Vitamin D injection is far better than oral for diabetics (poor gut) – RCT March 2017

Guesses of Vitamin D response if poor gut

Bio	Form	Speed	Duration
10	Injection ($$$) or Calcidiol or Calcitriol	D - Slow C -Fast	Long
10	Sun/UVB	Slow	Long
10	Topical (skin patch/cream, vagina)	Slow Fast nano	Normal
9	Nanoemulsion -mucosal perhaps activates VDR	Fast	Normal
9?	Inhaled (future)	Fast	Normal
8	Bio-D-Mulsion Forte	Normal	Normal
6	Water soluble (Bio-Tech)	Normal	Normal
4	Sublingual/spray (some goes into gut)	Fast	Normal
3	Coconut oil based	Slow	Normal
2	Food (salmon etc.)	Slow	Normal
2	Olive oil based (majority)	Slow	Normal

10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months

Poor gut is associated with Gut diseases as well as Diabetes, Multiple Sclerosis, and many other diseases
Reminder - Vitamin D is absorbed in the first portion of the small intestine
Some gut problems which only occur in large intestine may not be a problem
On-going research at VitaminDWiki as of March 2017
  Getting Vitamin D into your body has details on each thype of vitamin D and the following chart

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Parenteral vitamin D supplementation is superior to oral in vitamin D insufficient patients with type 2 diabetes mellitus

Diabetes & Metabolic Syndrome: Clinical Research & Reviews. online 6 March 2017, http://dx.doi.org/10.1016/j.dsx.2017.03.019
Awanindra Dwivedia, Balram Guptaa, Shalbha Tiwaria, d, Daliparthy D. Pratyusha, d, Saurabh Singhc, Surya Kumar Singha, sksendocrine at yahoo.com

Background/objectives
Oral vitamin D supplementation is better than parenteral in improving vitamin D deficiency in individuals with no systemic illness. Our aim was to compare the efficacy of oral and parenteral routes of vitamin D supplementation on circulating serum 25(OH) vitamin D level in patients with type 2 diabetes mellitus.

Methods
Total 85 cases of with type 2 diabetes mellitus were screened for vitamin D status of which 71 patients were vitamin D insufficient/deficient. They were randomized into two intent to treat groups with different vitamin D supplementation protocols

• (a) Oral-60000 IU per day for 5 days (group I; n = 40) and
• (b) injectable-300000 IU intramuscularly once (group II; n = 31).

Baseline and one-month post supplementation 25(OH) vitamin D levels were measured in both the groups.

Results
Baseline clinical characteristics and 25(OH) vitamin D levels were comparable in both the groups. Post treatment 25(OH) vitamin D level in

• group I was 26.06 ± 9.06 ng/ml and in
• group II was 49.69 ± 18.92 ng/ml.

After one month of vitamin D supplementation, increment in 25(OH) vitamin D level from baseline was significantly higher in group II than group I (p < 0.001).

Interpretation & conclusions
Injectable method of supplementation was better than oral route in improving serum 25 (OH) vitamin D status in patients with type 2 diabetes. The study suggested impaired absorption of vitamin D from the gastrointestinal tract in patients with type 2 diabetes mellitus and a need for parenteral route of vitamin D supplementation in deficient patients with type 2 diabetes mellitus.

Publisher wants $31.50 for the PDF
Purchased by VitaminDWiki

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Injection references in the study

• Comparison of oral versus injectable vitamin-D for the treatment of nutritional vitamin-D deficiency rickets July 2009
  "injectable form was shown to be statistically significant"    Can request full text at ResearchGate
• Treatment of Hypovitaminosis D With Pharmacologic Doses of Cholecalciferol, Oral vs Intramuscular Medscape 2013
  full text online, RCT, no difference for people without digestive problems
   Download the PDF from VitaminDWiki
• A Randomized controlled trial on safety and efficacy of single intramuscular versus staggered oral dose of 600 000IU Vitamin D in treatment of nutritional rickets. Jun 2014  Download the PDF from VitaminDWiki
  

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Bone Mineral Density - oral vs injection -Oct 2015

COMPARISON OF ORAL AND INJECTABLE VITAMIN D ON BONE MINERAL DENSITY IN PERI AND POSTMENOPAUSAL WOMEN WITH HYPOVITAMINOSIS D

• Full text online. 10 weeks of 60,000 IU vs 1 600,000 IU injection + daily 1 gram of Calcium
  "Although, with intramuscular route the serum vitamin D levels are maintained for 12 months, there is no improvement in BMD byeither route."
  Sufficiency (> 30 ng) at 12 month:s 85.7% injection, 22.9%. oral
  

Short URL = is.gd/BioForms