A Link Between Vitamin D Deficiency And Diabetic Retinopathy
Fifteen observational studies involving 17,664 subjects were included, explains the report.
The patients who qualified as deficient in vitamin D had a significantly higher risk or incidence of diabetic retinopathy.
Challenges Of Vitamin D Clinical Trials
A clinical trial is often labeled as positive or negative based on whether the P-value for the statistical test for the primary outcome falls below or above the traditional threshold of 0.05. This dichotomania, which is based on an arbitrary threshold, provides clarity for regulatory agencies when deciding whether to approve a pharmaceutical agent for clinical use however, it is overly simplistic when trying to determine whether an intervention has a real and clinically meaningful effect . When the primary outcome in a clinical trial fails, there are several considerations that may clarify whether the intervention may still have clinical value . We modified a set of questions, described in the article by Pocock and Stone , for relevance to trials on vitamin D supplementation for the prevention of type 2 diabetes . Below we address these questions in relation to the 3 major trials described above.
Questions to Address When the Primary Outcome Fails in Trials of Vitamin D Supplementation for Diabetes Prevention
Is there some indication of potential benefit?
Were the trials underpowered?
Were the trial populations appropriate?
Were the treatment regimens appropriate?
Was the primary outcome appropriate or accurately defined?
Was the duration of intervention and follow-up too short?
Were there deficiencies in trial conduct?
Do subgroup findings elicit positive signals?
Can alternative analyses help?
Were there any safety signals with the intervention?
Is Vitamin D Safe
Vitamin D when taken as a supplement is safe up to 4000 IU/day or when applied on the skin in the form of vitamin D lotions, for up to three months.
When used on the skin, allergic reactions can occur due to either vitamin D or due to a compound in the preparation . There is a strong correlation between vitamin D and blood sugar levels. People with diabetes need to consult their doctors before starting on a vitamin D supplement. People with blood pressure disorders need to be cautious with vitamin D supplementation as it affects blood pressure.
People suffering from headaches, heart disease, lymph cancer, tuberculosis, kidney disease, liver disease, lung disorders, skin disorders, stomach disorders, and thyroid disorders need to consult their doctors before starting vitamin D supplementation.
Pregnant and breastfeeding women should not overdose on their vitamin D supplementation. They also need the same dosage as non-pregnant or non-breastfeeding women do. Pregnant women should never take more than the recommended dosage as it can negatively affect the fetus.
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Fatty Acids And Lipids
One study on Eskimos by Ebbesson and colleagues from USA found that diabetes in the Eskimo population was related to fatty acid imbalance with lower concentrations of omega 3 and 6 and higher concentrations of saturated fatty acids and omega 9 fatty acids.
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However, none of the clinical trials that have been carried out to date on omega fatty acid supplementation have showed any impact on lowering of blood glucose or HbA1C. On the other hand, there are studies that provide preliminary evidence that these supplements may increase antioxidant capacity in type 2 diabetics, may be helpful against heart disease, high cholesterol, high blood pressure which are complications of diabetes.
Omega 9 generally does not have any side-effects as it is the most common fat in our bodies.
Vitamin D And Blood Sugar
A study published in “Diabetes Care” in April 2007 showed that taking vitamin D and calcium supplements over the course of three years might help reduce the risk of developing insulin resistance. Insulin resistance, where you body does not respond normally to insulin secretions in your body, is a precursor of diabetes, which is characterized by raised blood sugar levels. According to the University of Maryland Medical Center, high vitamin D levels were associated with a reduced risk of developing Type 2 diabetes, but there was no conclusive proof that vitamin D helps prevent or cure diabetes.
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Who Is At Risk Of B12 Deficiency
People who may not get enough vitamin B12 or who have trouble absorbing it include:
- Many older adults
- People who dont make enough hydrochloric acid and intrinsic factor in their stomachs
- People with pernicious anemia
- People who have had some types of stomach or intestinal surgery
- People with digestive disorders, such as celiac disease or Crohns disease
- People who follow a vegetarian or vegan eating plan
What Does Research Say About Vitamin D Deficiency And Diabetes
For years, vitamin D was known for its role in bone health. New research is now concluding that this vitamin can actually have an important role in the overall health of a person. Doctors believe that there is an unmistakable link between vitamin D and diabetes. This is because studies have conclusively indicated that people with low levels of vitamin D are at a higher risk of developing diabetes, later in life.
