D Vitamin Intervention in VA

The goal of this randomized clinical trial (RCT) is to determine vitamin D efficacy and
safety for improving early markers of T2DM in African American male (AAM) veterans at risk
for T2DM (n=180, duration 12 months).

The primary outcome will be change in oral glucose insulin sensitivity (OGIS). The secondary
outcomes will include various parameters of glucose metabolism, markers of adipose tissue
(from subcutaneous fat aspiration) and inflammation markers.

Analysis based on primary and secondary goal as well as various levels of 25OHD at the end
of the study.

Inclusion Criteria:

Veterans at Jesse Brown VA Medical Center (JBVAMC) only

1. Male

2. African American race

3. Age 35-85 years

4. BMI 28-39.9 kg/m2

5. Stable weight (+/- 10%) for at least 3 months prior to study entry

6. Waist circumference 102 cm or presence of metabolic syndrome*

7. FPG 95 - 125 mg/dl

8. A1C 5.7 - 6.4%

9. Circulating 25OHD 5.0 - 19.9 ng/ml

10. Subjects who take ergocalciferol are allowed in the study after a washout period 1 3
month.

11. Subjects who take vitamin D supplements other than ergocalciferol are allowed in the
study as long as total dose is no more than 600 IU/day (including MVI and calcium
plus D supplements).

12. Non-diabetic subjects who are diagnosed with T2DM during screening (A1C 6.5-6.9%) or
after randomization are allowed to continue if they follow lifestyle intervention and
do not need to take anti-diabetic medications.

Exclusion Criteria:

1. Subjects with T2DM

2. Weight gain or loss of more than 10% within 3 months prior to the study entry

3. History of kidney stones, hyperparathyroidism, sarcoidosis or hypercalcemia

4. A1C 7%.

5. Very low 25OHD levels (<5 ng/ml) and/or the presence of a physical consequence of
very low vitamin D levels (hypocalcemia, hypophosphatemia, proximal muscle weakness)

6. Chronic kidney disease (CKD) stage 4 and 5

7. Problems that in the judgment of PI may be associated with the risk to the subject or
non-compliance

8. Subjects who take vitamin D supplements and not willing to go through washout period
for ergocalciferol or to take no more than 600 IU/day of total vitamin D supplements

9. History, clinical manifestations or medications of significant metabolic, hepatic,
renal, hematological, pulmonary, cardiovascular, gastrointestinal, urological,
neurological, psychiatric/ psychological disorders, or social circumstances which in
the opinion of the investigator would be expected to interfere with the study or
increase risk to the subject

10. Non-diabetic subjects who are diagnosed with T2DM after randomization and need to
take anti-diabetic medications are brought for the final visit