Nowadays, vitamin D is a hot topic both within the medical field and even amongst the general public. Compared to just a decade ago, many more patients are now coming into their physician's office asking for their vitamin D level to be checked.
The so-called popularity of vitamin D has reached a level such that even people and doctors who do not generally believe in vitamins or supplements have started to jump on the bandwagon of keeping vitamin D levels hearty.
While I am adamantly in favor of using supplements to target various disease states, I am also very conservative in my recommendations of supplements to the patients I see in my clinic of integrative medicine in San Jose, Calif. In other words, I generally subscribe to the concept that vitamins should be treated as medications and thus should always be given with a specific treatment goal in mind and not just haphazardly taken without medical guidance.
Having said this, I am a big fan of vitamin D in general based on the various studies out there in literature. Therefore, I always check that vitamin level in my patients and always aim for a mid-range repletion level. Thus, with such growing popularity about vitamin D, I would like to touch on another study that recently came out in the fall of 2012.
It has long been suggested that vitamn D may help with diabetes management or perhaps even prevention, but a study that came out in the fall of 2012 further affirms us of this notion. In a study of nearly 2,000 individuals, the researchers looked at the serum of individuals who developed Type 1 diabetes mellitus compared to those who did not, and it looks as though people who had deficient vitamin D levels tended toward the development of diabetes mellitus Type 1. Another interesting part of this study suggests that people with a 25-hydroxyvitamin D level of about 50 ng/ml seemed to have lower risk of developing diabetes mellitus Type 1. (3)
Since, in most other studies, achieving a level of 50 is not considered harmful to our health in other ways, it seems that shooting for a 25-hydroxyvitamin D level of 50 ng/ml is a good idea in most patients, especially those with family history of Type 1 diabetes mellitus. (3)
With prior studies suggesting that adequate vitamin D may be beneficial for a diverse array of health issues, including, but not limited to, cancers, diabetes, lung function, and bone health, it is no wonder that patients and doctors alike are making sure that this vitamin level is in the normal range at all times. This study is yet another example of the potential positive health effects of vitamin D. (1-6)
In my clinic, several of my patients have in fact had improvement in glucose control with improvement of their vitamin D level. However, in clinical situations, I also instruct my patients to change their lifestyle habits, including diet and exercise. Therefore ,it is difficult to say whether the lifestyle change alone benefited the patient and/or the addition of supplements.
So, this study was helpful in shedding some light on the situation. Additional lifestyle changes such as diet and exercise were not a factor in this study; the researchers simply evaluated the association between vitamin D level and diabetes. So, based on this study, further support of the idea that vitamin D may be helpful with glucose management is now more clear.
This study may help to explain how some of my patients' diabetes became better controlled with diet and exercise, but glucose management continued to improve linearly with vitamin D level improvement despite no additional lifestyle changes other than the initial changes made to diet and activity level. It is likely that the lifestyle changes helped their bodies become healthier, but it also seems that the heartier vitamin D levels likely helped their body to become even more efficient in sugar management.
While this study was focused on Type 1 diabetes mellitus, prior studies have also suggested benefits to diabetes mellitus Type 2 when it comes to vitamin D's benefits for insulin sensitivity and glucose control. (1-6) Despite these encouraging studies, we are still in need of larger scale, randomized, controlled trials to see about the exact benefits and at which dosages of vitamin D might be the most helpful to those with diabetes. For now, this study was helpful in giving an estimation of how much vitamin D repletion is needed to help with diabetes.
While we await larger scale studies on vitamin D and diabetes, I highly encourage the tried-and-true techniques of eating a well-balanced low glycemic load diet and getting in daily exercise to help your body metabolize and function optimally. But if you have diabetes or have a family history of it, I would first caution patients to seek medical advice on diagnosis and management and ask about implementing healthy diet and exercise habits.
You should also ask your physician to check your 25-hydroxyvitamin D level and have your physician aim for a level of about 50 ng/ml. Make sure that your physician monitors your levels and doesn't just leave you on one dosage without reevaluating you.
Ultimately, we know that we have control over our health... whether it be taking our vitamin D supplements daily or making sure to eat a low-sugar diet and working out daily. So, while the studies are great in helping us understand more about the additional tools we can use to help our body be the healthiest it can be, it is still up to us to do the basics of healthy living... eat what Mother Nature provides for us, as close to its natural form as possible, and keep our body moving every day, because our bodies were made to move and thus we feel our best when we do just that.
1. Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham N: Baseline serum 25-hydroxy vitamin D is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely prospective study 1990-2000. Diabetes 57:2619-2625, 2008.
2. Holick MF: High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81:353-373, 2006.
3. E. D. Gorham, C. F. Garland, A. A. Burgi, S. B. Mohr, K. Zeng, H. Hofflich, J. J. Kim, C. Ricordi. Lower prediagnostic serum 25-hydroxyvitamin D concentration is associated with higher risk of insulin-requiring diabetes: a nested case-control study. Diabetologia, 2012; 55 (12): 3224 DOI: 10.1007/s00125-012-2709-8
4. Boucher BJ: Inadequate vitamin D status: does it contribute to the disorders comprising syndrome 'X'? Br J Nutr 79:315-327, 1998.
5. Christakos S, Friedlander EJ, Frandsen BR, Norman AW: Studies on the mode of action of calciferol. XIII. Development of a radioimmunoassay for vitamin D-dependent chick intestinal calcium-binding protein and tissue distribution. Endocrinology 104:1495-1503, 1979.
6. Norman AW, Frankel JB, Heldt AM, Grodsky GM: Vitamin D deficiency inhibits pancreatic secretion of insulin. Science 209:823-825, 1980.
For more by Julie Chen, M.D., click here.
For more on natural health, click here.