open access

Vol 10, No 2 (2021)
Research paper
Published online: 2021-05-05
Get Citation

Role of vitamin D deficiency in type 2 diabetes: Association or coincidence?

Mohammad Hayat Bhat, Mansoor Mohd, Ishrat Hussain Dar, Javaid Ahmad Bhat
DOI: 10.5603/DK.a2021.0029
·
Clinical Diabetology 2021;10(2):188-194.

open access

Vol 10, No 2 (2021)
Original articles (submitted)
Published online: 2021-05-05

Abstract

Background. Vitamin D has received considerable attention for its possible role in myriad of clinical conditions especially non-communicable chronic diseases. However, it is the role in the pathogenesis of type 2 diabetes (T2DM), which has generated a lot of enthusiasm to unravel the association between the two.

Aim. To determine the prevalence of hypovitaminosis D and its relation with the glycemic control in T2DM patients attending a tertiary care hospital in Kashmir.

Methods. A total of 108 cases of T2DM and 101 healthy controls aged between 35-65years were investigated in this study. 25-hydroxyvitamin D (25OHD), glycosylated hemoglobin (HbA1c) and fasting serum insulin levels were determined using standardised and automated assays. Insulin resistance (IR) and beta-cell function (B) were estimated by the homeostasis model assessment (HOMA).

Results. The mean serum level of 25OHD was significantly lower in T2DM group compared to controls (20.55 ± 12.27 vs 27.62 ± 5.32 ng/mL; P = 0.001). The prevalence of hypovitaminosis D was significantly higher in patients with T2DM (79.5% vs 62.7%; P = 0.031). Overall 51.1% and 28.4% patients with diabetes and 41.2% and 21.6% controls had vitamin D deficiency and insufficiency respectively. Vitamin D was found to have a significantly positive association with serum fasting insulin level and HOMA-B in both cases (P = 0.019), (P = 0.026) and controls (P = 0.022), (P = 0.008) respectively. Prolonged glycemic control as determined by HbA1c demonstrated a significant inverse correlation with vitamin D level in both cases (r = -0.225;P = 0.035) and controls (r = -0.373; P = 0.007).

Conclusion. We conclude that vitamin D deficiency (VDD) is a very common health problem and is relatively more common in patients with T2DM. There is an inversed association between vitamin D and glycemic control. Vitamin D status thus appears to affect glucose homeostasis. Vitamin D screening and supplementation is a plausible way to mitigate the impact of VDD on glucose homeostasis in T2DM.

Abstract

Background. Vitamin D has received considerable attention for its possible role in myriad of clinical conditions especially non-communicable chronic diseases. However, it is the role in the pathogenesis of type 2 diabetes (T2DM), which has generated a lot of enthusiasm to unravel the association between the two.

Aim. To determine the prevalence of hypovitaminosis D and its relation with the glycemic control in T2DM patients attending a tertiary care hospital in Kashmir.

Methods. A total of 108 cases of T2DM and 101 healthy controls aged between 35-65years were investigated in this study. 25-hydroxyvitamin D (25OHD), glycosylated hemoglobin (HbA1c) and fasting serum insulin levels were determined using standardised and automated assays. Insulin resistance (IR) and beta-cell function (B) were estimated by the homeostasis model assessment (HOMA).

Results. The mean serum level of 25OHD was significantly lower in T2DM group compared to controls (20.55 ± 12.27 vs 27.62 ± 5.32 ng/mL; P = 0.001). The prevalence of hypovitaminosis D was significantly higher in patients with T2DM (79.5% vs 62.7%; P = 0.031). Overall 51.1% and 28.4% patients with diabetes and 41.2% and 21.6% controls had vitamin D deficiency and insufficiency respectively. Vitamin D was found to have a significantly positive association with serum fasting insulin level and HOMA-B in both cases (P = 0.019), (P = 0.026) and controls (P = 0.022), (P = 0.008) respectively. Prolonged glycemic control as determined by HbA1c demonstrated a significant inverse correlation with vitamin D level in both cases (r = -0.225;P = 0.035) and controls (r = -0.373; P = 0.007).

Conclusion. We conclude that vitamin D deficiency (VDD) is a very common health problem and is relatively more common in patients with T2DM. There is an inversed association between vitamin D and glycemic control. Vitamin D status thus appears to affect glucose homeostasis. Vitamin D screening and supplementation is a plausible way to mitigate the impact of VDD on glucose homeostasis in T2DM.

Get Citation

Keywords

vitamin D deficiency, type 2 diabetes mellitus, HOMA-IR, HOMA-B

About this article
Title

Role of vitamin D deficiency in type 2 diabetes: Association or coincidence?

Journal

Clinical Diabetology

Issue

Vol 10, No 2 (2021)

Article type

Research paper

Pages

188-194

Published online

2021-05-05

DOI

10.5603/DK.a2021.0029

Bibliographic record

Clinical Diabetology 2021;10(2):188-194.

