VITAMIN D IN PATIENTS WITH TYPE-2 DIABETES MELLITUS WHY IS IT SO IMPORTANT?, Nikolay Kostadinov

ABSTRACT: Vitamin D deficiency is the most common nutritional deficiency worldwide, including in Bulgaria. Vitamin D is one of the most well-studied compounds, reducing the risks of many adverse health effects through genetic and non-genetic mechanisms. It is readily available over the counter, safe to use and inexpensive.
Healthcare costs are increasing exponentially, so there is a need to emphasize the causal relationship between serum 25-hydroxyvitamin D (25OHD), calcium (Ca), parathyroid hormone (PTH) levels, and coronary artery disease (CAD) risk in patients with diabetes. Vitamin D levels have been reported to be inversely related to the risk of cardiovascular disease. Endocrine functions of bone other than those related to mineral metabolism are numerous, such as regulation of insulin sensitivity, glucose homeostasis, and energy metabolism.
Vitamin D deficiency and insulin resistance are widespread in society. The latest studies show an inverse relationship between vitamin D levels, insulin resistance and type 2 diabetes.
Vitamin D deficiency predominates in diabetic patients, while patients who have better glucose-related parameters - such as fasting blood glucose, HOMA-IR - have better vitamin D status.
Vitamin D may have a beneficial effect on insulin action either directly by stimulating insulin receptor expression, thereby enhancing insulin responsiveness for glucose transport, and its deficiency is associated with both insulin resistance and reduced function of b -cells.
The importance of vitamin D in maintaining good bone health in diabetic patients cannot be underestimated either.

Keywords: type 2 diabetes, vitamin D, insulin resistance, cardiovascular risk

 

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