Temporal Relationship Strength Of Association And Dose Response
Evidence to support the prerequisites of the temporal relationship, strength of the association, and dose response comes from observational studies. Many cross-sectional studies have reported inverse associations between vitamin D status and glucose intolerance however, cross-sectional studies are not informative and can only be considered hypothesis-generating, as the directionality of the association cannot be established.
Several observational, longitudinal studies conducted in diverse cohorts have reported consistent inverse associations between blood 25D levels and the risk of incident diabetes. Results have been summarized in recent meta-analyses with similar findings. Song et al combined data from 21 longitudinal cohorts and estimated a 38% risk reduction for incident diabetes in the highest versus the lowest category of blood 25D level . The association did not differ by sex, duration of follow-up, cohort sample size, 25D assay method, or diabetes diagnostic criteria. Afzal et al combined data from 16 longitudinal cohorts and reported that the bottom quartile of blood 25D level was associated with a 50% higher risk for incident diabetes compared with the top quartile . Ye et al included data from 22 longitudinal cohorts and reported that a 10-ng/mL lower 25D level was associated with a 22% higher risk of incident diabetes .
Supplements That Impact Blood Sugar
Supplements may cause unwelcomeor dangerousside effects, especially if they interact with your medications. While some ingredients could intensify the effects of your diabetes meds, causing hypoglycemia , others may have the opposite effect, leading to hyperglycemia .
Research on many supplements is inconclusive. Talk to your health care provider before you start taking chromium, vitamin E, St. Johns wort, or niacin.
Confused about what to take? Unless your health care provider recommends a specific vitamin or supplement, its probably not all that helpfulor economicalto add another pill to your regimen.
Icipants And Study Design
This intervention study was a 6-month, double-blind, randomized, placebo-controlled trial conducted at Hamad Medical Corporation in Doha, Qatar. The research ethics board of HMC approved the protocol and the trial was registered at www.clinicaltrials.gov . An informed consent was obtained from all participants at enrollment.
Men and women aged 18-75 of multicultural backgrounds were recruited via telephone calls and campaigns held at Qatar landmarks. A two-step process was used to screen for eligibility as shown in Fig. . In the first step, screening 1, eligibility was based on a finger prick HbA1c result indicating pre-diabetes . During the second screening , eligibility was based on physical and biochemical measurements, which included medical history, prescribed medication, height, weight, waist circumference, BMI, pulse, fasting glucose, HbA1c, cholesterol, triglycerides, liver function, blood analyses, insulin, C-peptide, serum 25 vitamin D3, parathyroid hormone and calcium.
Fig. 1
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Review Strategy And Literature Search
Although results from high-quality randomized controlled trials are typically considered to be the highest level of evidence to establish whether an intervention has an effect on the outcome of interest, the totality of evidence from different lines of research should be considered when establishing causality. In synthesizing the available evidence, we have used the Bradford Hill general guidelines for causality and have structured our review to address these guidelines in relation to vitamin D and the prevention of type 2 diabetes .
A comprehensive literature review was performed using PubMed, Embase, and ClinicalTrials.gov to identify: recent meta-analyses of longitudinal observational studies that report on the association between blood 25D level and incident diabetes, and clinical trials of adults with prediabetes that have reported on the effect of vitamin D supplementation on incident diabetes.
How Much Vitamin D3 Should A Diabetic Take Best 3 Diabetes Programs For 2021
Diabetes is an extremely usual health problem worldwide. In the United States, 1 in 10 adults have diabetic issues, while an estimated 1 in 3 have prediabetes. Personally I do have family participants with diabetes mellitus. how much vitamin d3 should a diabetic take
While one may sometimes be caught up in the various kinds of diabetic issues, one point is clear: Type 2 diabetes mellitus represent greater than 90% of the diabetes mellitus cases in the world. The good news is that Type 2 diabetes results from our way of living as well as is well within our control.
When a person is prediabetic, it is vital to handle it. Thats because it can easily escalate to a full-blown diabetes which might create many dangerous difficulties. Some issues are kidney failure, damage to the retina in the eye, and also other nerves as well. how much vitamin d3 should a diabetic take
Typical western medicine begins with insulin medications then to insulin injections. However, this has a tendency to lead us down a slippery slope to being ultimately dependent on it permanently. Because of this, progressively people are seeking efficient all-natural treatments for diabetic issues.
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Consideration Of Alternative Explanations
Despite very promising and consistent data from observational studies, relying on observational data alone to establish causality is not sufficient, as evidenced by carefully examining the multiple determinants of the ones vitamin D status, as reflected in ones blood 25D level.
