The Journal of Steroid Biochemistry and Molecular Biology, Vol 175, Jan 2018, Pages 177-189. https://doi.org/10.1016/j.jsbmb.2016.09.017
Sunil J.Wimalawansa MD, PhD, MBA, FRCP, FACP, FRCPath, Dsc (Professor of Medicine)
- Hypovitaminosis D: is inversely correlates with obesity and stroke.
- Associate with increased CVD, myocardial infarction, diabetes, and mortality.
- Associate with metabolic syndrome (hypertension, low HDL, and insulin resistance).
- Sunscreen with greater than 12 sun protection factor (SPF), prevents generation of vitamin D.
- Increased safe exposure to sun and consuming vitamin D-fortified foods are encouraged.
- Supplements are necessary however, for those who cannot obtain adequate amounts.
Overview Diabetes and vitamin D contains the following summary
- 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
529 items: both Type 1 and Type 2
Vitamin D appears to both prevent and treat diabetes
- Appears that >2,000 IU will Prevent
- Appears that >4,000 IU will Treat , but not cure
- 90% less T2 Diabetes in the group having lots of Vitamin D
- Appears that Magnesium helps both Prevention and Treatment
- Many diabetics would be better treated if Gut-Friendly Vitamin D were used
Number of articles in both categories of Diabetes and:
'This list is automatically updated''
- Dark Skin
24 ; Intervention 56 ; Meta-analysis 38 ; Obesity 34 ; Pregnancy 43 ; T1 (child) 39 ; Omega-3 11 ; Vitamin D Receptor 23 ; Genetics 12 ; Magnesium 27 Click here to see details
Some Diabetes studies
- Type 2 Diabetes treated by Vitamin D (often 50,000 IU weekly) – meta-analysis July 2023
- Diabetic inflammation synergistically decreased by Vitamin D and exercise – RCT June 2022
- Incidence of Type-2 Diabetes increased 3X in 30 years (by the way, Vitamin D helps) – July 2022
- Vitamin d treats Type II Diabetes in many ways (14 article review) - Sept 2021
- T2 Diabetes 30 percent more likely if poor Vitamin D Receptor – meta-analysis of 47 studies – July 2021
- Diabetes helped somewhat by weekly 50,000 IU of vitamin D (5 ways to improve) – RCT Aug 2021
50 ng of Vitamin D fights Diabetes
- Saudi study defines normal Vitamin D level to be 50 to 70 ng (diabetes, etc.) - June 2020
- Diabetes 5X less likely if more than 50 ng of Vitamin D – April 2018
- T1 Diabetes 3X lower risk if high vitamin D (over 40 ng) – Meta-analysis Nov 2020
- Type 1 Diabetes is prevented and treated by Vitamin D – review of 16 studies – Sept 2019
- Type 1 Diabetes prevention with Vitamin D and Omega-3 – Symposium April 2019
- 4X reduction in prediabetes progressing to T2D if more than 50 ng of vitamin D – RCT March 2023
- Prediabetes reduced by weekly 60,000 IU of Vitamin D – RCT Jan 2021
- Prediabetes 1.5 X more likely to go away if take Vitamin D – meta-analysis July 2020
Diabetes category starts with the following
529 items In Diabetes category 33+ Prediabetes studies 64+ Type 1 Diabetes studies Autoimmune category listing has 189 items along with related searches
The aim of this study is to determine the relationships of vitamin D with diabetes, insulin resistance obesity, and metabolic syndrome. Intra cellular vitamin D receptors and the 1-α hydroxylase enzyme are distributed ubiquitously in all tissues suggesting a multitude of functions of vitamin D. It plays an indirect but an important role in carbohydrate and lipid metabolism as reflected by its association with type 2 diabetes (T2D), metabolic syndrome, insulin secretion, insulin resistance, polycystic ovarian syndrome, and obesity. Peer-reviewed papers, related to the topic were extracted using key words, from PubMed, Medline, and other research databases. Correlations of vitamin D with diabetes, insulin resistance and metabolic syndrome were examined for this evidence-based review. In addition to the well-studied musculoskeletal effects, vitamin D decreases the insulin resistance, severity of T2D, prediabetes, metabolic syndrome, inflammation, and autoimmunity. Vitamin D exerts autocrine and paracrine effects such as direct intra-cellular effects via its receptors and the local production of 1,25(OH)2D3, especially in muscle and pancreatic β-cells. It also regulates calcium homeostasis and calcium flux through cell membranes, and activation of a cascade of key enzymes and cofactors associated with metabolic pathways. Cross-sectional, observational, and ecological studies reported inverse correlations between vitamin D status with hyperglycemia and glycemic control in patients with T2D, decrease the rate of conversion of prediabetes to diabetes, and obesity.
