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T1 Diabetes reduction by high Omega-3 and Vitamin D – GRH ongoing observation

Update: Nov 2022: added 3 tests of T1D Autoantibodies in 16 months for $315

Vitamin D and Omega 3 Field Study on Progression of Type 1 Diabetes

CellR4 2019; 7: e2737
C. RicordP, M. Clare-Salzler2, M. Infante1, C. Baggerly3, J. Aliano3, S. McDonnell3, S. Chritton4 sonia at soniachritton.com
1Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA
2 department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA 3 GrassrootsHealth, Encinitas, CA, USA
4 Children With Diabetes Research Foundation, Superior, CO, USA

VitaminDWiki

Goal of Omega-3 index = 8 and Vitamin D 40-60 ng


VitaminDWiki Diabetes pages with T1 or TYPE 1 in title (46 as of Oct 2022)

This list is automatically updated

Items found: 49
Title Modified
T1 Diabetic adults 5X more likely to get COVID (hint low vitamin D)– Nov 2022 24 Nov, 2022
Milk Consumption Is strongly linked to Type 1 Diabetes – Dr. Greger Nov 2019 14 Nov, 2022
T1 Diabetes in child not prevented by a tiny amount of vitamin D during pregnancy – Nov 2015 15 Oct, 2022
T1 Diabetes 6.5 X more likely in South African Blacks if poor Vitamin D Binding Protein – July 2022 18 Jul, 2022
Prevent half of T1 Diabetes with vitamin D levels of 50 ng – Dec 2012 04 Jan, 2022
Vitamin D2 not help – again ( T1 diabetes– which has been helped by D3) – Jan 2022 17 Dec, 2021
Somewhat less Type 1 Diabetes in Wales recently – perhaps more sun or more vitamin D – March 2021 13 Mar, 2021
Endocrine Disrupting Chemicals and Vitamin D (T1 Diabetes in this case) - April 2020 12 Feb, 2021
Type 1 Diabetes (Autoimmune) and Vitamin D, Vitamin D Receptor and Cathelicidin - Dec 2020 03 Dec, 2020
T1 Diabetes 3X lower risk if high vitamin D (over 40 ng) – Meta-analysis Nov 2020 30 Nov, 2020
Poor CYP2R1 gene results in lower vitamin D and 2X increase in T1 Diabetes – Sept 2019 16 May, 2020
T1 Diabetes treated by Vitamin D and Omega-3 (many other studies agree) Jan 2018 23 Oct, 2019
Type 1 diabetes trial having problems getting participants – too many taking Vitamin D or Omega-3 – Aug 2019 03 Oct, 2019
Type 1 Diabetes is prevented and treated by Vitamin D – review of 16 studies – Sept 2019 14 Sep, 2019
T1 Diabetes reduction by high Omega-3 and Vitamin D – GRH ongoing observation 12 Sep, 2019
Type 1 Diabetes prevention with Vitamin D and Omega-3 – Symposium April 2019 25 Apr, 2019
Type 1 Diabetes risk increased if high postpartum Vitamin D binding protein – Jan 2019 24 Mar, 2019
T1 Diabetes – how it may be prevented and treated by Vitamin D – Dec 2018 29 Dec, 2018
Vitamin D and Omega-3 may treat Type 1 Diabetes – RCT 2024 24 Nov, 2018
Type 1 Diabetes is increasing – decreased vitamin D is one of the many possible reasons – Sept 2018 02 Nov, 2018
Type 1 diabetes 1.6 times more likely if a Vitamin D Receptor problem – Feb 2017 21 Aug, 2018
Early Type 1 Diabetes May Shorten Women’s Lives by 18 Years - Aug 2018 17 Aug, 2018
Type 1 Diabetes (T1DM) 1.6 X more likely if low vitamin D – meta-analysis Jan 2018 20 Jan, 2018
Type 1 Diabetes 14 percent more likely with 2 Vitamin D Receptor mutations – Oct 2017 12 Nov, 2017
Type 1 diabetes helped with 50,000 IU of vitamin D every two weeks – Nov 2014 20 Jul, 2017
T1 Diabetes associated with many other autoimmune diseases (all related to low vitamin D) – May 2017 03 Jun, 2017
Type 1 Diabetes association with poor Vitamin D Receptor: 39 studies – April 2017 20 Apr, 2017
Type 1 diabetes associated with faulty Vitamin D receptor genes – May 2013 20 Apr, 2017
Type 1 diabetes, genes and vitamin D 20 Apr, 2017
Type 1 diabetes risk not decreased if add 400 IU vitamin D while pregnant (no surprise) – Dec 2016 13 Dec, 2016
Diabetes (Type 1) increasing 4 percent per year, now 30,000 in the UK - May 2015 05 May, 2016
T1 diabetes in children helped with two doses of 150,000 IU of vitamin D and Calcium – March 2015 16 Nov, 2015
T1 Diabetes 35 percent more likely if 10 degrees further from equator (less vitamin D) – June 2014 16 Nov, 2015
Type 1 diabetes 3.5X more frequent if low vitamin D - Medscape CME Dec 2012 16 Nov, 2015
Type 1 Diabetes probability reduced by 2X if have more than 40 ng of vitamin D – Feb 2013 16 Nov, 2015
T1 Diabetes associated with low vitamin D - Nov 2014 16 Nov, 2015
Diabetes (Type 1) 14X more likely in dark skin children with low levels of vitamin D – May 2015 28 May, 2015
Type 1 diabetes strongly associated with low vitamin D – March 2013 06 Dec, 2014
Type 1 Diabetes associated with low vitamin D, especially in dark skinned youths – Dec 2012 06 Dec, 2014
Diabetes: Type 1 and 2 known for since 500 AD, Type 1.5 (LADA) known since 1993 22 Aug, 2014
Type 1 diabetes starting to decrease in Finland, they started Vitamin D fortification in 2003 – July 2013 26 Jul, 2014
T1 Diabetes increased about 15 percent per decade in Eastern Canada – Oct 2012 14 Jun, 2014
Type 1 diabetes is increasing, vitamin D deficiency may be one of the reasons – Aug 2013 14 Jun, 2014
Type 1 diabetes patients may be pissing away vitamin D – Jan 2011 14 May, 2014
T1 Diabetes independent of vitamin D for levels (disagrees with other studies) – Sept 2013 14 Sep, 2013
44 percent less Type 1 diabetes if high level of vitamin D – white skinned military – March 2013 13 Apr, 2013
Type 1 diabetes epidemic not correlated with vitamin D in womb – Aug 2011 15 Feb, 2012
Vitamin D deficient Type 1 diabetics 3X more likely to have calcification problems – Feb 2011 28 Oct, 2011
4000 IU vitamin D improved glycemic control for type 1 diabetes – Nov 2010 11 Nov, 2010

