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Background Vitamin D is a fat-soluble hormone that plays an important role in glycaemic control. In addition, it has a positive effect on improving liver enzyme function. Aim This study was performed to examine the effect of intramuscular injection of vitamin D on serum 25-hydroxyvitamin D [25(OH)D] levels, glycemic control, and liver enzymes in Libyan patients suffering from type 2 diabetes mellitus (T2DM) with vitamin D deficiency. Methods and Materials This cross-sectional study enrolled 100 T2DM (50 males and 50 females). Their serum 25(OH)D, fasting blood glucose (FBG), and liver enzymes were measured at the baseline and 12 weeks after treatment with vitamin D (200,000 IU) injection monthly for 3 months. Data analysis involved the estimation of mean ± standard error (SE) and comparison of means between pre and post-treatment values using paired t-test. Independent t-test was used to compare the means between males and females. The level of significance was set at p < 0.05. Results Females had a lower 25(OH)D blood levels than males at baseline (7.03 ± 0.25 ng/mL versus 7.86 ± 0.26 ng/mL, respectively p < 0.02). 25(OH)D levels in both sexes was increased significantly from 7.45 ± 0.18 ng/mL to 26.69 ± 0.24 ng/mL after 12 weeks of vitamin D injections (p < 0.001), with no significant differences between male and females. FBG levels in both sexes was significantly decreased from 144.68 ± 1.84 mg/dL to 85.96 ± 0.34 mg/dL post treatment (p < 0.001). Alanine aminotransferase (ALT) was increased from 10.24 ± 0.17 U/L at baseline to 20.34 ± 1.15 U/L post treatment (p < 0.001). Similarly, aspartate aminotransferase (AST) was increased from 11.23 ± 0.21 to 20.57 ± 0.22 U/L (p < 0.001), and alkaline phosphatase (ALP) was decreased from 124.95 ± 1.15 U/L to 111.17 ± 1.27 U/L (p < 0.001). There were no significant differences between male and female liver enzymes either pre- or post-vitamin D injections Conclusion Treatment with vitamin D injection showed a significant increase in 25(OH)D accompanied by decreased FBG and ALP levels and increased ALT and AST levels. Vitamin D levels should be monitored and adjusted in diabetic patients.

Background: Many epidemiological studies reported the association of Vitamin D deficiency and abnormal liver enzymes' levels with type 2 diabetes (T2D) and their findings remain inconsistent. Aim: The study investigated the status of both Vitamin D levels and liver enzymes' activity in a Libyan population with T2D. Materials and Methods: A total of 180 individuals of both genders whose ages ranged between 25 and 62 years were enrolled. Fasting blood sugar, (FBS), Vitamin D, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) were measured in patients' serum. The association of both Vitamin D and liver enzymes levels with T2D was evaluated by Chi-square analyses. Results: 55.6% of the study subjects were diabetics and 44.4% were healthy controls. 100% of T2D patients had deficient Vitamin D level (<20 ng/ml) (P = 0.000). The mean Vitamin D level was higher in nondiabetics (39.1 ± 4.0) ng/ml than in T2D patients (7.4 ± 1.8) ng/ml. 98% (P = 0.068), 97% (P = 0.118), and 100% of T2D patients had normal levels of AST, ALP, and ALT enzymes, respectively. The mean AST, ALP, and ALT enzymes levels for nondiabetics were 30.3 ± 4.1, 58.7 ± 8.0, and 24.8 ± 4.9 U/L, respectively. The mean AST, ALP, and ALT enzymes levels for T2D patients were 11.3 ± 2.9, 125.0 ± 11.5, and 10.3 ± 1.7 U/L, respectively. Conclusions: Vitamin D deficiency may be related to T2D in the Libyan population, while the liver enzymes showed no significant differences between diabetics and nondiabetics.

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A cluster-5 variant was detected in September 2020 in minks and humans in Denmark and currently classified as Alpha or B.1.1.7 strain. This variant presents several mutations in the spike region (S) which could increase the transmissibility of the virus 43-90% over previously circulating variants. The national center for disease control (NCDC) announced on 24th February 2021 the discovery of B.1.1.7 strain in Libya using a reverse-transcriptase PCR assay for S-gene target failure (SGTF) and reported that 25% of the tested samples were UK variant. This assay relies on the specific identification of the H69-V70 deletion in S gene which causes S gene drop out in RT-PCR; characteristic of the UK variant (B.1.1.7). This letter discusses our whole genome sequencing results of positive SARS-COV-2 samples with SGTF collected between 25th February - 4th March 2021 in Libya.