Does Vitamin D deficiency play a role in peripheral neuropathy in Type 2 diabetes?

Shehab, Diaa; Al-Jarallah, Khaled; Mojiminiyi, Olusegun A.; Mohamedy, Hisham Al; Abdella, Nabila

doi:10.1111/j.1464-5491.2011.03510.x

Cited by 129 publications

(127 citation statements)

References 25 publications

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“…DSPN was significantly associated with vitamin D deficiency after adjustment for diabetes duration, glycated hemoglobin, and LDLc (OR: 3.47. 95% CI: 1.04-11.56, p = 0.043) [83]. In a short, 8-week prospective study, the same authors demonstrated a significant (p < 0.001) improvement of neuropathic symptoms with oral vitamin D supplementation vs. placebo [84].…”

Section: Low Vitamin Dmentioning

confidence: 60%

“…In T2D, the level of vitamin D was found to be significantly lower in those patients with DSPN [83]. Of patients with DSPN, 81.5% had vitamin D deficiency compared with 60.4% of those without DSPN [83].…”

Section: Low Vitamin Dmentioning

confidence: 95%

“…Secondary risk factors are smoking and prediabetes [1,21,60,63]. Platelet activation [79][80][81][82], oxidative stress [65][66][67][68][69][70][71][72][73][74], low vitamin D [83,84], insulin resistance [58], and genetic factors [100][101][102][103][104][105][106] play another supplementary role, but, for the time being, there are limited options for intervention. A suggestion for targeting insulin resistance originates from the study by Pop-Busui et al, showing that reduced incident DSPN is less frequent in T2D patients receiving insulin-sensitizing oral agents (66%) than in those receiving insulinproviding treatment (66% vs. 72%, respectively, p = 0.02) [155].…”

Section: Discussionmentioning

confidence: 99%

“…Of patients with DSPN, 81.5% had vitamin D deficiency compared with 60.4% of those without DSPN [83]. DSPN was significantly associated with vitamin D deficiency after adjustment for diabetes duration, glycated hemoglobin, and LDLc (OR: 3.47.…”

Section: Low Vitamin Dmentioning

confidence: 99%

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Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015

2015

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■ AbstractDistal symmetric sensorimotor polyneuropathy (DSPN) is the most common neurological manifestation in diabetes. Major risk factors of DSPN include diabetes duration, hyperglycemia, and age, followed by prediabetes, hypertension, dyslipidemia, and obesity. Height, smoking, insulin resistance, hypoinsulinemia, and others represent an additional risk. Importantly, hyperglycemia, hypertension, dyslipidemia, obesity, and smoking are modifiable. Stringent glycemic control has been shown to be effective in type 1, but not to the same extent in type 2 diabetes. Antilipidemic treatment, especially with fenofibrate, and multi-factorial intervention have produced encouraging results, but more experience is necessary. The major comorbidities of DSPN are depression, autonomic neuropathy, peripheral artery disease, cardiovascular disease, nephropathy, retinopathy, and medial arterial calcification. Knowledge of risk factors and comorbidities has the potential to enrich the therapeutic strategy in clinical practice as part of the overall medical care for patients with neuropathy. This article provides an updated overview of DSPN risk factors and comorbidities.

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Section: Low Vitamin Dmentioning

confidence: 60%

Section: Low Vitamin Dmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Low Vitamin Dmentioning

confidence: 99%

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Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015

2015

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“…The results of our study expand existing knowledge by showing prospectively in a large cohort that low blood 25OH-D is also a risk factor for development of peripheral neuropathy, retinopathy, nephropathy, and amputation. Previous cross-sectional studies reported lower circulating 25OH-D concentrations in diabetic patients with microvascular disease events (16)(17)(18)(19). However, all of these studies were limited by their size and design.…”

Section: Discussionmentioning

confidence: 99%

Serum 25-Hydroxyvitamin D: A Predictor of Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes

et al. 2014

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OBJECTIVEPeople with diabetes frequently develop vascular disease. We investigated the relationship between blood 25-hydroxyvitamin D (25OH-D) concentration and vascular disease risk in type 2 diabetes. RESEARCH DESIGN AND METHODSThe relationships between blood 25OH-D concentration at baseline and the incidence of macrovascular (including myocardial infarction and stroke) and microvascular (retinopathy, nephropathy, neuropathy, and amputation) disease were analyzed with Cox proportional hazards models and logistic regression in an observational study of patients in the 5-year Fenofibrate Intervention and Event Lowering in Diabetes trial. RESULTSA total of 50% of the patients had low vitamin D concentrations, as indicated by median blood 25OH-D concentration of 49 nmol/L. These patients with a blood 25OH-D concentration <50 nmol/L had a higher cumulative incidence of macrovascular and microvascular events than those with levels ‡50 nmol/L. Multivariate analysis, stratified by treatment and adjusted for relevant confounders, identified blood 25OH-D concentration as an independent predictor of macrovascular events. A 50 nmol/L difference in blood 25OH-D concentration was associated with a 23% (P = 0.007) change in risk of macrovascular complications during the study, and further adjustments for seasonality, hs-CRP, and physical activity level had little impact. The unadjusted risk of microvascular complications was 18% (P = 0.006) higher during the study, though the excess risk declined to 11-14% and lost significance with adjustment for HbA 1c , seasonality, or physical activity. CONCLUSIONSLow blood 25OH-D concentrations are associated with an increased risk of macrovascular and microvascular disease events in type 2 diabetes. However, a causal link remains to be demonstrated.Diabetes is among the leading causes of death and affects 347 million people worldwide. The World Health Organization expects a 50% increase in deaths from diabetes over the next 10 years, and by 2030, diabetes is projected to be the seventh leading cause of death (1). Most major complications involve large vessel (macrovascular) or small vessel (microvascular) disease.

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