A study on 668 elderly individuals, who lived in the northern latitudes , found that these individuals were at a greater risk of developing type 2 diabetes due to vitamin D deficiency. The researchers went on to say that vitamin D sufficiency provides protection against type 2 diabetes.
A 2011 review looked at various studies that examined how much vitamin D people were getting, by conducting a blood test that assessed the amount of vitamin D in their blood. These people were then followed to see if they got type 2 diabetes later in life. It was found that people with higher amounts of vitamin D in the blood had a decreased chance of getting type 2 diabetes as compared to people with low levels of vitamin D .
Another study concluded that vitamin D deficiency inhibits the secretion of insulin from the pancreas. Now we all know how important normal levels of insulin are for the regulation of blood glucose levels. If insulin secretion is hampered in any way, it results in raised blood glucose levels and in turn can lead to full-blown diabetes.
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Can You Take Too Much Vitamin D
Too much vitamin D can be harmful. The body cant make too much vitamin D in the sun.
Excess weight gain often occurs as a result of taking supplements. However, it is very rare and usually only occurs when people take a very high dose for an extended period of time, such as over a year.
The highest amount of vitamin D a person can take before it causes health problems is 4,000 IU daily.
Signs of high vitamin D levels in the blood include:
How Much Vitamin D Should I Get From The Sun
In addition to wondering how much vitamin D should I take, many people wonder how much vitamin D should I get from the sun.
Theres a reason that vitamin D is referred to as the sunshine vitamin. Sunlight exposure on our bare skin is the single best way to get enough vitamin D. Unfortunately most people today dont spend enough time in the sun, due to factors like working long hours inside, living in cold climates, being afraid of sunburns, etc.
In order to get enough vitamin D naturally from the sun its important to get outside and expose your skin to sunlight, without sunscreen. Aim to spend about 1020 minutes in the sun daily with as much of your bare skin exposed as you can, which will help your body produce vitamin D. You will absorb the most sunlight between about 11 a.m. and 3 p.m.
Melanin is a substance that affects how light or dark your skin color is. The amount of melanin you have in your skin also affects the amount of vitamin D you can produce, so the fairer your skin, the more easily you can make vitamin D. If you have dark skin, you will likely need more time in the sun, roughly 40 to 60 minutes daily, to make enough vitamin D.
Eating vitamin D-rich foods like eggs, raw milk and fish can also helps improve your blood levels of vitamin D.
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Can You Take Too Much Vitamin D And How Do You Know If You Have
Be careful about taking too high of a supplement dose, as research suggests theres such a thing as taking too much vitamin D.
Consider an JAMA that looked at observational data of more than 39,000 survey participants from the National Health and Nutrition Examination Survey . During 20132014, 18 percent of the population took in more than 1,000 IU vitamin D daily, and 3 percent took in more than the tolerable upper limit of 4,000 IU daily. Getting too much vitamin D may be linked with heightened risk of fractures and falls in the elderly, and a higher risk of kidney stones when the higher vitamin D intake is alongside calcium.
People with diabetes also face risks from going overboard on vitamin D. Very high doses of vitamin D can lead to toxicity that can cause nausea, vomiting, and other complications, says Palinksi-Wade.
Also, people with type 2 diabetes who have a higher risk of heart and kidney disease should be aware that excess vitamin D intake can harden blood vessels and tissue due to raised blood levels of calcium, which can lead to heart and kidney damage, according to the NIH. And vitamin D can interfere with certain medications, so talk to your doctor before starting supplements.
If youre unsure about whether youre getting enough or too much vitamin D, consult your healthcare provider, who can give you blood tests to test for vitamin D deficiency or excess.
How Much Vitamin D Should People With Or At Risk For Diabetes Take
The daily vitamin D intake goal for most adults is 600 IU, and adults over age 70 need a little more 800 IU according to the National Institutes of Health . People with diabetes are no exception.
There are two main forms of vitamin D vitamin D2 and vitamin D3. Vitamin D2 is found in plants and fortified foods, while vitamin D3 comes from animal sources and is produced naturally in the body when your skin is exposed to sunlight. In terms of supplements, vegans can take vitamin D2, but for optimal benefits, vitamin D3 may be more effective, according to the Harvard T.H. Chan School of Public Health. This may be due in part to differences in their chemical structures and ability to bind to vitamin D receptors, according to a review published in August 2017 in the journal Proceedings of the Nutrition Society.
Make sure to choose a supplement thats been tested by a third party so you know it contains what it says it does on the label. I suggest opting for drops, emulsions, powders, or capsules to increase chances of absorption, says Devje.