Keywords

vitamin D deficiency
type 2 diabetes mellitus
HOMA-IR
HOMA-B

Authors

Mohammad Hayat Bhat
Mansoor Mohd
Ishrat Hussain Dar
Javaid Ahmad Bhat

References (30)
  1. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 edition. Diabetes Res Clin Pract. 2019; 157: 107843.
  2. Zargar AH, Khan AK, Masoodi SR, et al. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent. Diabetes Res Clin Pract. 2000; 47(2): 135–146.
  3. Dar IH, Dar SH, Bhat RA, et al. Prevalence of type 2 diabetes mellitus and its risk factors in the age group 40 years and above in the Kashmir valley of the Indian subcontinent. 2015; 16(3): 11.
  4. Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015; 6(6): 850–867.
  5. Liebl A, Khunti K, Orozco-Beltran D, et al. Health economic evaluation of type 2 diabetes mellitus: a clinical practice focused review. Clin Med Insights Endocrinol Diabetes. 2015; 8: 13–19.
  6. Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin North Am. 2014; 43(1): 205–232.
  7. Leung PoS. The potential protective action of vitamin D in hepatic insulin resistance and pancreatic islet dysfunction in type 2 diabetes mellitus. Nutrients. 2016; 8(3): 147.
  8. Palomer X, González-Clemente JM, Blanco-Vaca F, et al. Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes Obes Metab. 2008; 10(3): 185–197.
  9. Tai K, Need AG, Horowitz M, et al. Vitamin D, glucose, insulin, and insulin sensitivity. Nutrition. 2008; 24(3): 279–285.
  10. Bland R, Markovic D, Hills CE, et al. Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in pancreatic islets. J Steroid Biochem Mol Biol. 2004; 89-90(1-5): 121–125.
  11. Oli JM, Adeyemo AA, Okafor GO, et al. Basal insulin resistance and secretion in Nigerians with type 2 diabetes mellitus. Metab Syndr Relat Disord. 2009; 7(6): 595–599.
  12. Aparna P, Muthathal S, Nongkynrih B, et al. Vitamin D deficiency in India. J Family Med Prim Care. 2018; 7(2): 324–330.
  13. Zargar AH, Ahmad S, Masoodi SR, et al. Vitamin D status in apparently healthy adults in Kashmir Valley of Indian subcontinent. Postgrad Med J. 2007; 83(985): 713–716.
  14. Pittas AG, Lau J, Hu FB, et al. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007; 92(6): 2017–2029.
  15. Maestro B, Campión J, Dávila N, et al. Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J. 2000; 47(4): 383–391.
  16. Dunlop TW, Väisänen S, Frank C, et al. The human peroxisome proliferator-activated receptor delta gene is a primary target of 1alpha,25-dihydroxyvitamin D3 and its nuclear receptor. J Mol Biol. 2005; 349(2): 248–260.
  17. Williams PF, Caterson ID, Cooney GJ, et al. High affinity insulin binding and insulin receptor-effector coupling: modulation by Ca2+. Cell Calcium. 1990; 11(8): 547–556.
  18. Johnson JA, Grande JP, Roche PC, et al. Immunohistochemical localization of the 1,25(OH)2D3 receptor and calbindin D28k in human and rat pancreas. Am J Physiol. 1994; 267(3 Pt 1): E356–E360.
  19. Sergeev IN, Rhoten WB. 1,25-Dihydroxyvitamin D3 evokes oscillations of intracellular calcium in a pancreatic beta-cell line. Endocrinology. 1995; 136(7): 2852–2861.
  20. Iqbal K, Islam N, Mehboobali N, et al. Association of vitamin D deficiency with poor glycaemic control in diabetic patients. J Pak Med Assoc. 2016; 66(12): 1562–1565.
  21. Aljabri K. Study of vitamin D status and its correlation with glycated haemoglobinin type 2 diabetes mellitus. Journal of Obesity and Diabetes. 2019: 12–16.
  22. Kumar H, Singh BV, Meena BL, et al. Correlation of vitamin D level with glycemic control in type 2 diabetes mellitus. Sch J Appl Med Sci. 2015; 3(6): 2277.
  23. Prentice A, Schoenmakers I, Jones KS, et al. Vitamin D deficiency and its health consequences in africa. Clin Rev Bone Miner Metab. 2009; 7: 94–106.
  24. Kositsawat J, Freeman VL, Gerber BS, et al. Association of A1C levels with vitamin D status in U.S. adults: data from the National Health and Nutrition Examination Survey. Diabetes Care. 2010; 33(6): 1236–1238.
  25. Chinedu A, Fasanmade OA, Coker H, et al. Relationship between vitamin D levels and glycaemic control in Type 2 diabetes mellitus patients in Lagos, Nigeria. Journal of Diabetology. 2017; 8(2): 32.
  26. Autier P, Mullie P, Macacu A, et al. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014; 2(1): 76–89.
  27. Rafiq S, Jeppesen PB. Is Hypovitaminosis D Related to Incidence of Type 2 Diabetes and High Fasting Glucose Level in Healthy Subjects: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2018; 10(1).
  28. Chiu KC, Chu A, Go VL, et al. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004; 79(5): 820–825.
  29. Fondjo LA, Owiredu WK, Sakyi SA, et al. Vitamin D status and its association with insulin resistance among type 2 diabetics: A case -control study in Ghana. PLoS One. 2017; 12(4): e0175388.
  30. Sheth JJ, Shah A, Sheth FJ, et al. Does vitamin D play a significant role in type 2 diabetes? BMC Endocr Disord. 2015; 15: 5.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl