VITAMIN D insufficiency is highly prevalent amongst children with Type 1 diabetes, despite many maintaining normal parathyroid hormone and calcium levels, new research from the United Arab Emirates has found.
In a study of 102 children and adolescents with Type 1 diabetes, 73.3% had insufficient vitamin D levels. However, researchers found no significant association between vitamin D and parathyroid hormone (PTH), suggesting that compensatory mechanisms may help preserve calcium homeostasis.
Vitamin D and PTH have closely linked roles in maintaining calcium levels, while calcium itself is important for insulin function. Researchers therefore investigated the relationship between Type 1 diabetes, vitamin D deficiency, and PTH levels in a multicultural paediatric population in Dubai.
The cross-sectional study included 102 patients aged 3–18 years treated at Al Jalila Children’s Specialty Hospital in 2023. Researchers collected data on vitamin D, PTH, calcium and phosphate levels alongside HbA1c, BMI, comorbidities, insulin prescriptions, and vitamin D supplementation.
Of the participants, 52.9% were Emirati and 47.1% were from other nationalities, while 70.6% were aged 6–13 years.
Overall, 73.3% of participants had insufficient vitamin D, while 63.2% had normal PTH levels.
There was no statistically significant association between vitamin D and PTH levels. Researchers also found no significant relationship between vitamin D, PTH, and factors including phosphate levels, vitamin D supplementation, and comorbidities.
Notably, amongst patients who had insufficient vitamin D but normal PTH, 83.3% also maintained normal calcium levels.
The researchers suggested this indicates that children with Type 1 diabetes may retain the ability to regulate calcium homeostasis through PTH despite inadequate vitamin D levels.
While these compensatory mechanisms may maintain normal calcium levels in the short term, the authors cautioned that prolonged vitamin D insufficiency could have longer-term consequences.
Vitamin D plays an important role in bone development during childhood and adolescence, while sustained compensatory PTH activity can affect bone metabolism.
The authors therefore highlighted the importance of further research into causal pathways linking vitamin D, PTH, calcium regulation, and Type 1 diabetes.
The study was conducted at a single centre and was cross-sectional, meaning it cannot establish causality. Researchers also could not control for factors affecting vitamin D levels, including diet and seasonality.
Nevertheless, the findings demonstrate a substantial burden of vitamin D insufficiency in this multicultural paediatric Type 1 diabetes population and suggest further investigation may be needed into how reference ranges account for demographic variation.
Reference
Ibrahim MK et al. Prevalence of Vitamin D Deficiency and Its Association With PTH and Type 1 Diabetes Mellitus (T1DM) in a Multicultural Pediatric Population in the United Arab Emirates. 2023. J Diabetes. 2026;18(9):e70219.
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