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4X reduction in prediabetes progressing to T2D if more than 50 ng of vitamin D – RCT March 2023


Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials

Ann Intern Med. 2023 Mar;176(3):355-363. doi: 10.7326/M22-3018   PDF is behind a paywall
Anastassios G Pittas 1, Tetsuya Kawahara 2, Rolf Jorde 3, Bess Dawson-Hughes 4, Ellen M Vickery 1, Edith Angellotti 5, Jason Nelson 1, Thomas A Trikalinos 6, Ethan M Balk 6

Background: The role of vitamin D in people who are at risk for type 2 diabetes remains unclear.

Purpose: To evaluate whether administration of vitamin D decreases risk for diabetes among people with prediabetes.

Data sources: PubMed, Embase, and ClinicalTrials.gov from database inception through 9 December 2022.

Study selection: Eligible trials that were specifically designed and conducted to test the effects of oral vitamin D versus placebo on new-onset diabetes in adults with prediabetes.

Data extraction: The primary outcome was time to event for new-onset diabetes. Secondary outcomes were regression to normal glucose regulation and adverse events. Prespecified analyses (both unadjusted and adjusted for key baseline variables) were conducted according to the intention-to-treat principle.

Data synthesis: Three randomized trials were included, which tested cholecalciferol, 20 000 IU (500 mcg) weekly; cholecalciferol, 4000 IU (100 mcg) daily; or eldecalcitol, 0.75 mcg daily, versus matching placebos. Trials were at low risk of bias.
Vitamin D reduced risk for diabetes by 15% (hazard ratio, 0.85 [95% CI, 0.75 to 0.96]) in adjusted analyses, with a 3-year absolute risk reduction of 3.3% (CI, 0.6% to 6.0%). The effect of vitamin D did not differ in prespecified subgroups.
Among participants assigned to the vitamin D group who maintained an intratrial mean serum 25-hydroxyvitamin D level of at least 125 nmol/L (≥50 ng/mL) compared with 50 to 74 nmol/L (20 to 29 ng/mL) during follow-up, cholecalciferol reduced risk for diabetes by 76% (hazard ratio, 0.24 [CI, 0.16 to 0.36]), with a 3-year absolute risk reduction of 18.1% (CI, 11.7% to 24.6%).
Vitamin D increased the likelihood of regression to normal glucose regulation by 30% (rate ratio, 1.30 [CI, 1.16 to 1.46]).
There was no evidence of difference in the rate ratios for adverse events

  • (kidney stones: 1.17 [CI, 0.69 to 1.99];
  • hypercalcemia: 2.34 [CI, 0.83 to 6.66];
  • hypercalciuria: 1.65 [CI, 0.83 to 3.28];
  • death: 0.85 [CI, 0.31 to 2.36]).

Limitations: Studies of people with prediabetes do not apply to the general population. Trials may not have been powered for safety outcomes.

Conclusion: In adults with prediabetes, vitamin D was effective in decreasing risk for diabetes.

Primary funding source: None. (PROSPERO: CRD42020163522).


VitaminDWiki – Overview Diabetes and vitamin D contains

  • Diabetes is 5X more frequent far from the equator
  • Children getting 2,000 IU of vitamin D are 8X less likely to get Type 1 diabetes
  • Obese people get less sun / Vitamin D - and also vitamin D gets lost in fat
  • Sedentary people get less sun / Vitamin D
  • Worldwide Diabetes increase has been concurrent with vitamin D decrease and air conditioning
  • Elderly get 4X less vitamin D from the same amount of sun
        Elderly also spend less time outdoors and have more clothes on
  • All items in category Diabetes and Vitamin D 553 items: both Type 1 and Type 2

Vitamin D appears to both prevent and treat diabetes

Number of articles in both categories of Diabetes and:

  • Dark Skin 24;   Intervention 57;   Meta-analysis 40;   Obesity 36;  Pregnancy 44;   T1 (child) 39;  Omega-3 11;  Vitamin D Receptor 24;  Genetics 13;  Magnesium 30    Click here to see details

Some Diabetes studies

50 ng of Vitamin D fights Diabetes

T1 Diabetes

Pre-Diabetes

Diabetes, Metabolic Syndrome and Magnesium - many studies
Diabetic Epidemic

  • Step back to 1994. Suppose an epidemic struck the United States, causing blindness, kidney failure, and leg amputations in steadily increasing numbers.
    Suppose that in less than a decade's time, the epidemic had victimized one out of every eight people
    That epidemic is real, and its name is diabetes, now the nation's sixth leading cause of death.
    Chart from the web (2018?)
    Image

VitaminDWiki – Diabetes category contains

553 items In Diabetes category   34+ Prediabetes studies   64+ Type 1 Diabetes studies

see also Overview Diabetes and vitamin D  Overview Metabolic Syndrome and vitamin D

Autoimmune category listing has 204 items along with related searches