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Low 25-(OH)D levels tied to poor glycemic control, more insulin use
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In adults with type 2 diabetes and chronic kidney disease, lower vs. higher levels of serum 25-hydroxyvitamin D were associated with poorer glycemic control and use of more insulin, according to findings published in the Journal of Diabetes Investigation.
Lee Ling Lim, MRCP, MBBS, of the division of endocrinology, department of medicine at the University of Malaya in Malaysia, and colleagues evaluated 100 adults (mean age, 60.5 years; 59% women) with type 2 diabetes and stage 3 to 4 CKD to determine the relationship between 25-(OH)D and glycemic control. Most participants were Malay ethnicity (51%), followed by Indian (25%) and Chinese (24%).
Researchers observed a negative correlation between serum 25-(OH)D and HbA1c (P = .002). Serum 25-(OH)D was reduced and BMI and LDL cholesterol levels were elevated in participants with poor glycemic control. HbA1c levels were not significantly correlated with age, estimated glomerular filtration rate, serum hemoglobin, logarithmic-transformed HDL cholesterol or triglyceride levels.
Researchers observed a significant inverse relationship between HbA1c and serum 25-(OH)D levels in participants with or without adjustments for age, sex, eGFR, serum hemoglobin, smoking status, antihypertensive drugs, oral antidiabetes agents, statin therapy, logarithmic-transformed HDL cholesterol and triglyceride levels. A 0.2% increase in HbA1c level was associated with every 10-nmol/L decline in serum 25-(OH)D.
Reduced serum 25-(OH)D levels predicted the increased use of insulin therapy in logistic regression analysis (OR = 1.03; 95% CI, 1.01-1.05). The mean total daily dose of insulin was 61.5 U in insulin-treated participants (n = 65), and it was negatively correlated with serum 25-(OH)D (P = .042).
“Our findings highlight the importance of vitamin D screening in at-risk patients, for instance, patients who have poor glycemic control or with CKD,” Lim told Endocrine Today. “These patients will likely benefit from early surveillance and timely vitamin D repletion therapy to achieve better glycemic control and therefore, prevent the development or worsening of diabetes-related complications.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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