Comparison of Vitamin D Levels among Patients with Diabetes With or Without Polyneuropathy

Background Coronavirus disease-19 (COVID-19) is an ongoing pandemic causing considerable fatalities worldwide. Vitamin D modulates the immune response through effects on various cells, such as: macrophages, B and T lymphocytes, neutrophils, and dendritic cells. Aim To explore whether supplementation of vitamin D, in the form of a single intramuscular cholecalciferol injection, to patients with diabetes, COVID-19, and low vitamin D levels could improve the prognosis of those patients. Methods This was a placebo-controlled randomized prospective study. The study has two arms as follows: the intervention arm (40 vitamin D deficient diabetes elderly patients that acquired SARS-CoV-2), compared to the control arm (16 elderly diabetes patients, with deficient vitamin D with SARS-CoV-2). Patients in the intervention arm were given vitamin D as a single intramuscular injection (200,000 IU); patients in the control arm were given placebo. The primary outcome was mortality within 6 weeks of the diagnosis of COVID-19. Clinical, laboratory, treatment, and outcome data were recorded after 6 weeks of follow-up. Results No significant difference in 6 weeks mortality was observed between patients who received vitamin D and patients who received placebo (17.5% vs 18.8%, p = 0.838). Age, presence of hypertension, and chronic obstructive pulmonary disease were independent predictors of mortality at 6 weeks. Conclusion Vitamin D supplementation did not reduce the severity or mortality of COVID-19 at 6 weeks. Further large scale studies are required to explore the effect of vitamin D therapy on survival in patients with diabetes mellitus who acquire COVID-19.

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Vitamin D levels in patients with diabetes mellitus in combination with chronic kidney disease

Nephrology (Saint-Petersburg) ◽

10.36485/1561-6274-2021-25-6-81-86 ◽

2021 ◽

Vol 25 (6) ◽

pp. 81-86

Author(s):

A. P. Lichacheva ◽

N. V. Agranovich ◽

A. T. Klassova ◽

A. S. Anopchenko ◽

E. L. Solovyova

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Metabolic Effects ◽

Control Group ◽

Excretory Function ◽

Vitamin D Levels ◽

Wide Range ◽

Patients With Diabetes

BACKGROUND. Vitamin D has been known since 1928. The wide range of its metabolic effects paradoxically contrasts with the high prevalence of insufficiency and deficiency in the population of different regions of the world. A number of publications have demonstrated information about the relationship between vitamin D and insulin production by beta cells of the pancreas, as well as the excretory function of the kidneys.THE AIM: to assess the level of vitamin D in patients with diabetes mellitus in combination with chronic kidney disease (CKD).PATIENTS AND METHODS. A questionnaire and a study of the level of 25-hydroxyvitamin D, creatinine, urea, and glucose in the blood were conducted in 117 patients aged 18 to 84 years who gave voluntary consent. All patients were divided into three study groups: group 1 - patients with long-term DM, group 2 - patients with newly diagnosed DM, and 3 - control group. The glomerular filtration rate (GFR) is calculated by the formula CKD-EPI.RESULTS. As a result of the study, it was found that patients with DM, regardless of the duration of its course, were more likely to suffer from vitamin D deficiency, compared with the control group, where D-deficiency and D-deficiency occurred with the same frequency. In addition, patients with DM were more likely to have stage 2-3A CKD, in contrast to the control group, where preserved kidney function prevailed. We also identified and confirmed the direct dependence of GFR on the level of vitamin D in the blood of patients with DM.CONCLUSION. In the patients studied by us, a clear association was found between a lower vitamin D index in the blood serum and the presence of a history of diabetes. They also showed a tendency to decrease the excretory function of the kidneys and the formation of CKD. Consequently, a full-fledged diagnosis of vitamin D-deficient conditions and timely initiated therapy can prevent or at least slow down the progression of CKD in these patients, which will certainly improve their quality of life and reduce the costs of health services for renal replacement therapy and rehabilitation of this group of patients.