However, no firm conclusions can be drawn from current studies, because
- (A) studies were underpowered;
- (B) few were designed for glycemic outcomes,
- (C) the minimum (or median) serum 25(OH) D levels achieved are not measured or reported;
- (D) most did not report the use of diabetes medications;
- (E) some trials used too little
- (F) others used too large, unphysiological and infrequent doses of vitamin D; and
- (G) relative paucity of rigorous clinical data on the effects of vitamin D sufficiency on non-calcium endpoints.
Although a large number of observational studies support improving T2D, insulin resistance, obesity, and metabolic syndrome with vitamin D adequacy, there is a lack of conclusive evidence from randomized control clinical trials that, these disorders are prevented following optimization of serum levels of 25(OH)D. However, none of the currently conducted clinical studies would resolve these issues. Thus, specifically designed, new clinical studies are needed to be conducted in well-defined populations, following normalizing the serum vitamin D levels in vitamin D deficient prediabetes subjects, to test the hypothesis that hypovitaminosis D worsens these disorders and correction would alleviate it.
Scientific correlations between vitamin D and diabetes:
- Beta-cells contain vitamin D receptors
- 1,25(OH)2D stimulates insulin release
- Insulin “release” is reduced in vitamin D-deficient animals (and in humans)
- 1,25(OH)2D prevents development of diabetes in the NOD mouse
- Recent meta-analyses show association of low vitamin D status with increased risk of BOTH type 1 and type 2 diabetes
Vitamin D and function of pancreatic b-cells:
- Association between vitamin D and physiological functions of pancreatic b-cells
- b-cells possess VDRs, and 1a-hydroxylase is expressed in pancreatic islet tissues
- Vitamin D deficiency impairs glucose-mediated insulin release
- Insulin secretion is calcium dependent and calcium homeostasis depends on vitamin D
- Vitamin D supplements improve insulin release in response to oral glucose load and reduce free fatty acid levels
Vitamin D deficiency worsens diabetes:
- Diabetes is 5 times more common in non-equatorial areas
- Children getting 2000 IU of vitamin D are 8 times less likely to develop type 1 diabetes
- Sedentary and obese people get less sun exposure and thus have less vitamin D
- Worldwide, diabetes increases in parallel with vitamin D deficiency
- Elderly and those with dark skin get 3-6 times less vitamin D from the same amount of sun exposure
Concerns related to clinical study data:
Reasons to suspect Diabetes is related to low vitamin D – Jan 2018
- Lack of adequately powered, randomized controlled, clinical studies
- Among the vitamin D intervention studies done, virtually none were designed for glycemic outcomes
- Measurements of minimum (or median) serum 25(OH)D levels achieved were not reported;
- Most did not report the use of diabetes (or even other) concomitant use of medications
- Some trials used too little doses of vitamin D (e.g., <800 IU) above to bring serum vitamin D levels beyond 30ng/mL
- Others studies used too large, unphysiological and infrequent doses of vitamin D that will not maintain serum 25(OH)D concentrations throughout the study period
- Even the larger studies that are currently done are poorly designed to test vitamin D related hypotheses and hard endpoints
- Relative paucity of rigorous clinical data on the effects of vitamin D sufficiency on non-calcium endpoints.
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