Vitamin d treats Type II Diabetes in many ways (14 article review) - Sept 2021

Protective Role of Vitamin D Therapy in Diabetes Mellitus Type II

Cureus . 2021 Aug 20;13(8):e17317. doi: 10.7759/cureus.17317
Christine M Zakhary 1, Hiam Rushdi 1, Jaafar A Hamdan 2 1, Kerolos N Youssef 1, Aafreen Khan 1, Mohammed A Abdalla 1, Safeera Khan 1

Diabetes Mellitus type II (DM II) is a worldwide disease with a rapidly growing parallel prevalence and adversities affecting multi-body systems. Hence, it is imperative to treat DM II effectively, maintaining glucose homeostasis to avoid complications such as diabetic nephropathy, peripheral neuropathy, and retinopathy. Vitamin D, among many benefits, has positive outcomes on hemoglobin A1c (HbA1c) control. It aids in insulin secretion and sensitivity. We systematically screened four databases for relevant information; PubMed, Medline, PMC, and Google scholar. Inclusion and exclusion criteria were applied, and quality appraisal was then done using certain checklist tools: Newcastle-Ottawa tool, AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist, SANRA (Scale for the Assessment of Narrative Review Articles) checklist, and Cochrane bias assessment.

Data were collected from 14 articles, of which

• eight are systematic reviews and meta-analysis,
• one is a narrative review,
• five are randomized controlled trials and
• three are general information about DM II and Vitamin D.

In addition, this article evaluates the clinical significance of Vitamin D administration in DM II from a glucose homeostasis perspective, and complications such as nephropathy, neuropathy, and retinopathy. Vitamin D had a clinical positive impact on glucose level, particularly on hemoglobin A1c (HbA1c) reduction, alleviation of diabetic neuropathy and nephropathy symptoms, and hyperglycemia induced-oxidative stress on the retinal cells.

Conclusions (from PDF)

In this systematic review, the role of Vitamin D supplements and their effect on glucose control and most common complications was evaluated in diabetes mellitus II patients. It was concluded that Vitamin D acts in numerous ways on different systems, and its receptors present in many organs. Upon reviewing several studies, the role of Vitamin D was found to be beneficial in DM II for controlling blood glucose level and hemoglobin A1c level. It increases both insulin sensitivity and insulin secretion. Vitamin D suppresses the inflammatory state in DM II, which in diabetic peripheral neuropathy is crucial. Also, Vitamin D improves nerve conduction and hastens wound healing in cases of diabetic foot. Moreover, it acts as a potent analgesic. In case of diabetic nephropathy, it is very important to maintain its control as it can lead to endstage renal disease. It was noted that in post-Vitamin D administration urinary albumin excretion decreased. The retina is vulnerable to elevated blood sugar as it causes the release of reactive oxygen species, leading to retinal tissue damage. Vitamin D is a potent antioxidant, stimulating antioxidant enzyme to prevent damage caused by such oxidative stress. Diet control and antidiabetic agents are the cornerstones in controlling blood glucose which can slow any disease-associated complication. A future investigation of this systematic review would possibly investigate Vitamin D administration in having positive preventative outcomes on DM II-related complications. Moreover, it is worth examining if Vitamin D should be given to only Vitamin D deficient patients or all diabetic patients.
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