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Deficiency of Vitamin D: Influence on Diabetic Retinopathy and Hearing Loss Among Patients with Diabetes Mellitus Type 2

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2020068 ◽

2020 ◽

Vol 10 (4) ◽

pp. 282-286

Author(s):

Mashhood Farooq ◽

Syed Inamullah ◽

Shama Mashhood ◽

Mahmood Rana ◽

Muhammad Fahim

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Hearing Loss ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

P Value ◽

Hearing Status ◽

Vitamin D Levels ◽

Patients With Diabetes

Objective: To find a relationship between serum level of vitamin D with diabetic retinopathy and hearing loss in patients with diabetes mellitus type2. Study design and setting: This cross-sectional study was carried out at Ophthalmology, ENT and family physician Outpatient clinic of Mohsin Consultant Clinic Federal B Area, Karachi from study was April 2019 to December 2019. Methodology: Total 181 eligible type 2 diabetes mellitus patients. Complete ophthalmological, ENT and physical evaluation was carried out. Retinopathy and hearing status were recorded and were compared to serum 25-OH Vitamin D levels to find any association. SPSS version 23.0 was used to analyze the data. Results: Mean age of participants were found to be 60.56±7.3 (SD). When diabetic retinopathy status and hearing status was compared, non-proliferative diabetic retinopathy patients with normal hearing were 24(42.1%), with mild hearing 32(56.1%) and only 1(1.8%) with moderate-severe hearing loss was observed with P-value of <0.0001. Retinopathy status was compared with vitamin D levels. Insufficiency was seen in 14(38.9%) non-proliferative diabetic retinopathy, 2(5.6%) proliferative diabetic retinopathy patients and deficiency level was found in 33(32.7%) non-proliferative diabetic retinopathy and 15(14.9%) proliferative diabetic retinopathy patients. Level of vitamin D was compared to DR and HL status. Significantly low level of vitamin D was found with increasing severity of DR and HL with P-value <0.0001. Conclusions: Low level of vitamin D was associated with the severity of diabetic retinopathy and hearing loss in patients suffering from diabetes mellitus type2

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Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON)

Frontiers in Endocrinology ◽

10.3389/fendo.2021.723502 ◽

2021 ◽

Vol 12 ◽

Author(s):

João Soares Felício ◽

Hana Andrade de Rider Britto ◽

Pedro Celeira Cortez ◽

Fabrício de Souza Resende ◽

Manuela Nascimento de Lemos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Glycemic Control ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Vitamin D Levels ◽

Patients With Diabetes ◽

25 Hydroxy Vitamin D ◽

The Relationship

BackgroundThe effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified.ObjectiveEvaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM).Patients and MethodsCross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function.ResultsPatients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 – 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently.ConclusionOur study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.

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A prospective randomized controlled trial of bone metabolism in patients with charcot foot

Diabetes Mellitus ◽

10.14341/dm11272 ◽

2020 ◽

Vol 23 (1) ◽

pp. 12-18

Author(s):

Ekaterina L. Zaitseva ◽

Alla Y. Tokmakova ◽

Viktor M. Zhilyaev ◽

Natalia M. Malysheva ◽

Natalia I. Sazonova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Controlled Trial ◽

Type I ◽

Metabolic Markers ◽

Chronic Hyperglycemia ◽

Vitamin D Levels ◽

Patients With Diabetes ◽

25 Oh Vitamin D

BACKGROUND: Diabetic neuroosteoarthropathy (DNOAP, Charcots foot) - is a progressive destructive inflammatory disease of the osteoarticular apparatus of the foot, untimely and inadequate treatment of which can lead to the formation of gross deformities. More often, DNOAP is unilateral, bilateral lesion is relatively rare. It is not always possible to trace the relationship between the debut of DNOAP with trauma and chronic hyperglycemia. There is data demonstrating the role of individual pro-inflammatory factors in the pathogenesis of DNOAP, however, studies combining the evaluation of various metabolic markers of Charcots foot formation are currently extremely poor. AIM: To evaluate the hormonal and metabolic markers of bone formation and resorption in patients with DNOAP and without this diabetic complication. METHODS: A prospective, controlled trial included 70 patients with type 2 diabetes mellitus (37 men and 43 women) who formed 2 groups: group 1 included patients with DNOAP, group 2 was formed by patients with diabetes without foot skeleton damage. All patients underwent a study of 1,25-OH-vitamin D, sclerostin, pro-MMP-1, C-terminal propeptide type 1 collagen (PICP), type 1 collagen, osteocalcin, PTH, 25-OH-vitamin D, beta-cross-slaps. RESULTS: The results of the studies confirmed the presence of vitamin D deficiency in all patients with diabetes mellitus included in the study, revealed the absence of statistically significant differences between the groups in the values of sclerostin, pro-MMP-1; 25-OH-vitamin D, type I collagen, and osteocalcin (p 0.05). However, significant differences were found in the 1.25-OH vitamin D levels: patients with DNOAP presented the lower rates of 1,25-OH-vitamin D in comparison to control group (p 0.05). Beta-cross and PICP levels were significantly higher in DNOAP patients as well (p 0.05). Those findings show the more severe collagen degradation in patients with DNOAP and can be the genetically predisposed cause of DNOAP development. Though further studies are needed. CONCLUSION: In patients with DNOAP a decrease in 1,25-OH-vitamin D levels was found, as well as the alteration of the synthesis and destruction of collagen (beta-cross-slaps and PICP) compared to patients with diabetes mellitus without osteoarticular disorders.

