Hypovitaminosis D and effect of vitamin D supplementation in type 2 diabetes mellitus: a rural population based study
Keywords:Diabetes mellitus, Glycemic status, Vitamin D deficiency, Vitamin D supplement
Background: Deficiency of Vitamin D in general population and its association with various disease conditions have been studied worldwide. Type 2 Diabetes mellitus is increasing at an alarming rate in Indian subcontinent, contributing to increased morbidity and mortality. This study aimed to estimate level of Vitamin D and its association with patients with type 2 diabetes mellitus of rural origin. This study objective was to estimate the Vitamin D level of patients with Type 2 Diabetes mellitus and the effect of Vitamin D supplementation on glycemic status
Methods: This study was conducted at the Department of General medicine for a period of 1 year. Eighty patients with type 2 Diabetes mellitus were recruited in the study and baseline parameters of glycemic control and Vitamin D levels were assessed. Only 36 patients complied with the recommendation and evaluated further.
Results: All the patients included in the study had insufficient or deficient levels of Vitamin D. The mean vitamin D levels before and after supplementation were 17.75±6.30 and 29.33±6.34 respectively. The mean plasma HbA1c level before and after supplementation were 7.78 and 7.30 respectively. Patients after vitamin D replacement showed significant improvement in their glycaemic status.
Conclusions: Vitamin D supplementation of 2000 IU/day had shown to improve the glycaemic status. The beneficial effect of Vitamin D on diabetes was evident in a short period of supplementation.
Londhey V. Vitamin D deficiency: Indian scenario. J Assoc Physicians India. 2011;59(7):695-6.
Nikooyeh B, Neyestani TR, Farvid M, Alavi-Majd H, Houshiarrad A, Kalayi A, et al. Daily consumption of vitamin D-or vitamin D+ calcium-fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized clinical trial. Am J Clin Nutrition. 2011;93(4):764-71.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Ind Counc of Med Res-india diabetes (ICMR-INDIAB) study. Diabetol. 2011;54(12):3022-7.
Holick MF. Vitamin D deficiency. New Eng J Med. 2007;357(3):266-81.
Joergensen C, Gall MA, Schmedes A, Tarnow L, Parving HH, Rossing P. Vitamin D levels and mortality in type 2 diabetes. Diab Care. 2010;33(10):2238-43.
Sanwalka N. Vitamin D Deficiency in Indians-Prevalence and the Way Ahead. J Clin Nutr Diet. 2016, 1:2.
Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009;22(6):698-706.
Nagpal S, Na S, Rathnachalam R. Noncalcemic actions of vitamin D receptor ligands. Endocrine Rev. 2005;26(5):662-87.
Uitterlinden AG, Fang Y, van Meurs JBJ, van Leeuwen H, Pols HAP. Vitamin D receptor gene polymorphisms in relation to Vitamin D related disease states. J Steroid Biochem Mol Biol. 2004;89-90(1-5):187-93.
Hahn HJ, Kuttler B, Mathieu C, Bouillon R. 1,25-Dihydroxyvitamin D3 reduces MHC antigen expression on pancreatic beta-cells in vitro. Transplant Proc. 1997;29(4):2156-7.
Shab-Bidar S, Neyestani TR, Djazayery A, Eshraghian MR, Houshiarrad A, Gharavi AA, et al. Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinic trial. BMC Med. 2011;9(1):125.
Parameaswari PJ, Revathy C, Shanthi B. A cross-sectional study on Vitamin D3 level in type 2 diabetes mellitus patients from Chennai, India. Int J Basic Med Sci. 2012 Dec;3:130-4.
Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clinic Endocrinol Metabol. 2007;92(6):2017-29.
Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutrition Rev. 2006;64(11):479-86.
Need AG, O'loughlin PD, Horowitz M, Nordin BC. Relationship between fasting serum glucose, age, body mass index and serum 25 hydroxyvitamin D in postmenopausal women. Clinic Endocrinol. 2005;62(6):738-41.
Schwalfenberg G. Vitamin D and diabetes: improvement of glycemic control with vitamin D3 repletion. Canadian Fam Physician. 2008;54(6):864-6.
Kumar S, Davies M, Zakaria Y, Mawer EB, Gordon C, Olukoga AO, et al. Improvement in glucose tolerance and beta-cell function in a patient with vitamin D deficiency during treatment with vitamin D. Postgraduate Med J. 1994;70(824):440-3.
Dalgård C, Petersen MS, Weihe P, Grandjean P. Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians. Diabetes Care. 2011;34(6):1284-8.
Savinov AY, Tcherepanov A, Green EA, Flavell RA, Chervonsky AV. Contribution of Fas to diabetes development. Proceedings National Acad Sci. 2003;100(2):628-32.
Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and β cell dysfunction. Am J Clin Nutr. 2004;79(5):820-5..
Ljunghall S, Lind L, Lithell H, Skarfors E, Selinus I, Sørensen OH, et al. Treatment with one‐alpha‐hydroxycholecalciferol in middle‐aged men with impaired glucose tolerance-a prospective randomized double‐blind study. Acta Medica Scandinavica. 1987;222(4):361-7.
Fliser D, Stefanski A, Franek E, Fode P, Gudarzi A, Ritz E. No effect of calcitriol on insulin‐mediated glucose uptake in healthy subjects. Euro J Clinic Investigat. 1997;27(7):629-33.
Palomer X, González‐Clemente JM, Blanco‐Vaca F, Mauricio D. Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diab Obes Metabol. 2008;10(3):185-97.
Kull M, Kallikorm R, Tamm A, Lember M. Seasonal variance of 25-(OH) vitamin D in the general population of Estonia, a Northern European country. BMC Pub Heal. 2009;9(1):22.
Judd SE, Tangpricha V. Vitamin D therapy and cardiovascular health. Current Hypertension Rep. 2011;13(3):187-91.
Kositsawat J, Freeman VL, Gerber BS, Geraci S. Association of A1C levels with vitamin D status in US adults: data from the National Health and Nutrition Examination Survey. Diab Care. 2010;33(6):1236-8.
Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC, et al. Association of vitamin D with insulin resistance and β-cell dysfunction in subjects at risk for type 2 diabetes. Diab Care. 2010;33(6):1379-81.
Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr. 2007;85(3):649-50.
Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US), 1997. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23115811. Accessed 13 August 2014.
De Boer IH, Tinker LF, Connelly S, Curb JD, Howard BV, Kestenbaum B, et al. Calcium plus vitamin D supplementation and the risk of incident diabetes in the Women's Health Initiative. Diabetes Care. 2008;31(4):701-7.
Malhotra N, Mithal A, Gupta S, Shukla M, Godbole M. Effect of vitamin D supplementation on bone health parameters of healthy young Indian women. Arch Osteoporosis. 2009;4(1-2):47-53.
Shankar A, Sabanayagam C, Kalidindi S. Serum 25-hydroxyvitamin D levels and prediabetes among subjects free of diabetes. Diab Care. 2011;34(5):1114-9.
Robinson JG, Manson JE, Larson J, Liu S, Song Y, Howard BV, et al. Lack of association between 25 (OH) D levels and incident type 2 diabetes in older women. Diab Care. 2011;34(3):628-34.
Gupta AK, Brashear MM, Johnson WD. Prediabetes and prehypertension in healthy adults are associated with low vitamin D levels. Diab Care. 2011;34(3):658-60.
Talaei A, Mohamadi M, Adgi Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetol Metab Synd. 2013;5(1):8.