Correlation Between Vitamin D Deficiency and Glycemic Control in Type 2 Diabetic Patients. A clinical study

• SWAIBA AFZAL

  Assistant professor physiology , Sahiwal medical college Sahiwal

  Author

• NAZIA SHAHNAWAZ

  Women medical officer , Dhq Multan

  Author

• NISHAT AFROZ

  Women medical officer, Shahbaz sharif hospital Multan

  Author

Background: Vitamin D has significance in the glucose metabolism, its effects involve secretion and insulin sensitivity, and involvement in the regulation of inflammation. Deficiency of vitamin D has increasingly become the cause of poor glycemic control of patients with type 2 diabetes mellitus (T2DM). The authors of this paper sought to establish the relationship between the glycemic control, in the form of glycated hemoglobin (HbA1C), measured by T2DM patients and serum 25-hydroxyvitamin D [25(OH)D].

Methods: A cross-sectional clinical study was performed in one of the tertiary care hospitals with 100 adult patients with diagnosed T2DM (30-70 years). Serum 25(OH)D and HbA1c were sampled through a chemiluminescent immunoassay and high-performance liquid chromatography by respectively measuring blood samples by fasting and estimations respectively. Demographic variables, Body mass index, blood pressure and length of diabetes were inputted. The correlation analysis and multivariate regression were also conducted to establish the relationship between the level of vitamin D and the level of glycemic indices.

Results: The mean age of the subjects of a study was 52.8 + 9.6 and 54 percent of the research participants were males. Mean serum vitamin D amounted to 18.7 ± 7.8 ng/mL and mean HbA1c was 8.2 ± 1.4%. Sixty-four percent of patients had been identified to be short of vitamin D (<20 ng/mL). The correlation between serum vitamin D and HbA1c was established to be negative (r = -0.42, p = 0.001). The logistic regression analysis revealed that a 5-ng/ml increase in the vitamin D was associated to a reduced risk of poor glycemic control by 28 percent (aOR = 0.72, p = 0.004).

Conclusion: Vitamin D deficiency is highly prevalent in the T2DM patients and there is a steep connection between improper glycemic control and vitamin D deficiency. The screening and remedies towards vitamin D deficiency may serve as a supplemental ingredient to metabolic performance and it ought to be considered as part of the normal diabetes management.

1. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. J Clin Endocrinol Metab. 2007;92(6):2017–2029. doi:10.1210/jc.2007-0298

2. Al-Shoumer KA, Al-Essa TM. Is there a relationship between vitamin D deficiency and glycaemic control in type 2 diabetes mellitus? Int J Health Sci (Qassim). 2015;9(2):141–146. doi:10.12816/0024671

3. Kaur H, Donaghue KC, Chan AK, Benitez-Aguirre P, Hing S, Lloyd M, et al. Vitamin D deficiency is associated with retinopathy in children and adolescents with type 1 diabetes. Diabetes Care. 2019;42(10):2068–2075. doi:10.2337/dc19-0808

4. 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):820–825. doi:10.1093/ajcn/79.5.820

5. Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25-hydroxy vitamin D is predictive of future glycemic status and insulin resistance. Diabetes. 2008;57(10):2619–2625. doi:10.2337/db08-0593

6. Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr. 2011;65(9):1005–1015. doi:10.1038/ejcn.2011.118

7. 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. Diabetes Care. 2010;33(6):1379–1381. doi:10.2337/dc09-2321

8. Grimnes G, Figenschau Y, Almås B, Jorde R. Vitamin D, insulin secretion, sensitivity, and lipids: results from a case–control study and a randomized controlled trial using hyperglycemic clamp technique. Diabetes. 2011;60(11):2748–2757. doi:10.2337/db11-0650

9. Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, Jacques PF. Plasma 25-hydroxyvitamin D is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr. 2009;139(2):329–334. doi:10.3945/jn.108.093831

10. Herrmann M, Farrell CL, Pusceddu I, Fabregat-Cabello N, Cavalier E. Assessment of vitamin D status — a changing landscape. Clin Chem Lab Med. 2017;55(1):3–26. doi:10.1515/cclm-2016-0264

11. Dutta D, Maisnam I, Shrivastava A, Ghosh S, Mukhopadhyay S. Serum vitamin D status in newly diagnosed type 2 diabetes and correlation with glycemic parameters and insulin resistance. Diabetes Res Clin Pract. 2013;102(3):e70–e73. doi:10.1016/j.diabres.2013.10.018

12. Talaei A, Mohamadi M, Adgi Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetol Metab Syndr. 2013;5(1):8. doi:10.1186/1758-5996-5-8

13. Boucher BJ. Vitamin D deficiency and diabetes risk: the action of vitamin D on pancreatic insulin secretion and peripheral insulin sensitivity. Br J Diabetes Vasc Dis. 2012;12(6):289–295. doi:10.1177/1474651412464704

14. Pittas AG, Sun Q, Manson JE, Dawson-Hughes B, Hu FB. Vitamin D and risk of type 2 diabetes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98(8):3553–3563. doi:10.1210/jc.2013-1692

15. Alhumaidi M, Adnan AG, Dewish M. Vitamin D deficiency in patients with type-2 diabetes mellitus in southern region of Saudi Arabia. Maedica (Bucur). 2013;8(3):231–236. doi:10.26574/maedica.2013.8.3.231

16. Tiwari S, Pratyush DD, Gupta B, Dwivedi A, Chaudhary S, Gupta SK, et al. Prevalence and severity of vitamin D deficiency in patients with type 2 diabetes mellitus. Indian J Endocrinol Metab. 2012;16(4):528–532. doi:10.4103/2230-8210.98008

17. Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, et al. Association of vitamin D deficiency with insulin resistance, β-cell dysfunction, and metabolic syndrome in type 2 diabetes. Endocr J. 2013;60(6):873–880. doi:10.1507/endocrj.EJ12-0379

18. George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis. Diabet Med. 2012;29(8):e142–e150. doi:10.1111/j.1464-5491.2012.03672.x

19. Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, et al. Current vitamin D status in European and Middle East countries and strategies to prevent deficiency. Endocr Connect. 2019;8(2):R1–R12. doi:10.1530/EC-18-0338

20. Rafiq S, Jeppesen PB. Body mass index, vitamin D, and type 2 diabetes: a systematic review and meta-analysis. Nutrients. 2018;10(9):1182. doi:10.3390/nu10091182

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