Items in both categories Diabetes and Omega-3 are listed here:


84 clinical trials listed for Omega-3 and Diabetes as of Nov 2022

 Download the PDF from VitaminDWiki

Chronic inflammation has been linked to the progression of type 1 diabetes (T1D). Supplementation with vitamin D and omega-3 fatty acids, which have anti-inflammatory properties, may slow or stop the progression of T1D. A field study is underway to assess the relationship between these nutrients and T1D progression among auto-antibody positive individuals who have not been diagnosed with T1D.
The T1D Prevention Field Study is currently recruiting participants to complete online health surveys and home blood-spot tests for 25-hydroxyvitamin D [25(OH)D], Omega-3 Index, AA:EPA Ratio, high-sensitivity C-reactive protein, and HbA1c every three to four months for 5 years. Participants (or their parents/ guardians) are given information about the importance of achieving a 25(OH)D level between 40-60 ng/ml and an AA:EPA Ratio between 1.5-3.0 to reduce inflammation. However, participants are free to choose their own supplement or dietary regimens. Data analysis will focus on associations between vitamin D and omega-3 status and progression of T1D. Initial enrollment in the T1D Prevention Field Study includes 103 participants from fifteen countries; total enrollment is expected to reach at least 400 participants by the end of 2022.
The field study approach allows for cost- effective research that capitalizes on new technologies for recruitment, data collection, and blood level testing from home. However, some challenges have arisen. Many individuals are reading the open source protocols and some choose to supplement and test on their own so incentives may be needed to increase enrollment. Additionally, some participants do not have access to auto-antibody testing or are unable to get access to their test results; therefore, there is a need to provide blood spot autoantibody testing through the field study.