Vitamin D is obtained from oral sources or cutaneous biosynthesis and many factors influence each of these routes . The amount of vitamin D that reaches the circulation from oral sources is influenced by food selection, food fortification, supplement use, and absorption efficiency. For example, absorption is increased when supplemental vitamin D is co-ingested with a meal containing fat and it is decreased by medical conditions that produce intestinal malabsorption . Cutaneous biosynthesis declines with age and is reduced by higher levels of melanin in the skin . Season, latitude, altitude, time of day, ozone layer, and pollution also influence the degree of effective cutaneous biosynthesis. Individuals with a higher body weight have lower circulating vitamin D levels, probably reflecting the larger pool size over which vitamin D metabolites are distributed . Assuming that the supply of the precursor is not rate-limiting, the blood 25D level reflects the balance between liver production, the genetically determined amount of vitamin D binding protein, and the metabolism of 25D to 1,24-dihydroxyvitamin D or to 24,25-dihydroxyvitamin D .
Vitamin Ds Impact On Insulin Production And Insulin Resistance
A 2017 study in the Netherlands determined in animals that vitamin D plays a critical role in stimulating the secretion of insulin. The study also pinpointed an association with insulin resistance and the overall incidence of type 2 diabetes.
The first theory is focused on inflammation since vitamin D is associated with increased inflammation levels. As well as genetic polymorphisms of vitamin-D related genes that may increase a persons risk of developing type 2 diabetes.
Higher body fat levels were also associated with lower vitamin D levels and increased risk for type 2 diabetes and metabolic syndrome.
However, the report adds that supplementing with vitamin D did not appear to lower blood sugar levels.
Vitamin D deficiency needs to be prevented or cured, explained the studys author, but until the results of these trials are published, high-dose vitamin D supplementation cannot be recommended for prevention or amelioration of type 2 diabetes.
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Supplements : Vitamin D
Summary
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 .
Summary
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:
Low Vitamin D Levels And Type 2 Diabetes: Which Came First
A 2017 study in Italy found highly consistent data supporting the theory that vitamin D supplementation may actually reduce a persons risk of developing type 2 diabetes.
Of course, because most studies are observational versus controlled, a clear conclusion is impossible to make. The study emphasized that they are not certain whether the low levels of vitamin D contribute to the development of type 2 diabetes, or if low levels of vitamin D are a consequence after the development of type 2 diabetes.
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Supplements Every Diabetic Should Take
by Next Advanced Medicine | Dec 21, 2018 | Blog, Health News
Type 2 diabetes is a complex condition that impacts the immune system, metabolism, hormones, and every other system and function within the body.
At this point in time, diabetes is widely considered an inflammatory disease. While chronic inflammation is thought to be a precursor to T2D, high blood sugar and insulin resistance perpetuate inflammation, resulting in a vicious cycle. This stressful state affects energy, sleep, weight, circulation, digestion, mood, and concentration, which can lead to diabetic complications and disease progression.
While a whole food and nutrient-dense diet is the first step, diabetics have increased nutritional needs due to the stress their bodies are under.
High potency supplementation provides an increase in micronutrients and plant extracts that act as therapies for the body to help it balance and heal, often without the nasty side effects of pharmaceuticals. These six supplements improve the bodys ability to regulate glucose and are well-supported by scientific research to benefit people suffering from high blood sugar and diabetes.
Histamine H Receptor Antagonist /proton Pump Inhibitor Induced Vitamin B12 Depletion
Literature suggests that drugs which suppress stomach acid production such as PPIs and HRAs interfere with vitamin B12 absorption, by reducing dietary B12 release from food proteins. A 5389% reduction in protein-bound B12 absorption was noted following HRA treatment,, with ranitidine specifically reported to induce decreases in B12 status. Similarly, there have been other reports of an inverse correlation between vitamin B12 levels and duration of PPI therapy. The enzyme cytochrome P450 2C19 , catalyses the metabolism of PPIs and a polymorphism of this enzyme has been demonstrated to influence levels of vitamin B12 in patients using these medications. Hence, those who poorly metabolize PPIs are likely to exhibit increased suppression of acid production and thus more interference with absorption of vitamin B12. Alternatively, patients who have enhanced PPI metabolism are likely to experience diminished acid suppression with a lower interference with absorption of B12.
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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.
A Link Between Vitamin D Deficiency And Diabetic Retinopathy
A 2017 study in China found that vitamin D levels likely play a significant role in the development of diabetic retinopathy in patients with type 2 diabetes.
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.
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Getting Your Daily Quota Of Vitamin D
While the body makes vitamin D when the skin is exposed directly to sunlight, it is difficult for most people to get enough of the vitamin this way. Since it’s important to use sunscreen to protect your skin against the risk of skin cancer, it isn’t likely that youll make enough vitamin D to meet your body’s needs.
