Investigating the Association between Diabetic Neuropathy and Vitamin D in Emirati Patients with Type 2 Diabetes Mellitus

Abstract

(1) Background: Vitamin D deficiency is a common public health problem in the United Arab Emirates (UAE) and globally, and interestingly, improvements in diabetic neuropathy after taking Vitamin D supplementation for a short time have been reported. Despite living in a country that is sunny all year round, hypovitaminosis D, indicated by an obvious low serum vitamin D level, has been recurrently noted in the UAE, as well as in the surrounding Arabian Gulf countries. This problem is receiving much attention and attracting clinical and academic interest. Therefore, the main objective of the present study is to identify the association, if any, between vitamin D deficiency and the development of diabetic neuropathy in the UAE population with T2DM. (2) Methods: a total of 600 Emirati patients (male and female) with T2DM, aged between 20 and 80, were recruited from University Hospital Sharjah (UHS). The medical records of the patients were reviewed and analyzed. (3) Results: The results of the present study showed that among the 600 patients, 50% were affected with diabetic neuropathy. Vitamin D level in patients with neuropathy were estimated to be around 20 ng/mL (IQR 14–25), and vitamin D levels were significantly higher (33 ng/mL (IQR 20–42)) among patients without neuropathy, with p < 0.001. Another important finding was that patients without neuropathy had a better vitamin D status, with only 19% being deficient and 18% having insufficient vitamin D levels, compared to patients with neuropathy, where 39% were deficient (vitamin D < 20 ng/mL) and 44% had insufficient vitamin D levels (20–30 ng/mL). (4) Conclusion: The findings of the present study show that the prevalence of vitamin D deficiency (low serum 25-hydroxy vitamin D 25-OHD level) is significantly high in diabetic neuropathy in Emirati patients with T2DM.

Vitamin D—A New Therapeutic Target in the Management of Type 2 Diabetes Patients

“…Moreover, vitamin D may enhance the function of calcium channels, which are important for nerve conduction and neurotransmission [ 57 ]. Regarding diabetic macroangiopathy, vitamin D is involved in reducing chronic inflammation and oxidative stress, which are major factors in endothelial dysfunction, atherosclerosis, and modulating angiogenesis, which is impaired in diabetes.…”

Efficacy and safety of high-dose intramuscular vitamin D2 injection in type 2 diabetes mellitus with distal symmetric polyneuropathy combined with vitamin D insufficiency: study protocol for a multicenter, randomized, double-blinded, and placebo-controlled trial

“…Vitamin D deficiency is a growing global health problem, even in countries like the United Arab Emirates, which receives plenty of sunshine yearly (18). This implies that the vitamin D produced by the sun's ultraviolet rays is insufficient.…”

“…This evidence highlights an early treatment window for patients with T2DM and the possibility that vitamin D supplementation may prevent the development of DSPN. A previous retrospective study found that vitamin D levels in patients with T2DM and DSPN were one-third lower than those without DSPN, suggesting that vitamin D may affect DSPN progression (18). Furthermore, clinical studies have shown that HDVD supplementation can significantly reduce the pain score of DSPN, reduce demyelination, improve axonal regeneration, and even improve the quality of life of patients with DSPN (33,34,54).…”

“…Vitamin D nutritional status is determined by measuring serum 25-(OH)D levels-a sum of 25-(OH)D 2 and 25-(OH)D 3 . The Endocrine Society recommends a 25-(OH)D level of 30 ng/mL (17); a patient is considered to have a vitamin D -insufficient state if this level is not reached (17)(18)(19). Studies have shown that vitamin D deficiency occurs in 74.7% of people with T2DM and affects people with prediabetes.…”