Our Reporter, New York
Nigerian-born Dr. Benjamin Udoka Nwosu, a professor of pediatrics at the Zucker School of Medicine at Hofstra University, and the Chief of Endocrinology at the Cohen Children’s Medical Center of New York, has published an important paper in the Journal of the American Medical Association identifying the mechanism of action of vitamin D to prolong the honeymoon phase, also known as the partial clinical remission phase, of type 1 diabetes.
Dr. Nwosu’s research explains how vitamin D improves the function of the cells that make insulin in patients with type 1 diabetes.
Type 1 diabetes is marked by consistently elevated blood sugar levels due to autoimmune destruction of the insulin-producing beta-cells of the pancreas. Type 1 diabetes places a significant financial burden on individuals with the disease, their family members, and the national healthcare budget. Prolonging the duration of the honeymoon phase of type 1 diabetes improves blood glucose control in the short term and reduces the complications of the disease in the long term.
A 2021 estimate by the World Health Organization noted that 24 million Africans are living with diabetes, that is one in 22 adults. By 2045, that figure will increase by 129% to 55 million people. As of 2021, 416,000 Africans died from diabetes.
Dr. Nwosu has previously reported on the safety and efficacy of high-dose vitamin D supplementation to improve glucose control and prolong the honeymoon phase of type 1 diabetes, but that work did not address the mechanism of the findings.
In this publication, Dr. Nwosu reports that vitamin D prolongs the honeymoon phase of type 1 diabetes by augmenting beta-cell function through significant reductions in the proinsulin-to-C-peptide ratio and consequently slowing the rate of loss of C-peptide, which is the active indicator of partial clinical remission. The proinsulin-to-C-peptide ratio, which shows how efficiently the human body converts proinsulin to both insulin and C-peptide, is the gold standard marker for beta-cell health.
Dr. Nwosu’s findings place the use of high-dose vitamin D at the center of scientific approaches to modify the lifetime trajectory of type 1 diabetes to reduce its long-term complications.