So how do you get enough vitamin D and how much do you need? The Food and Nutrition Board suggests 600 international units for children ages one and up, while adults need 800 IUs.9 However, that amount has been challenged by some experts as too low and not nearly sufficient to boost blood levels to where they should be.10 Yet, too much can be toxic. This is especially true if you are deficient in vitamin D, which is very, very common. The ”upper tolerable” amount of D is 4,000 IUs daily for children ages nine years through adulthood.
Its always best to try and meet your nutrient needs through diet first. Salmon, tuna and mackerel are among the best sources of vitamin D and provide important heart-healthy fatty acids too. Dairy products, including cheese, fortified milk, yogurt, and egg yolks are good sources of vitamin D, too. Because it can be difficult to get enough vitamin D from foods alone, many must take a vitamin D supplement. However, if your doctor tells you your blood level of vitamin D, is low, ask about the amount you’ll need to bring your blood level into the healthy range and what is the best way for you to get the right amount.
What We Dont Yet Know About The Benefits Of Vitamin D For Diabetes
Yet more research is still needed in this area. Importantly, the American Diabetes Association notes that theres insufficient evidence to recommend the routine use of vitamin D to improve blood sugar control in people who have diabetes, and not all research suggests that vitamin D is useful when it comes to preventing diabetes. For example, a study published in June 2019 in The New England Journal of Medicine looked at close to 2,500 people at risk for type 2 diabetes who either received vitamin D supplementation of 4,000 international units or received a placebo. After two years, the people receiving the supplements did not have a significantly lower risk of diabetes than people receiving the placebo.
Its important to review the scientific evidence with a critical lens, says Devje. Much of the research has focused on observational and epidemiological studies, which illustrate an association between vitamin D and diabetes, and do not prove causality.
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Is It Safe To Take Supplements If You Have Diabetes
You will find supplements for anything and everything these days. Even when you do not suffer from an ailment, supplements are suggested to keep you healthy and ailment-free. According to CDC, use of supplements is common among US adult population over 50% adults used supplements during 2003-2006, with multivitamins/multiminerals being the most commonly used.
So when you are a diabetic, especially if you have prediabetes and type-2 diabetes, you may find yourself confronting a large number of options for supplements that claim to support, reduce and even cure your diabetes. Diabetes is quite a frustrating disorder and you may find yourself tempted to try out these supplements one after another. But is it really safe to take supplements when you are a diabetic? Let us find out. But before that you need to understand what exactly supplements are.
Can You Get Enough Vitamin D In The Sun Only
Some people will be able to get enough vitamin D from the sun. However, it depends on where they live in the world, the time of year, the time of day, and the color of their skin.
People living near the equator get a lot of suns. In the Northern Hemisphere, a person may not be getting enough vitamin D from the sun during the winter.
The sun usually rises between 11:00 am and 3:00 pm In summer, one does not need to stay in the sun too long to make enough vitamin D.
The amount of melanin a persons skin contains affects how much vitamin D they can produce. A small amount of melanin leads to light, unprotected skin, and harmful ultraviolet radiation.
People with a lot of melanin on their skin are better protected from the sun, but it takes longer to make vitamin D. In the United States, the Centers for Disease Control and Prevention found that many Mexican, American, and non-Spanish blacks are more likely to be deficient in vitamin D.
These various factors make it difficult to recommend how much sun a person should get to make the vitamin D his body needs.
Vitamin D Council provides some examples:
- At noon during the summer in Miami, a person with a medium skin tone will need to expose one-quarter of his or her skin to sunlight for six minutes.
- At noon during the summer in Boston, someone with a dark skin tone will have to expose one-quarter of their skin to sunlight for two hours.
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Expert Advice On Vitamin D Levels: Whats Enough
Based on our results,5 Dr. Gardner says, those with blood level above 50 ng/dl have the best chance at avoiding diabetes. However, an expert panel of the Endocrine Society recommends 30 ng/dl as a healthy goal,6 Dr. Garland points out, so more research is needed on the most effective level of the vitamin needed to lessen the risk of diabetes before that recommendation might be reconsidered.
Dr. Garland’s advice: get a blood test to see where you stand on vitamin D, then ask your doctor for advice on how best to proceed given your overall health and diet.
Dr. Rubin’s advice: Until further evidence is in, maintaining a level between 20 and 40 ng/ml ”is usually advisable for most people, including those with diabetes or prediabetes.”
When you do get a blood test for vitamin D levels, your lifestyle may play a role in your results. For example, researchers found that women taking hormonal contraceptives were more likely to have their vitamin D levels overestimated.7 So your doctor may want to take that into account. And another endocrine disease: autoimmune thyroiditis appears to be affected by low vitamin D levels, too, specifically individuals who are overweight or have obesity are at significant risk for developing this condition.8
