Vitamin D and Diabetic Complications: True or False Prophet?

Uazman Alam, Vilashini Arul-Devah, Saad Javed, Rayaz Malik

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Vitamin D deficiency is now recognized as a condition of increasing prevalence worldwide. Vitamin D has an established role in calcium and bone metabolism; however, more recently associations with vitamin D deficiency and risk of developing diabetes, diabetes complications, and cardiovascular disease have all been acknowledged. The vitamin D receptor is ubiquitously expressed, and experimental, in vitro, and in vivo studies strongly suggest a role in regulating the transcription of multiple genes beyond calcium homeostasis. These include antiproliferative, immunomodulatory, angiogenic, inhibition of the renin–angiotensin–aldosterone system, and neurotrophic factor expression. Observational studies report a strong association between vitamin D deficiency and cardiovascular and metabolic disorders; however, there remains a paucity of large long-term randomized clinical trials showing a benefit with treatment. An increasing body of literature suggests a possible pathogenetic role of vitamin D in the long-term complications of diabetes and vitamin D deficiency may also exacerbate symptoms of painful diabetic peripheral neuropathy. It remains unknown if supplementation of vitamin D to normal or non-deficient levels alters pathogenetic processes related to diabetic microvascular complications. With the high prevalence of vitamin D deficiency in patients with diabetes and putative mechanisms linking vitamin D deficiency to diabetic complications, there is a compelling argument for undertaking large well-designed randomized controlled trials of vitamin D supplementation.

Original languageEnglish
Pages (from-to)11-26
Number of pages16
JournalDiabetes Therapy
Volume7
Issue number1
DOIs
Publication statusPublished - 1 Mar 2016

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Keywords

  • Cardiovascular disease
  • Diabetic nephropathy
  • Diabetic neuropathy
  • Diabetic retinopathy
  • Pain
  • RAAS inhibition
  • Vitamin D

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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