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Category: Volume 07 Issue 02 February 2019
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Title: Vitamin D Status in Patients with Type II Diabetes Mellitus: A Case Control Study

Authors: Dr Naik M.R, Dr Umar Quadri, Dr Eshant Kurunjekar, Dr Nilofer Patel, Dr Arshi Khan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.102

Abstract

Introduction: Vitamin D is a product of cholesterol metabolism. One of the most important step of vitamin D production is (conversion of 7-dehydro-cholesterol to active vitamin D is dependent upon exposure to sunlight. The common causes of vitamin D deficiency include advancing age, inadequate exposure to sunlight and chronic hepatic and renal failure. The relation of vitamin D deficiency and diabetes is complex and many studies have suggested that vitamin D deficiency may be related to onset of type II diabetes and adequate vitamin D levels are necessary to reduce inflammation which is a major factor in progression to overt diabetes mellitus. We have conducted this study to know the vitamin D status of individuals with type II diabetes mellitus and compared it with healthy individuals of   comparable age groups.

Materials and Methods: This was a case control study carried out in a tertiary care hospital situated in an urban area with an aim to determine the frequency of vitamin D deficiency or insufficiency in patients with type II diabetes mellitus. 50 known cases of type II diabetes were enrolled in this study as cases on the basis of a predefined inclusion and exclusion criteria. Control group comprised of 50 individuals of similar age and physical characteristic. In both these groups detailed history was taken. Investigations like Complete Blood Count, Serum Calcium and Alkaline Phosphatase was done in all the cases. The data was tabulated and analyzed using SPSS 21.0 version software.

Results: The mean weight and Body mass indexes were comparable in both the groups. The mean weight of control group was 63.28 +/- 7.42 kg while in cases group the mean weight was 69.48 +/- 8.72 kg. While mean height in control and cases group was 5.42 +/- 0.082 and 5.36 +/- 0.064 feet respectively. Serum calcium in cases and control groups was 8.24 +/- 0.22 and 8.82 +/- 0.161 while ALP was 96.30 +/- 8.12 and 106.04 +/- 6.12 respectively. 25 (OH) Vit D was found to be 94.36 +/- 7.92 in control group and 76.60 +/- 5.52 in cases group. Individuals with diabetes were found to have a statistically significantly reduced vitamin D levels as compared to individuals in control group.

Conclusion: Patients having type II DM were found to have significantly lower 25 (OH) vitamin D levels. It is essential that patients with type II DM be screened for vitamin D deficiency and if present it should be treatedappropriately.

Keywords: Vitamin D, Alkaline Phosphatase, Type II Diabetes Mellitus, Insulin Resistance.

References

  1. Naser KA, Gruber A, Thomson GA. The emerging pandemic of obesity and diabetes: are we doing enough to prevent a disaster? Int J Clin Pract. 2006 Sep;60(9):1093-7.
  2. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379(9833):2279-90.
  3. Nickerson HD, Dutta S. Diabetic complications: current challenges and opportunities. J Cardiovasc Transl Res. 2012;5(4):375-9.
  4. Hardy OT, Czech MP, Corvera S. What causes the insulin resistance underlying obesity?. Curr Opin Endocrinol Diabetes Obes. 2012;19(2):81-7.
  5. Nuttall FQ. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutr Today. 2015 May;50(3):117-128. Epub 2015 Apr 7.
  6. Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014;11(11):1185-200. Published 2014 Sep 6.
  7. Benetti E, Mastrocola R, Chiazza F, et al. Effects of vitamin D on insulin resistance and myosteatosis in diet-induced obese mice. PLoS One. 2018;13(1):e0189707. Published 2018 Jan 17.
  8. Al-Shoumer KA, Al-Essa TM. Is there a relationship between vitamin D with insulin resistance and diabetes mellitus?. World J Diabetes. 2015;6(8):1057-64.
  9. 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 Clin Endocrinol Metab. 2007;92(6):2017-29.
  10. Bannon MP, van Heerden JA, Palumbo PJ, Ilstrup DM. The relationship between primary hyperparathyroidism and diabetes mellitus. Ann Surg. 1988;207(4):430-3.
  11. Williams S, Malatesta K, Norris K. Vitamin D and chronic kidney disease. Ethn Dis. 2009;19(4 Suppl 5):S5-8-11.
  12. Iraj B, Ebneshahidi A, Askari G. Vitamin d deficiency, prevention and treatment. Int J Prev Med. 2012;3(10):733-6.
  13. Papandreou D, Hamid ZT. The Role of Vitamin D in Diabetes and Cardiovascular Disease: An Updated Review of the Literature. Dis Markers. 2015;2015: 580474.
  14. Nguyen QM, Xu JH, Chen W, Srinivasan SR, Berenson GS. Correlates of age onset of type 2 diabetes among relatively young black and white adults in a community: the Bogalusa Heart Study. Diabetes Care. 2012;35(6):1341-6.
  15. Koopman RJ, Mainous AG, Diaz VA, Geesey ME. Changes in age at diagnosis of type 2 diabetes mellitus in the United States, 1988 to 2000. Ann Fam Med. 2005;3(1):60-3.
  16. Golay A, Ybarra J. Link between obesity and type 2 diabetes. Best Pract ResClin Endocrinol Metab. 2005 Dec;19(4):649-63.
  17. Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes. 2014;7:587-91. Published 2014 Dec 4.
  18. Ayhan R, Türker BÇ, Ahbab S, Türker F, Ataoğlu HE. Low serum vitamin D associated with prediabetes. Int J Community Med Public Health 2018;5:3776-81
  19. Abbasi F, Blasey C, Feldman D, Caulfield MP, Hantash FM, Reaven GM. Low circulating 25- hydroxyvitamin D concentrations are associated with defects in insulin action and insulin secretion in persons with prediabetes. J Nutr. 2015;145(4):714– 9.
  20. Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, et al. Association of vitamin D deficiency with incidence of type 2diabetes in high-risk Asian subjects. Am J Clin Nutr. 2013;97:524–30.

Corresponding Author

Dr Eshant Kurnjekar

Resident, Lecturer, Department of Medicine MGM Medical College Aurangabad (MS) India