How do I install the Endo Vitd Supplementation Prediabetes skill?

Run npx skillmds@latest add dromlakhani/endo-vitd-supplementation-prediabetes in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Which AI agents work with Endo Vitd Supplementation Prediabetes?

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Is Endo Vitd Supplementation Prediabetes free to use?

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Who published Endo Vitd Supplementation Prediabetes?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Vitd Supplementation Prediabetes by dromlakhani

Name: Endo Vitd Supplementation Prediabetes
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Vitd Supplementation Prediabetes

Suggests empiric vitamin D supplementation plus lifestyle modification to reduce diabetes progression in adults with high-risk prediabetes. Triggered by clinician questions such as "Should I prescribe vitamin D to this patient with prediabetes?" or "Is vitamin D supplementation indicated for prediabetes management?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Vitamin D supplementation for prediabetes

STEP 1 — Gather Information

Collect fasting plasma glucose, HbA1c, and 2‑hour glucose after a 75‑g oral glucose tolerance test to confirm prediabetes (meeting 2 or 3 ADA glycemic criteria). Screen for conditions that constitute established indications for vitamin D testing/treatment (e.g., hypocalcemia, hyperparathyroidism, granulomatous diseases) and assess whether lifestyle modification (diet, physical activity, weight loss) is already in place.

STEP 2 — Rule In / Rule Out

Is the patient an adult with high‑risk prediabetes (≥2 abnormal ADA criteria) and without contraindications to empiric vitamin D?

Yes → proceed to STEP 3.
No → do not prescribe empiric vitamin D for diabetes prevention; manage prediabetes with lifestyle modification alone and consider standard indications for vitamin D testing if present.

STEP 3 — Classify or Stratify

Classify as a candidate for empiric vitamin D supplementation; the guideline does not require baseline 25(OH)D testing or stratification by dose, age, or BMI for the recommendation (though greater benefit may be seen in those >62 y, baseline 25(OH)D <12 ng/mL, or BMI <30 kg/m²).
Decision: proceed to prescribe empiric vitamin D supplementation.

STEP 4 — Decide

Prescribe empiric vitamin D supplementation (dose range used in trials: 842–7543 IU daily; weighted average ≈3500 IU/day) in addition to continuing lifestyle modification. Do not obtain routine 25(OH)D levels to guide dosing; re‑evaluate lifestyle adherence and glycemic parameters at routine follow‑up intervals.

Clinical Guardrails / Mimics / Pitfalls

Do not rely on 25(OH)D testing to decide supplementation; avoid high‑dose intermittent bolus regimens without monitoring for hypercalcemia; do not use in patients with granulomatous diseases, certain lymphomas, or primary hyperparathyroidism where vitamin D may increase calcium absorption risk; do not substitute vitamin D for lifestyle modification; avoid exceeding the tolerable upper intake level without clinical supervision (generally ≤4000 IU/day unless monitored).

Concrete Clinical Example

A 58‑year‑old man with BMI 31 kg/m² has fasting glucose 112 mg/dL, HbA1c 6.1 %, and 2‑hour glucose 158 mg/dL (meets 2 ADA criteria). He has no history of hypercalcemia or granulomatous disease and has begun a reduced‑calorie diet and walking 150 min/week. According to the guideline, prescribe empiric vitamin D supplementation (e.g., 2000–4000 IU daily) alongside continued lifestyle modification; do not order a 25(OH)D level to guide the decision.

Source: Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2024, https://doi.org/10.1210/clinem/dgae290

---name: endo-vitd-supplementation-prediabetesdescription: Suggests empiric vitamin D supplementation plus lifestyle modification to reduce diabetes progression in adults with high-risk prediabetes. Triggered by clinician questions such as "Should I prescribe vitamin D to this patient with prediabetes?" or "Is vitamin D supplementation indicated for prediabetes management?"---# Vitamin D supplementation for prediabetes## STEP 1 — Gather InformationCollect fasting plasma glucose, HbA1c, and 2‑hour glucose after a 75‑g oral glucose tolerance test to confirm prediabetes (meeting 2 or 3 ADA glycemic criteria). Screen for conditions that constitute established indications for vitamin D testing/treatment (e.g., hypocalcemia, hyperparathyroidism, granulomatous diseases) and assess whether lifestyle modification (diet, physical activity, weight loss) is already in place.## STEP 2 — Rule In / Rule OutIs the patient an adult with high‑risk prediabetes (≥2 abnormal ADA criteria) **and** without contraindications to empiric vitamin D? - **Yes** → proceed to STEP 3. - **No** → do not prescribe empiric vitamin D for diabetes prevention; manage prediabetes with lifestyle modification alone and consider standard indications for vitamin D testing if present.## STEP 3 — Classify or StratifyClassify as a candidate for empiric vitamin D supplementation; the guideline does not require baseline 25(OH)D testing or stratification by dose, age, or BMI for the recommendation (though greater benefit may be seen in those >62 y, baseline 25(OH)D <12 ng/mL, or BMI <30 kg/m²). **Decision:** proceed to prescribe empiric vitamin D supplementation.## STEP 4 — DecidePrescribe empiric vitamin D supplementation (dose range used in trials: 842–7543 IU daily; weighted average ≈3500 IU/day) **in addition to** continuing lifestyle modification. Do **not** obtain routine 25(OH)D levels to guide dosing; re‑evaluate lifestyle adherence and glycemic parameters at routine follow‑up intervals.## Clinical Guardrails / Mimics / PitfallsDo not rely on 25(OH)D testing to decide supplementation; avoid high‑dose intermittent bolus regimens without monitoring for hypercalcemia; do not use in patients with granulomatous diseases, certain lymphomas, or primary hyperparathyroidism where vitamin D may increase calcium absorption risk; do not substitute vitamin D for lifestyle modification; avoid exceeding the tolerable upper intake level without clinical supervision (generally ≤4000 IU/day unless monitored).## Concrete Clinical ExampleA 58‑year‑old man with BMI 31 kg/m² has fasting glucose 112 mg/dL, HbA1c 6.1 %, and 2‑hour glucose 158 mg/dL (meets 2 ADA criteria). He has no history of hypercalcemia or granulomatous disease and has begun a reduced‑calorie diet and walking 150 min/week. According to the guideline, prescribe empiric vitamin D supplementation (e.g., 2000–4000 IU daily) alongside continued lifestyle modification; do not order a 25(OH)D level to guide the decision.**Source:** Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2024, https://doi.org/10.1210/clinem/dgae290

Frequently asked questions