Vitamin D and cardiometabolic risk factors for the development and progression of type 2 diabetes and its complications

Abstract

Type 2 diabetes (T2D) and vitamin D deficiency are so common in the population that they are referred to as pandemics, which justifies the use of vitamin D to correct its deficiency. Objective. To study the association between vitamin D status in patients with T2D and cardiometabolic risk factors for the development of T2D and its complications, as well as to analyze the dose-time dependence of the effectiveness of vitamin D deficiency correction according to recent data. Results. The prevalence of vitamin D deficiency among patients with T2D is quite high and is even more common in patients with complicated T2D. There was a significant negative correlation between serum 25(OH)D concentrations and the levels of fasting plasma glucose, HbA1c, cholesterol, LDL cholesterol, and body mass index (BMI), while there was a positive correlation between the levels of 25(OH)D and HDL cholesterol. A consensus was reached on the need to optimize vitamin D status in T2D patients. Different doses and regimens of vitamin D supplementation are used to correct vitamin D deficiency. Important factors in the effectiveness of vitamin D administration are the patients’ baseline vitamin D status, dosage and duration of vitamin D3 intake. The effect of vitamin D3 on serum 25(OH)D concentrations was shown to be more pronounced in individuals with initial vitamin D deficiency. To correct vitamin D deficiency, the duration of administration should be 3 to 6 months, using doses that are not less than the recommended daily intake. High doses of vitamin D (more than 2000 IU/day) were more effective in correcting serum 25(OH)D levels and improving glycemic control and lipid metabolism in patients with T2D and vitamin D deficiency. Conclusions. To eliminate the lack of vitamin D, its daily long-term administration at a dose of 800–1000 IU is advisable. Optimization of vitamin D supply should be considered as a part of diet therapy for T2D, contributing to the mitigation of clinical manifestations of the disease and its associated complications. Key words: type 2 diabetes, insulin resistance, vitamin D, doses, efficacy