and calcium homeostasis in Saudi children. J Clin Res Pediatr Endocrinol. 2016;8(4):461-7.
  • 22. Coffey JT, Brandle M, Zhou H, Marriott D, Burke R, Tabaei BP, et al.Valuing health-related quality of life in diabetes. Diabetes Care. 2002;25(12):2238-43.
  • 23. Moradi N, Rashidian A, Nosratnejad S, Olyaeemanesh A, Zanganeh M, Zarei L. The worth of a quality-adjusted life-year in patients with diabetes: an investigation study using a willingness-to-pay method. PharmacoEco-nomics-open. 2019;3(3):311-9.
  • 24. Goudarzi R, Sari AA, Zeraati H, Rashidian A, Mohammad K, Amini S. Valuation of quality weights for EuroQol 5-dimensional health states with the time trade-off method in the capital of Iran. Value Health Regional Issues. 2019;18:170-5.
  • 25. Kelishadi R, Majdzadeh R, Motlagh M-E, Heshmat R, Aminaee T, Ardalan G, et al. Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV study. Int J Prev Med. 2012;3(10):699.
  • 26. Ganji V, Tangpricha V, Zhang X. Serum Vitamin D concentration 75 nmol/L is related to decreased Cardiometabolic and inflammatory biomarkers, metabolic syndrome, and diabetes; and increased cardiorespiratory fitness in US adults. Nutrients. 2020;12(3):730.
  • 27. Kuchay MS, Jevalikar GS, Mithal A, Mishra SK, Dang N. Efficacy and safety of a single monthly dose of cholecalciferol in healthy school children. J Pediatr Endocrinol Metab. 2016;29(4):413-6.
  • 28. Iran CBotIRo. Central Bank of the Islamic Republic of Iran. 2018.
    https://www.cbi.ir/Inflation/Inflation_en.aspx.
  • 29. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387(10027):1513-30.
    https://doi.org/10.1016/S0140-6736(16)00618-8. Epub 2016 Apr 6. Erratum in: Lancet. 2017;389(10068):e2. Zandieh et al. BMC Complementary Medicine and Therapies (2022) 22:1 Page 9 of 9
  • 30. Kuntz K, Sainfort F, Butler M,Taylor B, Kulasingam S, Gregory S, et al. Decision and simulation modeling in systematic reviews. 2013.
  • 31. Weinstein MC, Russell LB, Gold MR, Siegel JE. Cost-effectiveness in health and medicine: Oxford university press; 1996.
  • 32. Moradi N, Rashidian A, Nosratnejad S, Olyaeemanesh A, Zanganeh M, Zarei L. Willingness to pay for one quality-adjusted life year in Iran. Cost Effect Resource Alloc. 2019;17(1):1-10.
  • 33. Rajakumar K, Moore CG, Khalid AT, Vallejo AN, Virji MA, Holick MF, et al. Effect of vitamin D3 supplementation on vascular and metabolic health of vitamin D-deficient overweight and obese children: a randomized clinical trial. Am J Clin Nutr. 2020;111(4):757-68.
  • 34. Niroomand M, Fotouhi A, Irannejad N, Hosseinpanah F. Does highdose vitamin D supplementation impact insulin resistance and risk of development of diabetes in patients with pre-diabetes? A double-blind randomized clinical trial. Diabetes Res Clin Pract. 2019;148:1-9. https:// doi.org/10.1016/j.diabres.2018.12.008.
  • 35. Cesareo R, lozzino M, D'Onofrio L, Terrinoni I, Maddaloni E, Casini A, et al. Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis. Minerva Endocrinol. 2015;40(3):231-7.
  • 36. Ito K. Cost-effectiveness of single-dose zoledronic acid for nursing home residents with osteoporosis in the USA. BMJ Open. 2018;8(9):e022585.
  • 37. Buckley LM, Hillner BE. A cost effectiveness analysis of calcium and vitamin D supplementation, etidronate, and alendronate in the prevention of vertebral fractures in women treated with glucocorticoids. J Rheumatol. 2003;30(1):132-8.
  • 38. Floreskul V, Juma FZ, Daniel AB, Zamir I, Rawdin A, Stevenson M, et al. Cost-effectiveness of Vitamin D supplementation in pregnant woman and Young children in preventing rickets: a modeling study. Front Public Health. 2020;8:439.
  • 39. Weaver CM, Bischoff-Ferrari HA, Shanahan CJ. Cost-benefit analysis of calcium and vitamin D supplements. Arch Osteoporos. 2019;14(1):50.
  • 40. Zarca K, Durand-Zaleski I, Roux C, Souberbielle JC, Schott AM, Thomas T, et al. Cost-effectiveness analysis of hip fracture prevention with vitamin D supplementation: a Markov micro-simulation model applied to the French population over 65 years old without previous hip fracture. Osteo-poros Int. 2014;25(6):1797-806.
  • 41. Lilliu H, Pamphile R, Chapuy MC, Schulten J, Arlot M, Meunier PJ. Calciumvitamin D3 supplementation is cost-effective in hip fractures prevention. Maturitas. 2003;44(4):299-305.
  • 42. Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamad-khani M, Asemi Z, et al. High prevalence of Vitamin D deficiency among Iranian population: a systematic review and Meta-analysis. Iran J Med Sci. 2018;43(2):125-39.
  • 43. Reis JR von Mühlen D, Miller ER 3rd, Michos ED, Appel LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics. 2009;124(3):e371-9.
  • 44. Denova-Gutierrez E, Munoz-Aguirre P Lopez D, Flores M, Medeiros M, Tamborrel N, et al. Low serum vitamin D concentrations are associated with insulin resistance in Mexican children and adolescents. Nutrients.
  • 2019;11(9):2109.
  • 45. Littorin B, Blom P Schölin A, Arnqvist H, Blohme G, Bolinder J, et al. Lower levels of plasma 25-hydroxyvitamin D among young adults at diagnosis of autoimmune type 1 diabetes compared with control subjects: results from the nationwide diabetes incidence study in Sweden (DISS). Diabeto-logia. 2006;49(12):2847-52.
  • 46. Pozzilli P Manfrini S, Crino A, Picardi A, Leomanni C, Cherubini V, et al. Low levels of 25-hydroxyvitamin D3 and 1, 25-dihydroxyvitamin D3 in patients with newly diagnosed type 1 diabetes. Horm Metab Res. 2005;37(11):680-3.
  • 47. Azab SF, Saleh SH, Elsaeed WF, Abdelsalam SM, Ali AA, Esh AM. Vitamin D status in diabetic Egyptian children and adolescents: a case-control study. Ital J Pediatr. 2013;39(1):1-7.
  • 48. Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, et al. Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D. J Clin Endocrinol Metab. 2008;93(3):677-81.
  • 49. Bacon CJ, Gamble GD, Horne AM, Scott MA, Reid IR. High-dose oral vitamin D3 supplementation in the elderly. Osteoporos Int. 2008;20(8):1407.

