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

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

Mohammad Hayat Bhat1, Mansoor Mohd2, Ishrat Hussain Dar2, Javaid Ahmad Bhat1
Clin Diabetol 2021;10(2):188-194.


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.

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  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.