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Vitamin D deficiency in patients with tuberculosis and its correlation with glycemic status

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195915 ◽

2019 ◽

Vol 8 (1) ◽

pp. 239

Author(s):

Ritu Karoli ◽

Shobhit Shakya ◽

Prem Shanker Singh

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Cross Sectional Study ◽

Vitamin D Supplementation ◽

Glycemic Status ◽

Cross Sectional ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Patients With Diabetes

Background: Comorbidity of diabetes and tuberculosis has serious health implications. Presence of diabetes at least three times increases the risk of tuberculosis which may be mediated by an abnormal innate immune response due to hyperglycaemia or low vitamin D levels.Aim of the study- Present study was carried out to investigate whether lower serum 25(OH) D might be associated with higher prevalence of pulmonary or extra pulmonary tuberculosis which might provide an evidence for a role of vitamin D in the comorbidity of these two diseases and does it have any correlation with glycemic status.Methods: In a hospital based cross sectional study, 264 patients with newly diagnosed tuberculosis were enrolled and according to glycemic status they were divided into three groups. They were assessed for vitamin D deficiency in addition to routine laboratory and biochemical parameters.Results: The patients with diabetes had significantly lower vitamin D levels. The prevalence of severe vitamin D deficiency was highest in patients who had diabetes with tuberculosis. There was negative correlation between vitamin D levels and Hba1C and extensiveness of pulmonary tuberculosisConclusions: Serum vitamin D levels were significantly lower in tuberculosis patients with pre-diabetes and type 2 diabetes compared with those, who had normal glycemic status. We suggest that there is a need to pay more attention to vitamin D status in this country and if there is coexisting diabetes or impaired glucose intolerance, emphasis on vitamin D supplementation can be of utmost importance.

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Vitamin and HbA1C Status in Tuberculosis Patients with Diabetes and its Association

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i07/04 ◽

2018 ◽

Vol 3 (07) ◽

Author(s):

Dr. Charanpreet Singh

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Communicable Disease ◽

Normal Subjects ◽

Mean Value ◽

Control Group ◽

Vitamin D Levels ◽

Significant Difference ◽

High Prevalence ◽

Patients With Diabetes

Diabetes mellitus (DM)-tuberculosis is associated with poor glycemic control in DM patients. 2. DM is the most common risk factor associated with tuberculosis (TB); TB is also the third cause of death due to non-communicable disease (NCD). Materials and Methods: Present study was conducted in Dept. of TB and Chest Vedanta Institute of Medical sciences, Vedanta Hospital. A total of 100 patients of Type 2 DM were enrolled in the study of which 60 were male and 40 were female. Written consent was obtained from each patient to participate in the study. The study will be conducted in the patients admitted in the Department of TB and Chest in collaboration with Dept. of Biochemistry, Intensive Coronary Care Unit at Vedanta Hospital. All patients of DM with TB infection are diagnosed by clinician and admitted in our hospital for treatment. Informed consent was taken from all patients, who participated in our study and the study was approved by the college ethics committee. Blood pressure, height, body weight, and waist and hip circumferences of each patient were measured as an anthropometric and dietary measurement. Body mass index (BMI) and ratios of waist to hip circumference was calculated. Blood pressure of each patient was measured after giving rest for at least 5 min. Results: HbA1C levels were higher in the selected group of DM + TB patients mean value being 8.1 ± 0.56 %. There was a significant difference in Vit. B12 levels between cases (218.15 ± 35.65) and controls (355.02 ± 23.39), where serum level was low in cases compared to control group. About 13(18.88%) patients had Vit. B12 level less than 150pg/ml and 28(40.58%) were lying in the intermediate level between 150pg/ml to 350pg/ml. Serum vit.B12 levels ranged from 118pg/ml to 315pg/ml. 25(OH) D3 levels were 17.09 ± 2.15 ng/ml in study group where as in control group the levels were found to be 22.88±4.01.The BMI was higher in those suffering from DM+TB (28.13± 3.24) in comparison to normal subjects (24.89 ± 3.95). Conclusion: Our study has showed high prevalence of TB-DM co-burden of disease in our hospital settings and TB+DM TB-DM were significantly associated with age. Also it is concluded that vitamin D is a link between PTB and DM. Vitamin D levels are lower in patients with TB with DM. This study recommends the importance of performing diabetes screening among pulmonary TB patients and further similar studies needs to be done to determine the feasibility of TB-DM co-management.

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