Introduction

Type 1 diabetes (T1D), which is a chronic autoimmune disease characterized by the destruction of insulin-producing pancreatic beta cells, affects approximately 1.25 million people in the U.S1. Almost 18,000 new cases of T1D are diagnosed each year among those aged less than 20 years1. Complications related to T1D include cardiovascular disease, blindness, and kidney failure2. The estimated yearly cost of T1D in the United States in terms of medical costs and lost income is $14.4 billion3.
Studies have linked vitamin D and omega-3 status with T1D risk. Incidence rates of T1D were found to be higher in countries further from the equator, which have lower UVB irradiance from the sun4. Vitamin D and omega-3 intake and increased nutrient levels have been associated with a lower risk of developing autoimmunity against insulin-producing (islet) cells of the pancreas, or islet autoimmunity, and T1D diagnosis5-11. Also, studies have shown that use of Cod Liver Oil, which contains both vitamin D and omega-3 fatty acids, is associated with a lower risk of T1D10,11. Therefore, improving both vitamin D and omega-3 status may prevent T1D.
Chronic inflammation has also been associated with the development and progression of many chronic diseases including T1D12-15. Therefore, the mechanism for the association of vitamin D and omega-3s with reduced risk of T1D may, in part, be related to the known anti-inflammatory properties of vitamin D and omega-3 fatty acids16-19. A recent randomized clinical trial demonstrated that co-supplementation with vitamin D and omega-3s has beneficial effects on inflammation biomarkers among those with diabetes20. The T1D Prevention Field Study was initiated to further evaluate the combined effect of vitamin D and omega-3 on inflammation and T1D prevention, with specific regard to nutrient levels rather than intake amount due to the significant variability in dose-response21,22. In accordance with the Open Source Movement, this paper describes the T1D Prevention Field Study in an effort to make participation as openly available as possible and allow protocol modifications if needed.

Type 1 Diabetes (T1D) Prevention Field Study

GrassrootsHealth, a non-profit public health research organization, has been running a field study on nutrient levels and health outcomes since 2008. This field study is a long-term (5+ years), real-world prospective cohort study with a large worldwide participant population (N=10,000+). Participation includes completing online health surveys and home blood-spot 25-hydroxyvitamin D [25(OH)D] test kits. This field study has no inclusion or exclusion criteria and participants are allowed to achieve the nutrient status of their choice.
In July 2018, a T1D prevention sub-study was initiated and is currently recruiting auto-antibody positive individuals who have not been diagnosed with T1D to assess the relationship between vitamin D and omega-3 status with T1D progression. Participants complete online health surveys, which collect demographics, auto-antibody status, T1D diagnosis, supplement intake, and other health-related information. Blood-spot tests for serum 25(OH) D and Omega-3 Index, the physiological measures of vitamin D and omega-3 status, are completed at home every three to four months for a duration of 5 years. The AA:EPA Ratio, which is a measure of the primary pro-inflammatory omega-6 (arachi- donic acid, AA) to the primary anti-inflammatory omega-3 (eicosapentaenoic acid, EPA), is also measured along with HbA1c levels and high-sensitivity C-reactive protein (hs-CRP), a biomarker of inflammation. Participants do not have any in-person visits with project staff or medical professionals as part of the field study. This study is neither designed nor intended to replace any communication or treatment from the participant’s physician(s).
Different from a clinical trial, participants in this field study are not assigned to treatment and control groups or required to take a specific dose or achieve a specific nutrient level. Participants (or their parents/guardians) receive their blood-spot test results and information about the importance of achieving 25(OH)D levels between 40-60 ng/ml, an Omega-3 Index at or above 8%, and an AA:EPA Ratio between 1.5-3.0 to reduce chronic inflammation and improve health. However, they are free to choose their own supplement or dietary regimens and nutrient status targets. Due to non-supplemen- tal inputs (e.g. diet, sun exposure) and inter-individual variability in dose response, participants are able to personalize their supplement doses based on their test results and desired nutrient status. Participants also receive information about islet autoantibodies, anti- and pro-inflammatory foods, and other T1D-related information. The dissemination of test results and information allows participants to take ownership over their health and creates a more interactive and dynamic study environment compared to other observational study designs.
Participants have been recruited via social media, websites, and conferences for T1D families. Initial enrollment in the T1D Prevention Field Study includes 103 participants from fifteen countries; total enrollment is expected to reach at least 400 participants by the end of 2022. Data analysis will focus on associations between vitamin D and omega-3 status and progression of T1D. Specifically, the individual and combined effects of 25(OH)D, Omega-3 Index, and AA:EPA Ratio on hs-CRP levels, HbA1c levels, auto-antibody status, and diagnosis of T1D will be assessed. All participants provide informed consent and this study was approved by the Western Institutional Review Board (Olympia, WA, USA).

