A pan-India study has linked Vitamin D deficiency and insufficiency to type-2 diabetes and hypertension, making it about more than just bone health.
Vitamin D, also known as the sunshine vitamin that is produced by the skin on exposure to sunlight, is a critical micronutrient that helps regulate the amount of calcium and phosphorus in the body that are required to keep bones, teeth and muscles healthy.
The study shows that 84.2% of type 2 diabetes patients and 82.6% of hypertension patients were Vitamin D deficient, contributing further to the body of research that links Vitamin D deficiency to chronic non-communicable diseases (NCDs).
The overall prevalence of patients with low Vitamin D levels (deficiency and insufficiency) was 83.7%, of which 82% were newly diagnosed cases.
“Our aim was to look at the levels of vitamin D in patients suffering from type-2 diabetes and hypertension to establish a link. We are not saying the deficiency has caused the disease but that those who with the disease may be vitamin D deficient,” said Dr PG Talwalkar of Talwalkar Diabetes Clinic, principal investigator of the study.
“The next step will be to see how improving vitamin D levels in these patients will impact the treatment outcome, since we are always looking for any additional pathways that will further reduce complications in patients with diabetes and hypertension,” he added.
Correcting vitamin D deficiency should not be the top priority for managing diabetes and hypertension.
“If you are looking from the public health point of view, then vitamin D deficiency will not be on my list of top 5 things to handle diabetes and hypertension. One needs to prioritise. However, if looking at musculoskeletal disorders (pertaining to joints, muscles, nerves etc.) than vitamin D deficiency will be a priority. Having said that, I don’t mean there should be no research around it,” said Dr Nikhil Tandon, head of the department of endocrinology, All India Institute of Medical Sciences, New Delhi.
The causes of vitamin D deficiency in India are manifold. Most people do not receive adequate exposure to sunlight, as modernized lifestyles have resulted in less time spent outdoors for work or leisure. High levels of air pollution further hamper the transmission of ultraviolet B (UVB) rays needed to synthesize Vitamin D in the skin.
A social fetish for fair complexion also leads many to avoid exposure to sunlight, especially during noon hours when it is most beneficial.
The study tracked 1,501 adults above 18 years with diagnoed type-2 diabetes, hypertension, or both, across 29 sites between June to September, 2017. The results were published in the Indian Journal of Diabetes and Endocrinology on Wednesday.
Vitamin D insufficiency and deficiency was defined as serum 25(OH)D levels 21-29 ng/ml and ≤20 ng/ml, respectively.
“These findings highlight the need for routine screening to ensure early diagnosis and effective management of Vitamin D deficiency to help reduce the burden and risks associated with non-communicable disease,” said Dr Talwalkar.
Apart from exposure to sunshine for about 45 minutes, the dietary sources of Vitamin D include cod liver oil, salmon fish, mackerel, sardines, tuna, egg yolk and mushrooms exposed to sunlight.