Vitamin D Deficiency in Elderly With Diabetes Mellitus Type 2: A Review

Papaioannou, Ioannis; Πανταζίδου, Γεωργία; Kokkalis, Zinon T.; Georgopoulos, Neoklis A.; Jelastopulu, Eleni

doi:10.7759/cureus.12506

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…[47][48][49][50] Another recent report stressed the controversy in the literature about the effect of vitamin D on T2DM complications and the need for more studies in this respect, especially in the elderly. 51 In conclusion from the present study, we may say that the highly significant correlations between total vitamin D and the absolute value of free vitamin D or its per cent would confirm that total vitamin D can be used to represent vitamin D status and that vitamin D deficiency in T2DM could be considered as a part of the manifestation of malnutrition of this disease rather than being a risk factor. One of the supportive evidence for this hypothesis is that vitamin D deficiency has been recorded in children with type 1 diabetes, known to be an autoimmune disease.…”

Section: Discussionsupporting

confidence: 70%

The total and free vitamin D in type 2 diabetes mellitus patients in Baghdad city

Subber¹,

Al-Shamma²,

Hashim³

2021

Baghdad J. Biochem. Appl. Biol. Sci.

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Background: The free-form of vitamin D has been used by many researchers as an index of vitamin D status in health and disease. Several methods are there to estimate free, total, and even bioavailable vitamin D. Objective: The present work was carried out to measure free vitamin D using a special formula suggested by Bikle and Schwartz in 2019, which includes the vitamin D binding protein (VDBP). The results will be used to evaluate the vitamin D status in patients with type 2 diabetes mellitus (T2DM), and its relation to the disease progression. Methods: Sixty-four patients with T2DM and 73 healthy subjects, all from Baghdad city, were enrolled in the current study from March to October 2020. For each participant, fasting blood glucose, hemoglobin (HbA1c), insulin resistance HOMA-IR, and body mass index (BMI) were measured in addition to the total vitamin D and VDBP. Moreover, free vitamin D was calculated by the formula of Bikle & Schwartz. Results: There were highly significant correlations between total vitamin D and absolute values of free vitamin D or its percentage. The difference in total vitamin D was significant between patients and healthy controls with no significant change in VDBP, free and bio-available vitamin D, while free vitamin D% was higher in the patient’s group. Correlations between vitamin D and each of BMI, fasting glucose, HbA1c, and HOMA-IR were not significant; however, there was a negative correlation with BMI and fasting glucose in the healthy control subjects only. The Receiver Operating Characteristic (ROC) curve analysis of vitamin D in the diagnosis of diabetes mellitus was poor. Conclusion: Total vitamin D can represent vitamin D status, but it cannot be used as a factor for diagnosing T2DM. However, it could be of importance to change the glycemic status.

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Section: Discussionsupporting

confidence: 70%

The total and free vitamin D in type 2 diabetes mellitus patients in Baghdad city

Subber¹,

Al-Shamma²,

Hashim³

2021

Baghdad J. Biochem. Appl. Biol. Sci.

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“…The elderly patients with T2DM have many additional predisposing factors for increased fracture prevalence. These factors are the presence of senile osteoporosis, more severe vitamin D deficiency [31], comorbidities and pharmacotherapies that affect bone quality and predispose to falls, longstanding diabetes-induced bone fragility [30], and increased probability for diabetes-induced complications such as retinopathy, diabetic peripheral neuropathy, and poor cognitive performance, which increase the risk of a fall and subsequent fracture [32].…”

Section: Discussionmentioning

confidence: 99%

Systematic Review: Are the Elderly With Diabetes Mellitus Type 2 Prone to Fragility Fractures?

