Journal List > J Korean Diabetes > v.12(2) > 1054773

Ju: Vitamin D and Diabetes


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.


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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
Inflammatory bowel disease
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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