INTRODUCTIONDiabetes and vitamin D deficiency are global epidemics. Presently, around 285 million people have diabetes and this number is expected to reach 438 million by the year 2030.1 Given the burden of diabetes and its complications, researchers have long been exploring the role of potentially modifiable factors to identify at-risk individuals prior to diagnosis. Our focus has now shifted to prediabetes, which is an intermediate form of dysglycemia on a spectrum ranging from normal to overt diabetes.2 As per American Diabetes Association, a fasting glucose of 100 -<126 mg/dL, a 2-hour plasma glucose of 140 -<200 mg/dL after a 75-g OGT test, or HbA1c 5.7% (39mmol/mol) to <6.5% (48mmol/mol) defines prediabetes. Diabetes mellitus is diagnosed when fasting glucose >126mg/dL, 2-hour plasma glucose ≥200 mg/dL or HbA1c ≥6.5% (48mmol/mol). Despite the advances in the diagnosis and management of diabetes, achieving normoglycemia or optimal glycemic control is still considered challenging.4 This is because care of prediabetes and type 2 diabetes warrants intense life-style adaptations, polypharmacy and insulin centered regimens. ABSTRACT Background:The growing incidence of diabetes, consequent devastating morbidity, increasing mortality highlight the need for innovative approaches for prevention and management of disease. Pleiotropic hormonal effect of vitamin D3 has speculated its role in pathogenesis of diabetes. This study aims to assess vitamin D3 levels in study and control group and co-relate its level with HbA1c. Methods: This is a cross-sectional observational study done on randomly selected patients from January 2015 to September 2016. Patients were divided into 2 groups: control group and study group including pre-diabetics and diabetics. Venous sample for serum 25-OH vitamin D and HbA1c were collected. Results: 109 subjects were included in the study: 37 controls, 41 pre-diabetics, 31 diabetics. Out of the 37 healthy subjects, 14 (37.9%) had sufficient levels, 11 (29.7%) had insufficient levels whereas 12 (32.4%) were deficient in Serum vitamin D3 levels. Vitamin D3 deficiency was prevalent in 46.3% pre-diabetics, 41.7% diabetics with good glycaemic control and 84.2% diabetics with poor glycaemic control. Conclusions: Using Pearson Chi square, inverse co-relation was found between glycated haemoglobin and vitamin D3 levels (p<0.003).
Objective: It has been explored that Vitamin D play role in various non-skeletal disorders including Diabetes Mellitus. The present study was designed with the aim to assess association among control, pre-diabetic and diabetic with vitamin D and association between lipid profile and vitamin D. Materials and Methods: A total of 109 subjects were recruited for the cross-sectional study including 37 as control, 41 pre-diabetic and 31 diabetic. A clinical examination was done for all the groups including fasting samples (12hrs) for lipid parameters, serum 25 (OH) vitamin D level and (HbA1/C). Results: It was found that in control subjects 37.9% have the sufficient vitamin D3 level whereas 17.1% subjects in pre-diabetic, 16.6% in diabetic with good glycemic control and no subject was found to have sufficient vitamin D3 level in diabetic with poor glycemic control. The mean vitamin D3 levels was highest in control i.e. -26.53±11.99 ng/ml followed by 20.23±4.12ng/ml in prediabetics,19.07±8.01ng/ml in diabetics with good glycemic control and 12.92±6.77ng/ml in diabetics with poor glycemic control. HBA1/c and serum vitamin D3level share a significant association (P-value< 0.01).Total cholesterol (P-value< 0.0), serum triglyceride (P-value< 0.01), serum LDL cholesterol (P-value< 0.01) and serum VLDL (P-value< 0.01) had inverse association with vitamin D levels. HDL cholesterol has no effect with vitamin D. Conclusion: The present study showed vitamin D3 deficiency as a risk factor for worsening glycemic control and dyslipidemia.
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