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In type 2 diabetes, problems with dietary advice or physical activity are far more frequent than problems with medication, and not all physicians are fully aware of patients' problems. More active listening and shared decision-making should enhance adherence and improve outcomes.

Background: Several studies have shown that vitamin D supplementation could be useful for treating diff use musculoskeletal (DMS) pain in adults.Objectives: The aim of this study was to evaluate the eff ects of correcting a vitamin D defi ciency ( Յ 50 nmol/l) on DMS pain and quality of life in adults. Methods: A pragmatic prospective study was conducted in a general practice setting in the Rhone-Alps area between 1 February and 30 April 2009. Patients between the ages of 18 and 50 years old who consulted their general practitioner (GP) for DMS pain or chronic unexplained asthenia and had a defi cient serum 25 (OH) D level with no signs of any other disease were enrolled in this study. The patients received high doses of vitamin D supplements (400 000 to 600 000 units). Mean pain evaluation scores were evaluated before and after vitamin D supplementation using mixed models and accounting for repeated measures. Results: Before vitamin D supplementation, the adult study cohort ( n ϭ 49) had an adjusted mean serum 25 (OH) D level of 23.7 nmol/l, a mean pain evaluation score of 5.07 and a mean quality of life score of 3.55. After vitamin D supplementation, the adjusted mean serum 25 (OH) D level increased to 118.8 nmol/l ( P Ͻ 0.001), the mean quality of life score increased to 2.8 nmol/l ( P Ͻ 0.001) and the mean pain evaluation score decreased to 2.8 ( P Ͻ 0.001). Conclusion:In this small before-and-after study, vitamin D supplementation decreased pain scores in adult patients with diff use musculoskeletal pain and vitamin D defi ciency. These results must be confi rmed by further studies. Many studies have reported that hypovitaminosis D exists all over the world. In the UK, Hypponen reported that 87.4% of the studied population had vitamin D levels below 75 nmol/l, 46.6% had levels below 40 nmol/l and 15.5% had levels below 20 nmol/l in the winter and spring. In the summer, the proportions of the population at each of the three levels were 60.9%, 15.4% and

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