Metabolic effects of oral vitamin D supplementation as an adjuvant therapy on subjects with type 2 diabetes
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20193192Keywords:
Diabetes mellitus, Supplementation, Vitamin DAbstract
Background: It is common for patients with type 2 diabetes mellitus (T2DM) to have vitamin D deficiency. Aim of the study is to determine the metabolic effects of oral vitamin D supplementation in a cohort of T2DM subjects.
Methods: Subjects with T2DM were divided into two groups. Group A (Control) included subjects who received the standard treatment (conventional antidiabetic drugs). Group B (Intervention), apart from the standard treatment (conventional antidiabetic drugs), was also supplemented with Vitamin D3. All the patients were followed up at baseline, 6 months, 12 months and 18 months.
Results: Vitamin D deficiency was noted down in all the study subjects. Even after 18 months of supplementation, all subjects remained vitamin D deficient. There was a significant improvement in the circulating levels of 25-hydroxyvitamin D. Improvement in the lipid profile of subjects was observed as evidenced by a decrease in total cholesterol (5.0±0.92 mmol/l) as compared to baseline (5.5±1.6 mmol/l). HOMA-IR changed significantly after 18 months of supplementation from baseline (7.0±1.06 vs 10.8±1.96 nmol/l).
Conclusions: Supplementation to achieve higher levels of vitamin D remains a promising adjuvant therapy for T2DM patients. Additionally, the intervention brought out a favourable change in HDL/LDL ratio among study subjects.
References
Ardawi MS, Sibiany MM, Bakhsh TM, Qari MH, Maimani AA: High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int 2012, 23:675–686.
Bansal A, Singh AA, Goel S, Goel AK, Singh A, Chhoker VK et al. Evidence of vitamin d deficiency and its relation with possible cardiovascular risk among postmenopausal women. Healthline. 2014;5(2):41-5.
Gupta V, Singh A, Goel S. Correlation of Vitamin D Level with Biochemical Parameters in Healthy Indians Aged≥ 50 Years. Sch. J. App. Med. Sci., 2017; 5(7C):2655-2658.
Qi D, Nie XL, Wu S, Cai J. Vitamin D and hypertension: Prospective study and meta-analysis. PloS one. 2017 Mar 30;12(3):e0174298.
Vaidya A, Williams JS. The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes. Metabolism. 2012 Apr 1;61(4):450-8.
Pereira-Santos M, Santos JY, Carvalho GQ, Santos DB, Oliveira AM. Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny country: Geospatial meta-analysis in Brazil. Critical reviews in food science and nutrition. 2018 Mar 6:1-8.
Makariou SE, Elisaf M, Challa A, Tentolouris N, Liberopoulos EN. No effect of vitamin D supplementation on cardiovascular risk factors in subjects with metabolic syndrome: a pilot randomised study. Archives of medical sciences. Atherosclerotic diseases. 2017;2:e52.
Eftekhari MH, Akbarzadeh M, Dabbaghmanesh MH, Hasanzadeh J. Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients. Asia Pacific journal of clinical nutrition. 2011 Dec 1;20(4):521-6.
Mathieu C, Badenhoop K: Vitamin D and type 1 diabetes mellitus: state of the art. Trends Endocrinol Metab 2005, 16:261–266.
Di Cesar DJ, Ploutz-Snyder R, Weinstock RS, Moses AM: Vitamin D deficiency is more common in type 2 than in type 1 diabetes. Diabetes Care 2006, 29:174.
Deleskog A, Hilding A, Brismark K, Hamsten A, Efendic S, Ostenson CG: Low serum 25-hydroxyvitamin D levels predict progression to type 2 diabetes in individuals with prediabetes but not with normal glucose tolerance. Diabetologia 2012, 55:1668–1678.
Harris SS. Does vitamin D deficiency contribute to increased rates of cardiovascular disease and type 2 diabetes in African Americans. Am J Clin Nutr 2011, 93:1175S–1178S.
Boucher BJ: Hypovitaminosis D and risk of type 2 diabetes in British South Asians. Diabet Med 2006, 23:336.
Wu C, Qiu S, Zhu X, Li L. Vitamin D supplementation and glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Metabolism. 2017 Aug 1;73:67-76.
Nada AM, Shaheen DA. Cholecalciferol improves glycemic control in type 2 diabetic patients: a 6-month prospective interventional study. Therapeutics and clinical risk management. 2017;13:813.
Mirhosseini, N, Vatanparast H, Mazidi, M, Kimball SM. The Effect of Improved Serum 25-Hydroxyvitamin D Status on Glycemic Control in Diabetic Patients: A Meta-Analysis. J. Clin. Endocrinol. Metab. 2017; 102: 3097–3110.
Soric MM, Renner ET, Smith SR. Effect of daily vitamin D supplementation on HbA1c in patients with uncontrolled type 2 diabetes mellitus: a pilot study. J. Diabetes 2012; 4: 104–105.