Discussion

Families with children who have a high risk of developing T1D have asked for a less invasive, less expensive, and more convenient way of intervening in the progression of T1D. Vitamin D and omega-3 testing and supplementation are safe and affordable and could be a key tool to slow or stop T1D progression. Given the opportunities created by Open Source, such as through support groups and social media, many are aware of the possible benefits of vitamin D and omega-3 and have been supplementing for many years. Anecdotal evidence from these individuals indicates that the T1D status of some has been updated to “non-progressor” or “reverter.” The T1D Prevention Field Study allows for the collection of data from individuals across the vitamin D and O3 status ranges so that the relationship between nutrient status and T1D progression can be determined and quantified.
A field study approach allows for more cost-effective and generalizable research than most clinical trials. New technology can be utilized to increase research efficiency and participant involvement in the study. This includes internet-based recruitment, enrollment, and data collection; at home blood spot testing; and a personalized and interactive nutrient health system for participants. A field study with this new technology can easily collect measurements for multiple co-nutrients and data on many risk factors and health outcomes, which can be used to identify associations and synergistic effects between nutrients. Data collected from the field study may be used to help inform clinical trial hypotheses and promote collaborative research.
Some challenges have arisen during the first year of the T1D Prevention Field Study. Since many individuals are reading the open source protocols, some have chosen to supplement and test on their own. Incentives could be helpful to increase enrollment in the T1D Prevention Field Study. For example, providing supplements at no charge could increase enrollment and ensure supplement quality. Additionally, some participants do not have access to auto-antibody testing or are unable to get access to their test results. Providing blood spot auto-antibody testing through the field study could increase data completion and provide valuable information to participants about their status. Also, there has been concern that supplementation within or outside of the field study may interfere with pharmaceutical drug trials. However, we suggest that vitamin D and omega-3 supplementation and measurement may have an important role in any T1D clinical trial because the reduction of chronic inflammation and immuno- modulation could be critical to the success of any other clinical intervention strategy.
While the T1D Prevention Field Study focuses on individuals who are auto-antibody positive without a T1D diagnosis, additional sub-studies are being planned to also assess the effect of vitamin D and omega-3 status among those who have an increased genetic risk but are not yet auto-antibody positive and those who have already been diagnosed with T1D. Preliminary findings from other research studies suggest that this therapeutic approach may halt autoimmunity, preserve residual beta-cell function, and reduce exogenous insulin requirements in patients with T1D23-25. Importantly, even a partial level of beta-cell function is associated with reduced risk of chronic complications26, hypoglycemia, and diabetic ketoacidosis27. The relative contribution of vitamin D and omega-3s to reduce inflammation and autoimmune responses is being investigated by the ongoing POSEIDON trial, a phase I/II trial enrolling T1D children (6-17 years) and adults (18-65 years) with both new-onset (<6 months of disease duration) and established disease (>6 months and up to 10 years of disease duration)28,29. Participants are randomly assigned to receive vitamin D in a dose that achieves 40 ng/ ml and omega-3 fatty acids in a dose that achieves an AA:EPA Ratio of 1.5-3.0, or vitamin D alone. As the additional GrassrootsHealth sub-study for those already diagnosed with T1D is established, participants who are unable to participate in the POSEIDON trial may enroll this alternative study, which will focus on the potential benefit of vitamin D and omega-3s beyond prevention.

Funding: The T1D Prevention Field Study is funded by the Children With Diabetes Research Foundation and GrassrootsHealth, both non-profit entities.
Conflict of Interest: The Authors declare that they have no conflict of interests.

References

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  5. Munger KL, Levin LI, Massa J, Horst R, Orban T, Asch- erio A. Preclinical serum 25-hydroxyvitamin D levels and risk of type 1 diabetes in a cohort of US military personnel. Am J Epidemiol 2013; 177: 411-419.
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  7. Norris JM, Lee HS, Frederiksen B, Erlund I, Uusitalo U, Yang J, Lernmark A, Simell O, Toppari J, Rewers M, Ziegler AG, She JX, Onengut-Gumuscu S, Chen WM, Rich SS, Sundvall J, Akolkar B, Krischer J, Virtanen SM, Hagopian W; TEDDY Study Group. Plasma 25-hy- droxyvitamin D concentration and risk of islet autoimmunity. Diabetes 2018; 67: 146-154.
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