The Impact of Vitamin D Deficiency and Insufficiency on the Outcome of Type 2 Diabetes Mellitus Patients: A Systematic Review

Abstract

Vitamin D deficiency and insufficiency are public health concerns that have contributed to multiple negative health outcomes. Recent studies have revealed that vitamin D deficiency and insufficiency influence glycaemic control and the development of diabetes complications. The goal of this systematic review is to summarise the latest evidence on the impact of vitamin D deficiency and insufficiency on the outcome of Type 2 Diabetes Mellitus (T2DM) patients. In this PRISMA-guided systematic review, articles were sourced from three databases, namely, PubMed, Scopus, and Web of Science. The review only included literature published from 2012 until 2022, and 33 eligible studies met the inclusion criteria for this review. The included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT). According to our findings, vitamin D deficiency or insufficiency is associated with mental health status, macrovascular and microvascular complications of T2DM, metabolic syndrome, increased risk of obesity, increased blood pressure, dyslipidaemia, glycaemic control, nerve-related disease, musculoskeletal-related complications, and reduced quality of life. Due to the diverse implications of vitamin D deficiency and insufficiency, screening for vitamin D levels in T2DM patients may be beneficial.

Association between vitamin D status and cardiometabolic risk factors in adults with type 2 diabetes in Shenzhen, China

“…Therefore, the identification of risk factors other than the well-known ones such as poor glycemic control, increased BP or hypertension, and obesity is essential to improve glycemic control rates. Over the last decade, the pleiotropic metabolic roles of vitamin D have attracted widespread concern, especially in glucose metabolism and cardiovascular health, along with the discovery of the expression of vitamin D receptors in non-skeletal organs and tissues such as adipose, vascular smooth muscles, cardiomyocytes, and pancreatic β-cells ( 11 ). Most of the epidemiologic and meta-analysis studies have reported consistent inverse associations between serum 25(OH)D level and the risk of incident diabetes in the general population and that of poor glycemic control among adults with T2DM.…”

“…However, the association between vitamin D and these cardiometabolic risk factors remains controversial and limited, especially for patients with T2DM. To date, only two studies have investigated the association between vitamin D status and BP and hypertension, respectively, and one of these studies simultaneously looked at its association with dyslipidemia among patients with T2DM according to the recent systematic review by Md et al (9)(10)(11) In terms of glucose metabolism, most results of related studies are consistent, suggesting that lower concentrations of serum vitamin D are closely related to poor glycemic control, however, these studies were limited to the general population, the older, pregnant women, and other nondiabetic populations, and few studies focused on patients with T2DM, who are more prone to vitamin D deficiency (VDD) (12)(13)(14)(15)(16)(17)(18).…”

Decoding cardiovascular risks: analyzing type 2 diabetes mellitus and ASCVD gene expression

“…Doxercalciferol, a vitamin D receptor agonist, highlights the close association between vitamin D deficiency and conditions such as diabetes, arterial hypertension, and chronic kidney disease ( 34 , 35 ). The detection of nuclear vitamin D receptors (VDRs) in vascular endothelial cells and cardiomyocytes indicates that vitamin D is directly involved in the development and progression of cardiovascular diseases ( 36 , 37 ). Topiramate, promotes insulin secretion and enhances insulin sensitivity, offering an effective solution for the critical challenges of β-cell dysfunction and insulin resistance in T2DM ( 38 ).…”

High prevalence of vitamin D deficiency in Taiwanese patients with inflammatory bowel disease

“…Globally, vitamin D deficiency, defined as a concentration < 20 ng/mL (50 nmol/L) according to the Endocrine Society guideline 25 , is common in the general population across all age groups 26 . Vitamin D deficiency is associated with many health problems such as chronic kidney disease 27 – 29 , diabetes mellitus 20 , 30 , cardiovascular disease 31 , cerebrovascular disease 32 , certain types of malignancy 33 , and autoimmune disease 20 , 21 . However, it remains unclear whether a lack of vitamin D leads to the development of these disorders or whether it is a symptom.…”