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Vitamin D and T2D: Where does research stand, where are we headed?

Posted on: December 3, 2013   by  Brant Cebulla

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This past November was American Diabetes Month. As many know, diabetes is becoming a major public health problem. Nearly 26 million children and adults in the United States have diabetes, with an additional 79 million Americans having prediabetes.

It is projected that one in three American adults will have diabetes in 2050, unless public health efforts successfully slow down the rising incidence rate. Currently, diabetes costs $245 billion dollars in medical care costs.

Can vitamin D help in type II diabetes (T2D)? Can it slow the rising incidence rate? Can it help prevent T2D? Can it help treat T2D?

As outlined in our T2D summary, to date, research on the effect of vitamin D on T2D has been modest. There has been no research showing vitamin D supplementation can prevent T2D. For treatment, some research shows that vitamin D helps improve insulin sensitivity and decrease insulin resistance.

However, what would really excite the T2D research field is if vitamin D could improve glucose control. To date, randomized controlled trials haven’t been able to show that vitamin D can help in this department, and thus vitamin D has failed to excite clinicians for use of vitamin D as add-on therapy in T2D.

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3 Responses to Vitamin D and T2D: Where does research stand, where are we headed?

  1. tierrainc@email.com

    There is another aspect of these studies that need to be considered. 2000iu is often called high dose. It is hardly a high dose by definition today. My wife and I are taking over 5000iu daily and our blood levels are between 50 and 60 ng/ml. both of us have experienced major improvement in knee pain. This was not the case when we were taking 2000iu with blood levels in the high 30s and low 40s. And it also was not an expected outcome for us. A randomized study published in June using 2000iu found no significant reduction in pain by vitamin D supplementing. While our experience is not scientific, it certainly presents the possibility that blood levels matter. It could be that different levels could affect diseases differently which will certainly complicate accessing the value of vitamin D.

  2. Brant Cebulla

    tierrainc@email.com, very fair argument in that we need to make sure that people are getting big enough doses to see an effect.

    There was a trial published earlier this year that I think most here would argue was very well designed:

    Davidson MB, Duran P, Lee ML, Friedman TC. High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes Care. 2013 Feb;36(2):260-6. doi: 10.2337/dc12-1204. Epub 2012 Oct 1. PubMed PMID: 23033239; PubMed Central PMCID: PMC3554269.

    The researchers administered titrated vitamin D doses to patients with pre-diabetes to ensure that all patients in the vitamin D group had a vitamin D level of about 70 ng/ml by the end of the trial. They wanted to know if these blood levels protected against development of diabetes compared to placebo (blood levels of about 20-25 ng/ml). After a year, there was no effect of having higher vitamin D levels on risk of developing diabetes.

    Hopefully longer trials will prove differently.

  3. IAW

    So I went to the above cited article by Brant titled “High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes Care”. Brant said “that I think most here would argue was very well designed”.

    It says in the results that “At 12 months, A1C levels were significantly slightly less (0.2%) in the vitamin D group.” They used the word “significantly”.

    At one point a while ago I was looking up A1C and came across this article ” The Pros and Cons of Diagnosing Diabetes With A1C” by Enzo Bonora, MD, PHD1⇓ and Jaakko Tuomilehto, MD, MA, PHD2. There seem to be an awful lot of “cons” for using the test.
    So I am neither a doctor or scientist but I am not sure if the A1C measurement was a good way to go to determine anything. Maybe a lot of people were included as pre diabetic that really are not. Maybe there is another factor(s).

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