Vitamin D and Diabetes
Section snippets
Type 1 diabetes
T1D is a chronic autoimmune disease that results from the immune-mediated destruction of pancreatic β cells, thus resulting in insulin deficiency. The autoimmune process most commonly initiates in childhood and progresses for a variable period of months and even years before it leads to hyperglycemia and, thus, diagnosis. By the time of diagnosis only 10% to 30% of functional β-cell mass remains.10, 11 T1D is the second most common chronic disease in children, second only to asthma, and is
Type 2 diabetes
T2D is a disorder that results from defects in both insulin secretion and insulin sensitivity, and accounts for 90% of all diabetes cases. The growing rate of T2D is worrisome, with in the United States alone an estimated 1 million new cases every year.97 Initially, patients counteract their increased insulin resistance and stabilize circulating glucose levels through increased insulin production by pancreatic β cells. As the disease progresses and functional alterations are accentuated,
Gestational diabetes
GD is defined by β-cell dysfunction and insulin resistance during pregnancy. Women who have had GD have a 20% to 50% chance of developing T2D within 5 to 10 years.
Several studies demonstrated that pregnant women are more susceptible to hypovitaminosis D181, 182 and can suffer from insulin resistance.4, 183 Studies on the role of vitamin D and the regulation of glucose homeostasis in pregnancy are scarce, and data are not always consistent. Nevertheless, Zhang and colleagues184 reported that
Kidney Failure
Over time, hyperglycemia can have a damaging effect on the kidneys. Zhang and colleagues187 reported that the prodrug vitamin D analogue, doxercalciferol (1α(OH)D2), may protect kidneys in mice with diabetic nephropathy. This result suggests that vitamin D might be useful and preventative for the kidneys. The NHANES survey found that 25(OH)D levels were significantly lower in persons with severely decreased glomerular filtration rate when compared with healthy individuals. In addition, persons
Summary
There is no doubt that vitamin D deficiency is the cause of several metabolic bone diseases, but vitamin D status is also linked to many major human diseases including immune disorders. Mounting data strengthen the link between vitamin D and diabetes, in particular T1D and T2D. Despite some inconsistencies between studies that associate serum 25(OH)D levels with the risk of developing T1D or T2D, there seems to be an overall trend for an inverse correlation between levels of 25(OH)D and both
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This work was supported by a postdoctoral fellowship for C.G. and a clinical fellowship for C.M. from the Flemish research fund “FWO Vlaanderen.” T.T. received an SBA scholarship from the Katholieke Universiteit Leuven.