VitaminDWiki - Overview Diabetes and vitamin D contains

  • Diabetes is 5X more frequent far from the equator
  • Children getting 2,000 IU of vitamin D are 8X less likely to get Type 1 diabetes
  • Obese people get less sun / Vitamin D - and also vitamin D gets lost in fat
  • Sedentary people get less sun / Vitamin D
  • Worldwide Diabetes increase has been concurrent with vitamin D decrease and air conditioning
  • Elderly get 4X less vitamin D from the same amount of sun
        Elderly also spend less time outdoors and have more clothes on
  • All items in category Diabetes and Vitamin D 553 items: both Type 1 and Type 2

Vitamin D appears to both prevent and treat diabetes

Number of articles in both categories of Diabetes and:

  • Dark Skin 24;   Intervention 57;   Meta-analysis 40;   Obesity 36;  Pregnancy 44;   T1 (child) 39;  Omega-3 11;  Vitamin D Receptor 24;  Genetics 13;  Magnesium 30    Click here to see details

Some Diabetes studies

50 ng of Vitamin D fights Diabetes

T1 Diabetes

Pre-Diabetes

Diabetes, Metabolic Syndrome and Magnesium - many studies
Diabetic Epidemic

  • Step back to 1994. Suppose an epidemic struck the United States, causing blindness, kidney failure, and leg amputations in steadily increasing numbers.
    Suppose that in less than a decade's time, the epidemic had victimized one out of every eight people
    That epidemic is real, and its name is diabetes, now the nation's sixth leading cause of death.
    Chart from the web (2018?)
    Image

VitaminDWiki - One pill every two weeks gives you all the vitamin D most adults need

Diabetes + Heart Failure + Chronic Pain + Depression + Autism + Breast Cancer + Colon Cancer + Prostate Cancer + BPH (prostate) + Preeclampsia + Premature Birth + Falls + Cognitive Decline + Respiratory Tract Infection + Influenza + Tuberculosis + Chronic Obstructive Pulmonary Disease + Lupus + Inflammatory Bowel Syndrome + Urinary Tract Infection + Poor Sleep + Growing Pain + Multiple Sclerosis + PMS + Schizophrenia + Endometriosis + Smoking    27 problems
   Note: Once a week also fights: COVID, Headaches, Colds, Fibromyalgia, Asthma, Hives, Colitis etc.

VitaminDWiki - Cost savings with Vitamin D includes

158 items include:

VitaminDWiki - Vitamin D Proven to fight 93 health problems

VitaminDWiki - Weekly, Monthly Vitamin D are typically better than daily - many studies



Diabetes prevented by 50,000 IU vitamin D monthly (Iran) – Jan 2022        
7043 visitors, last modified 17 Mar, 2024,
Printer Friendly Follow this page for updates
Diabetes 510 Cost savings with Vitamin D 153 Middle East 152 Intervention 816 Intervention - non daily 268
Page actions
Print
Edit Files 1