Vitamin D and Diabetes

Dallae Ju

doi:10.4093/jkd.2011.12.2.104

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Ju: Vitamin D and Diabetes

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J Korean Diabetes 2011;12(2):104-108.

Published online: 22 January 2011

DOI: https://doi.org/10.4093/jkd.2011.12.2.104

Vitamin D and Diabetes

Dallae Ju

Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Epidemiologic evidence suggests that vitamin D status, as assessed by serum 25-hydroxyvitamin D levels, is associated with increased risk for diabetes, and that adequate intake of vitamin D may prevent or delay the onset of diabetes. Many individuals with diabetes have decreased levels of vitamin D, and lack of vitamin D may be associated with hyperglycemia, increased hemoglobin A1c, insulin resistance, and progression of diabetes. Optimal vitamin D status is needed to prevent adverse outcomes in diabetic patients. Increasing intake of vitamin D by diet, oral supplements and sun exposure may be easy and cost-effective methods to improve metabolic control and prevent diabetes.

Keywords: Vitamin D, Diabetes, 25-hydroxyvitamin D, Vitamin D supplement

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Fig. 1.

Vitamin D metabolism. Ca, calcium; 1,25(OH)₂D, 1,25-dihydroxyvitamin D; 25(OH)D, 25-hydroxyvitamin D; PTH, parathyroid hormone.

Table 1.

Applications for vitamin D testing

Clinical risk factors for vitamin D deficiency
Decreased intake	Inadequate oral intake
	Malnutrition (poor oral intake)
	Limited sun exposure
Gastrointestinal malabsorption	Short bowel syndrome
	Pancreatitis
	Inflammatory bowel disease
	Amyloidosis
	Celiac sprue
	Malabsorptive bariatric surgery procedures
Hepatic	Some antiepileptic medication (increased 24-hydroxylase activity)
	Severe liver disease or failure (decreased 25-hydroxylase activity)
Renal	Aging (decreased 1-α hydroxylase activity)
	Renal insufficiency, glomerular filtration rate ＜ 60% (decreased 1-α hydroxylase activity)
	Nephrotic syndrome (decreased levels of vitamin D-binding protein)
Laboratory and radiographic findings that suggest possible vitamin D deficiency
Laboratory	Low 24-hour urine calcium excretion (in the absence of thiazide use)
	Elevated parathyroid hormone level
	Elevated total or bone alkaline phosphatase level
	Low serum calcium and/or serum phosphate level
Radiographic	Decreased bone mineral density (osteopenia or osteoporosis)
	Nontraumatic (fragility) fracture
	Skeletal pseudofracture

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