Abstract
India has widespread prevalence of diabetes and hypovitaminosis D. This study was conducted to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] and glycemic control in patients with type 2 Diabetes Mellitus [T2DM]. 157 subjects (100 T2DM; 57 controls) were sampled and their 25(OH)D, FBG, PPBG and HbA1c were measured. Additionally, T2DM patients were classified into controlled diabetic and uncontrolled diabetic group based on glycemic control (HbA1c level <7% or ≥ 7%). Data analysis was done by t-test for continuous measures and chi-square test for categorical measures. Mean vitamin D level was significantly lower in the diabetic compared to Control group (15.1 ± 5.18 v/s 22.66 ± 5.49 ng/ml, P<0.01). 82% diabetics and 33.4% controls were Vitamin D “deficient” (<20ng/ml). 18% diabetics and 56.1% Controls were Vitamin D “insufficient” (20-29 ng/ml). FBS (96.8±16.3 v/s 146.5±55.2, P<0.01), PPBS (125.3±22.9 v/s 210.5±76.6, P<0.01), HbA1c (8.1 ± 2.2 % v/s 5.6 ± 0.2 %, P<0.01) and calcium (9.21±.89 v/s 7.89±.70, P =0.04) were also found to be statistically different between controls and diabetics. Mean vitamin D level in the controlled diabetic v/s uncontrolled diabetic group was (14.95±4.77 v/s 15.15±5.59 ng/ml, P =1.00). Thus, Vitamin D deficiency may be an etiological factor for the development of T2DM, but may not have a role in the glycemic control in T2DM
Keywords: Type 2 diabetes mellitus; Vitamin D; Glycemic control; Glycated haemoglobin
References
- David R, Leonor G, Clara W, Jonathan S. IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94:311-321.
- Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr 2004; 80(6):1678-1688.
- Norman AW. Sunlight, season, skin pigmentation, vitamin D and 25-Hydroxyvitamin D: Integral components of the vitamin D endocrinesystem. Am J Clin Nutr 1998; 67:1108-1110.
- Mithal A. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 2009; 20:1807–20.
- Kadowski S, Norman A. Dietary vitamin D is essential for normal insulin secretion from the perfused rat pancreas. J Clin Invest 1984;73:759-766.
- Nyomba BL, Bouillon R, DeMoor P. Influence of vitamin D status on insulin secretion and glucose tolerance in the rabbit. Endocrinology 1984; 115:191-197.
- Ishida H, Norman AW. Demonstration of a high affinity receptor for 1,25-dihydroxyvitamin D3 in rat pancreas. Mol Cell Endocrinol 1988; 60:109-117.
- Christakos S, Friedlander EJ, Frandsen BR, Norman AW. Studies on the mode of action of calciferol XIII. Development of a radioimmunoassay for vitamin D-dependent chick intestinal calcium binding protein and tissue distribution. Endocrinology 1979;104:1495-1502
- Brock KE, Huang WY, Fraser DR, et al. Diabetes prevalence is associated with serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in US middle-aged Caucasian men and women: a cross-sectional analysis within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Br J Nutr. 2011; 106(3):339-44.
- Pittas AG, Harris SS, Stark PC, Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in non diabetic adults. Diabetes Care 2007; 30: 980–986.
- Ishida H, Seino Y, Matsukura D, et al. Diabetic osteopenia and circulating levels of vitamin D metabolites in type 2 diabetes. Metabolism 1985; 34:797-801.
- Lise LN, Betina HT, et al. Serum 25(OH)D and Type 2 Diabetes Association in a General Population. Diabetes Care 2012; 35:1695–1700.
- Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome ‘X’? Br J Nutr 1998; 79:315–327.
- Boucher BJ, Mannan N, Noonan K et al. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in East London Asians. Diabetologia 1995; 38:1239-1245.
- Scragg R, Sowers M, Bell C. Third National Health and NutritionExamination Survey Serum 25-Hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition ExaminationSurvey. Diabetes Care 2004; 27: 2813–2818.
- Lu, Z. Yu, A. Pan, et al. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 2009; 32(7):1278-1283.
- McGill AT, Stewart JM, Lithander FE, et al. Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutr J 2008;7:4-7.
- Jatupol K, Vincent LF, Ben SG, et al. Association of A1C Levels With Vitamin D Status in U.S. Adults. Diabetes Care 2010; 33:1236–1238.
- Forouhi NG, Luan J, Cooper A, et al. Baseline serum 25-hydroxy vitamin D is predictive of future glycemic status and insulin resistance the medical research council ely prospective study 1990–2000. Diabetes 2008; 57(10):2619–2625.
- Vupputuri, R Goswami, Nandita Gupta, et al. Prevalence and functional significance of 25-hydroxyvitamin D deficiency and vitamin D receptor gene polymorphisms in Asian Indians. Am J Clin Nutr 2006;83:1411–19.
- Daga RA, Laway BA, Shah ZA, et al. High prevalence of vitamin D deficiency among newly diagnosed youth-onset diabetes mellitus in north India. Arq Bras Endocrinol Metab. 2012;56(7):423-428.
- Goswami R, Gupta N, Goswami D, et al. Prevalence and significance of low 25- hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr 2000; 72 : 472-5
Corresponding Author
Fahmiya Leena Yacoob
Aspira Pathlab and Diagnostics Ltd., Mumbai, India
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DOI: https://dx.doi.org/10.18535/jmscr/v5i10.189
