Update on the Role of Adequate Vitamin D Provision for Avoiding Insulin Resistance and its Sequelae [Type 2 Diabetes and Cardiovascular Disease]
Main Article Content
Abstract
Type 2 diabetes prevalence is increasing, reaching ‘pandemic’ proportions globally, and associated with increasing obesity rates. Concomitantly, vitamin D deficiency persists world-wide and is worsened by obesity because it reduces hepatic 25-hydroxylation of vitamin D, which reduces circulating 25(OH)D availability to target tissues; these include islet beta cells, since vitamin D is essential for adequate insulin responses to hyperglycemia. Increased insulin resistance increases type-2 diabetes risks and precedes its development by decades, reflecting changes in hepatic and muscle function that are corrected experimentally by activated hormonal vitamin D [calcitriol]; similarly, abnormal insulin resistance can be corrected in humans by correcting vitamin D deficiency using oral supplementation. Since vitamin D deficiency and inadequacy persist world-wide despite various guidelines on vitamin D intake, the possibility that correcting deficiency would contribute to reducing T2DM risks through beneficial effects on pancreatic islet beta cells and on the metabolic disorders contributing to insulin resistance through vitamin D inadequacy warrants consideration. If this is the case, then ensuring vitamin D adequacy in populations at high risk of Type-2 diabetes would be a valuable adjunct to other measures being taken to reduce that risk such as increased exercise and weight reduction. It would also reduce cardiovascular disease risks, well known to increase with insulin resistance, with or without concomitant Type-2 diabetes. Cardiovascular disease risks themselves can be reduced by adequately correcting deficiency and are lower with higher lifetime circulating 25-hydroxyvitamin D in deficient subjects from Mendelian randomization analysis. This report, therefore, reviews the evidence for increased insulin resistance as a risk factor for Type-2 diabetes, the beneficial effects of correcting vitamin deficiency on insulin resistance, Type-2 diabetes and cardiovascular risks, some basic mechanisms accounting for those benefits, the reasons for the persistence of vitamin D inadequacy globally and how best that problem could be corrected.
Article Details
How to Cite
BOUCHER, Barbara J.
Update on the Role of Adequate Vitamin D Provision for Avoiding Insulin Resistance and its Sequelae [Type 2 Diabetes and Cardiovascular Disease].
Medical Research Archives, [S.l.], v. 11, n. 5, may 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3792>. Date accessed: 26 apr. 2024.
doi: https://doi.org/10.18103/mra.v11i5.3792.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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5. Tinajero MG, Malik VS. An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinol Metab Clin North Am. 2021Sep;50(3):337-355. doi: 10.1016/j.ecl.2021.05.013.
6. Perng W, Conway R, Mayer-Davis E, Dabelea D. Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic. Diabetes Care. 2023 Mar 1;46(3):490-499. doi: 10.2337/dci22-0046.
7. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017 Jun 3;389(10085):2239-2251.doi:10.1016/S0140-6736(17)30058-2.
8. Himsworth HP. Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types. 1936. Int J Epidemiol. 2013 Dec;42(6):1594-8. doi: 10.1093/ije/dyt203.
9. Himsworth. The syndrome of diabetes mellitus and its causes. Lancet. 1949 Mar 19;1(6551):465-73. doi: 10.1016/s0140-6736(49)90797-7
10. Jorge de Faria Maraschin, 2013 pubmed.ncbi.nlm.nih.gov/23393666/ [The first worldwide accepted classification scheme for DM was published in 1979 by the National Diabetes Data Group (NDDG) and classified DM based on the pharmacologic therapy applied into two major groups: Insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM).]
11. Hulman A, Simmons RK, Brunner EJ, Witte DR, Færch K, Vistisen D, et al. Trajectories of glycaemia, insulin sensitivity and insulin secretion in South Asian and white individuals before diagnosis of type 2 diabetes: a longitudinal analysis from the Whitehall II cohort study. Diabetologia 2017;60(7):1252-1260.
12. Wu F, Juonala M, Pitkänen N, Jula A, Lehtimäki T, Sabin MA, et al. Both youth and long-term vitamin D status is associated with risk of type 2 diabetes mellitus in adulthood: a cohort study. Ann Med 2018;50(1):74-82
13. Sagesaka H, Sato Y, Someya Y, Tamura Y, Shimodaira M, Miyakoshi T, et al. Type 2 Diabetes: When Does It Start? J Endocr Soc 2018 Sagesaka H, Sato Y, Someya Y, Tamura Y, Shimodaira M, Miyakoshi T, et al. Type 2 Diabetes: When Does It Start? J Endocr Soc 2018;2(5):476-484.
14. Morgante G, Darino I, Spanò A, Luisi S, Luddi A, Piomboni P, et al. PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment. J Clin Med. 2022 Aug 2;11(15):4509. doi: 10.3390/jcm11154509.
15. Boucher BJ. Re Niroomand M, Fotouhi A, Irannejad N et al. Does high-dose vitamin D supplementation impact insulin resistance and risk of development of diabetes in patients with pre-diabetes? A double-blind randomized controlled trial. Diabetes Res Clin Pract. 2019;148:1-9. Diabetes Res Clin Pract. 2019 Sep;155:107782. doi: 10.1016/j.diabres.2019.107782. Epub 2019 Jul 17.
16. Matthews, D.R., Hosker, J.P., Rudenski, A.S. et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419 (1985). https://doi.org/10.1007/BF00280883
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