Papaioannou¹,

Πανταζίδου²,

Kokkalis³

et al. 2021

Cureus

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Diabetes mellitus type 2 (T2DM) is an emerging public health issue with high prevalence rates among older adults while fragility fractures constitute a significant public health burden with a great impact. Osteoporosis is the most important metabolic bone disease in patients with diabetes mellitus. Based on current evidence, individuals with T2DM are more vulnerable to fragility fractures than their non-diabetic counterparts, although until now, there aren't any systematic reviews or meta-analyses concerning the impact of T2DM on the risk of fragility fractures in elderly patients. The aim of this study is to fill this gap in the current literature concerning this specific patient group.Literature in PubMed and Google Scholar was searched for relevant articles published up to January 2021. The keywords used were: elderly, diabetes mellitus type 2, and fragility fractures. Among the 180 articles retrieved, only four full-text articles were eligible and, finally, two studies (one population-based cohort study and one cross-sectional study) met the inclusion criteria for the review. Although we identified 15 records through the manual research, finally 17 records were included in the current review. The records retrieved from the manual research were 11 prospective cohort studies, two population-based studies, one prospective observational study, and one retrospective cohort study. The author's name, year of publication, country, type of study, and number of patients were reported.According to this systematic review, there is almost consensus about the increased prevalence of all kinds of fragility fractures and especially low-energy hip fractures among elderly patients with T2DM compared with their counterparts without T2DM while there is relative controversy concerning non-vertebral fractures. Vertebral fractures in the elderly with T2DM require further evaluation because the results from cohort studies are more conflicting. Finally, insulin usage can increase the possibility of fragility fractures and can even double this risk. Bone fragility should be recognized as a new complication of T2DM, especially in elderly patients, due to several additional aggravating factors such as senile osteoporosis, severe vitamin D deficiency, presence of many comorbidities, increased possibility of insulin usage, and the presence of diabetes-related complications (mainly neuropathy and retinopathy). Clinicians who treat these patients should be aware of the special diagnostic and therapeutic approaches concerning these patients.

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“…Vitamin D is a fat-soluble vitamin acquired from the diet and synthesized from direct sunlight exposure (cholecalciferol) [3]. This vitamin is hydroxylated as 25-hydroxyvitamin D (25OHD) in the liver and then converted into its final form, Calcitriol (1, 25 (O.H.)…”

Section: Introductionmentioning

confidence: 99%

Assessment of Vitamin D Level and Its Relation to Glycemic Control Among Patients with Type 2 Diabetes Mellitus in Khartoum State

Abdoalnasir Abdoalrasol Abdallah,

Ahmed Elrheima Ahmed

2023

Sudan JMS

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Background: Type II diabetes is a chronic hyperglycemic disorder. Vitamin D appears to be associated with chronic disease prevention and modulation of immunity. This study was designed to associate vitamin D levels with glycemic control among type 2 diabetes mellitus in Khartoum state. Methods: This was a prospective case-control study conducted between June and November 2021 in Khartoum, Sudan. In total, 80 individuals were included in the study, of which 40 had type 2 diabetes mellitus, while the other 40 were normal, apparently healthy individuals. Vitamin D was measured by ELISA. Results: SPSS was used for statistical analysis. Results showed that 20% of the case group (patients with diabetes mellitus) had suboptimal vitamin D levels, whereas 80% had vitamin D deficiency. Vitamin D levels were significantly decreased among the case group when compared to the control group (P-value = 0.00). The glycated hemoglobin was negatively correlated with vitamin D level (P-value = 0.017, R = –0.376). Conclusion: In this study, a significant decrease in vitamin D was seen among people with type 2 DM. There was a weak negative correlation between hemoglobin A1C and vitamin D levels, and no significant difference in Vitamin D levels among gender and different types of treatment.

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Vitamin D Deficiency in Elderly With Diabetes Mellitus Type 2: A Review

Cited by 6 publications

References 39 publications

The total and free vitamin D in type 2 diabetes mellitus patients in Baghdad city

The total and free vitamin D in type 2 diabetes mellitus patients in Baghdad city

Systematic Review: Are the Elderly With Diabetes Mellitus Type 2 Prone to Fragility Fractures?

Assessment of Vitamin D Level and Its Relation to Glycemic Control Among Patients with Type 2 Diabetes Mellitus in Khartoum State

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