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Vitamin D and type 2 diabetes: a systematic review

Abstract

Background/Objectives:

Vitamin D may modify the risk of type 2 diabetes mellitus. The aim of this review was to examine the association between vitamin D status and incident type 2 diabetes, and the effect of vitamin D supplementation on glycemic outcomes.

Methods:

We performed a systematic review of English-language studies using MEDLINE through February 2011. Longitudinal cohort studies reporting associations between vitamin D status and incident type 2 diabetes, and randomized controlled trials (RCTs) of vitamin D supplementation, were included. Study characteristics and results were extracted, and study quality was assessed.

Results:

A total of 8 observational cohort studies and 11 RCTs were included. In meta-analyses of observational studies, vitamin D intake >500 international units (IU)/day decreased the risk of type 2 diabetes by 13% compared with vitamin D intake <200 IU/day. Individuals with the highest vitamin D status (>25 ng/ml) had a 43% lower risk of developing type 2 diabetes (95% confidence interval 24, 57%) compared with those in the lowest group (<14 ng/ml). In post hoc analyses from eight trials among participants with normal glucose tolerance at baseline and in three small underpowered (n=32–62) trials of patients with established type 2 diabetes, there was no effect of vitamin D supplementation on glycemic outcomes. In two trials among patients with baseline glucose intolerance, vitamin D supplementation improved insulin resistance.

Conclusions:

Vitamin D may play a role in type 2 diabetes; however, to better define the role of vitamin D in the development and progression of type 2 diabetes, high-quality observational studies and RCTs that measure blood 25-hydroxyvitamin D concentration and clinically relevant glycemic outcomes are needed.

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Acknowledgements

This study was supported by NIH research grants R01DK76092 and R01DK79003 (to AGP; by the National Institute of Diabetes and Digestive and Kidney Disease, the Office Of The Director-National Institutes of Health and the National Institutes of Health Office of Dietary Supplements) and UL1 RR025752 (to Tufts Medical Center; by the National Center for Research Resources) and the Endocrine Fellows Foundation Marilyn Fishman Grant for Diabetes Research grant (to JM). We thank Dr Robert Goldberg for helpful comments and suggestions.

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Correspondence to A G Pittas.

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Mitri, J., Muraru, M. & Pittas, A. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr 65, 1005–1015 (2011). https://doi.org/10.1038/ejcn.2011.118

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