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How Much Vitamin D Should I Take
A high percentage of adults, somewhere between 50 percent and upward of 90 percent depending on ethnicity and location, are believed to be at least somewhat deficient in vitamin D. It makes sense then that vitamin D is now one of the most widely consumed supplements, though you may wonder how much vitamin D should I take. Its a tricky question, but its important to get enough of this essential vitamin.
Deficiency in vitamin D is a real problem considering that this nutrient has been shown to promote health by helping with absorption of minerals like calcium, aiding in bone health, boosting immune function, supporting growth and development, and much more. If you spend little time outdoors in the sun, have dark skin, are over the age of 70 or live in northern regions of the world where theres less sunshine year-round, then youre more likely to experience vitamin D deficiency symptoms.
When it comes to reaping the many benefits of vitamin D, you may be wondering how much vitamin D should I take? The optimal amount of vitamin D to take in supplement form depends on a number of factors for example, if youre already deficient in vitamin D, your diet, age, health status, where you live and so on. As you can see, answering the question of how much vitamin D I should take isnt necessarily cut and dry.
Supplements : Vitamin D
Vitamin D is involved in many of your bodys functions. There are two forms in the diet, D2 and D3. It can also be produced in your skin when exposed to sunlight.
Vitamin D deficiency is a problem all over the world.
However, its pervasive in young women, infants, older adults, and people who have dark skin .
About 42% of the U.S. population is vitamin D deficient. However, this rate rises to 82% in Black people and 70% in Hispanics, which systemic problems likely play a role in .
If you have access to strong sun all year, then occasional sun exposure may be enough to fulfill your vitamin D requirements.
However, if you live far north or south of the equator, your vitamin D levels may fluctuate depending on the season. The levels may go down during the winter months due to a lack of sufficient sunlight .
In that case, you may need to rely on your diet for vitamin D as well as on vitamin D thats stored in body fat (
- intensify bone loss
- increase the risk of fractures
In children, a severe vitamin D deficiency can cause delays in growth and rickets, a disease where the bones become soft.
Furthermore, vitamin D deficiency is linked with several cancers, type 1 diabetes, multiple sclerosis, high blood pressure, and thyroid problems .
Vitamin D deficiency is prevalent worldwide but occurs at higher rates in specific populations. A deficiency in vitamin D is linked to various health problems.
How much vitamin D you need depends on many factors. These include:
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Benefits And Risks Of Taking Supplements
Supplements may help you get adequate amounts of important nutrients in case your food is unable to provide these, but these supplements cannot replace a varied diet which is important for a healthy life. According to the Office of Dietary Supplements at the National Institute of Health , scientific evidence has showed that some supplements can be beneficial in maintaining overall health and for managing some health conditions like calcium and vitamin D supplements for bone health and for preventing bone loss, and fish oil that provides omega-3 fatty acids may help people with heart disease.
Having said this, supplements may contain active ingredients and these may have a strong effect on the body in terms of unexpected side-effects. Another thing to be wary of is that supplements are not medicines, so one cannot really replace the medicine with supplements. Some supplements may interact with your prescription medicines and give you really bad side-effects they may reduce the effect of your medicines, they can break-down your medicine, or they may even produce some combinatorial effects with your medicine to produce unexpected side effects. Some may increase bleeding and should therefore also be stopped if you are about to have a surgery or take blood thinning medications.
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People With Inflammatory Bowel Disease Or Similar Conditions
If your body struggles to absorb vitamins properly especially fat-soluble vitamins it will also struggle to maintain healthy levels of vitamin D. IBS, celiac disease, Crohns disease, liver disease, cystic fibrosis, and ulcerative colitis are all examples of health conditions that could impair vitamin D absorption.
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Risks And Side Effects
What happens if you take too much vitamin D? Can you overdose on vitamin D?
Taking high doses of vitamin D causes your liver to produce a chemical called 25D, which makes calcium accumulate in your bloodstream. Youre most likely to experience symptoms of too much vitamin D when taking supplements in high doses for a long period of time. This can potentially cause side effects if levels of 25 in the blood become elevated.
Potential side effects can include high blood calcium levels exhaustion abdominal pain and digestive issues like nausea, constipation, diarrhea or loss of appetite increased thirst and dry mouth and possibly kidney stones. The best way to avoid experiencing vitamin D toxicity is to not take very high doses of vitamin D in supplement form, such as 10,000 IU per day for more than several days in a row. Instead, get the vitamin D you need from sunlight, a healthy diet and supplements in the recommended dosage range.