How does Vitamin D affect Diabetes?

The common endocrine disorder diabetes is most prevalent in today’s day in age due to the rise in the populations’ weight, poor diet choices, and lack of physical exercise. Personally, I know of multiple family members who fit well into this category and uncoincidentally are living their lives with diabetes. I was familiar with their routines in self-administering insulin before meals and at bedtime and the importance of monitoring their blood sugar. But what I found myself thinking about was the correlation between the vitamin D supplementations they took and how that affected their diabetes in general.  

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Diabetes can be characterized as an endocrine disease that affects the ability to control blood sugar and can be classified as either Type 1 or Type 2. Type 1 diabetics generally affect those in the early adolescent age and can be characterized as an autoimmune disease by which the pancreas is unable to produce a vital hormone called insulin. These types of diabetics are going to require insulin for life because their own immune system attacks their pancreas and therefore are unable to regulate their blood sugar independently. Type 2 diabetes was said to generally affect the older population, but now that we see a rise in the obesity epidemic we also see an increase in the amount of younger population that has Type 2 diabetes. Type 2 diabetes is characterized by the inability of the pancreas to properly produce insulin or resisting insulin by overall poor diet and lack of exercise. Though the two diseases differ slightly in characteristics, both types of diabetes share similarities when it comes to vitamin D. In the following paragraphs, we will review multiple articles on how vitamin D affects diabetes.

Our first article consists 205 type two diabetics who are separated into groups according to sex and were monitored of different factors including vitamin D levels, high sensitivity C-reactive protein, hemoglobin A1C, albumin, and creatinine (Aljack et al.; 2019). As a result, the article found that type two diabetics with a vitamin D level of less than 30 were negatively related with higher levels of the tests ran above and can lead to cardiovascular disease (Aljack et al.; 2019). In contrast, Navaz (2017) diabetic participants were measured according to the amount of vitamin D receptors which are responsible for increasing the sensitivity of insulin, and the amount of vitamin D in the body. Overall Navaz (2017) found that diabetics with lower amounts of vitamin D were at risk of developing vascular complications due to the low amounts of vitamin D receptors needed for insulin sensitivity and its role in decreasing thrombotic activity in the arteries. In comparison of the two, both articles list different factors in their study of how low levels of vitamin D can lead to cardiovascular diseases and complications. But what the first article failed to explain is why the need to test high sensitivity C reactive protein, albumin, and creatinine (Aljack et al.; 2019). How does each of these tests attribute to risk and development of cardiovascular disease (Aljack et al,; 2019)? Both articles can lead to a conclusion in our question as to how vitamin D affects diabetics by concluding that low levels of vitamin D deficiency lead to cardiovascular disease (Aljack et al.; 2019) ( Navaz 2017).

In the study by Onalan and Gozel (2019), we follow 100 diabetic participants that are closely monitored by their hemoglobin A1C, fasting blood glucose of a total of eight hours, HDL & LDL cholesterol, triglycerides, and blood sugar after consuming food. The factors were all tested to determine if there is a relation between low levels of vitamin D and glycemic control in diabetics (Onalan and Gozel, 2019). Overall, the study concluded that the participants who had lower levels of vitamin D had negatively higher levels of HA1C, fasting blood sugar during an eight-hour frame, and high level of blood sugar after consumption of food (Onalan and Gozel, 2019). Therefore, the hypothesis the article made in terms of a relationship between vitamin D and glycemic control can be deemed conclusive as evidenced by the lower levels of blood sugars in patients who had adequate amounts of vitamin D (Onalan and Gozel, 2019). While as Yeğin et al.; (2017) studied diabetic participants and divided them into two groups categorizing one group with a vitamin D deficiency and the other group whose vitamin D were normal, with both groups being monitored in a four-month period. The two groups were tested by vitamin D levels by blood and by cognitive status with the use of the mini-mental status examination as a questionnaire (Yeğin et al.; 2017). The mini-mental status examination tests 5 categories of orientation, registration, attention, recall, and language skills all to sum up a total score of 30 points (Yeğin et al.; 2017). It is important to note that 30 points are the maximum amount of points earned while 27 to 30 points shows normal mental status and a score of 24-27 can suggest slight cognitive dysfunction that correlates with characteristics of dementia (Yeğin et al.; 2017). Overall, the results in the study revealed that the group with a vitamin D deficiency and the group without it remains inconclusive due to the fact that when comparing the score of the mini-mental status examination the results differed by about one point (Yeğin et al.; 2017). The question still remains on whether we can confirm that lack of proper vitamin D levels can ultimately cause mental and cognitive decline by such a slight result difference.

Most of the articles were able to distinguish a correlation with vitamin D and multiple tests that determined cardiovascular health (Aljack et al.; 2019) and glycemic control (Onalan & Gozel, 2019) but no real correlation could be concluded with the lack of vitamin D and mental status (Yeğin et al.; 2017). In conclusion, vitamin D is essential for diabetics by increasing insulin sensitivity thus making it more manageable for diabetics to manage their blood sugar and overall disease.

References

• Aljack, H. A., Abdalla, M. K., Idris, O. F., & Ismail, A. M. (2019). Vitamin D deficiency increases risk of nephropathy and cardiovascular diseases in Type 2 diabetes mellitus patients. Journal of Research in Medical Sciences, 24, 1–7. https://doi-org.libraryaccess.sdcity.edu/10.4103/jrms.JRMS_303_18
• Navaz Gangji, S. (2017). Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus Leads to Vascular Complications. Western Undergraduate Research Journal: Health & Natural Sciences, 8(1), 1–6. https://doi-org.libraryaccess.sdcity.edu/10.5206/wurjhns.2017-18.2
• Onalan, E., & Gozel, N. (2019). Prevalence of vitamin D deficiency in patients with type 2 diabetes and its relationship with glycemic control. Journal of Turgut Ozal Medical Center, 26(1), 222–225. https://doi-org.libraryaccess.sdcity.edu/10.5455/annalsmedres.2018.10.228
• Yeğin, Z., Fidan, C., & Kut, A. (2017). Impact of Vitamin D Deficiency on Cognitive Functions in Type 2 Diabetic Patients. Acta Endocrinologica (1841-0987), 13(4), 410–416. https://doi-org.libraryaccess.sdcity.edu/10.4183/aeb.2017.410