Jothydev’s Diabetes Research Center presented 4 original publications at the 73rd Scientific Sessions of the American Diabetes Association held at Chicago, Illinois in June. The research team led by Dr. Jothydev Kesavadev identified that only 18% of diabetes patients had normal Vitamin D levels. Yet another study discusses the superiority of a telemedicine based counselling in ensuring multi drug compliance in type 2 diabetes.

The prevalence of type 2 diabetes in Kerala, a southern state in India is 21%; one of the highest in the country. There is no data on Vitamin D levels in this population. In this cross-sectional study, Vitamin D levels were measured among 1485 consecutive type 2 diabetes patients on treatment (aged 53±12.7 years, 65% male) presenting at our clinic from August to December 2012.

Of these, 15% (n=215) were previously treated with low dose Vitamin D supplements. None of the patients were on full dose supplements. Average vitamin D levels (range <3ng/ml-63.3ng/ml) (n=1270) was 18.8±10.2, compared to 31.1±12.8 in those previously treated for Vitamin D deficiency. Vit D was significantly lower with increasing BMI (β=-0.2,se=0.07,p=0.01) and higher with age (β=-0.17, se=0.02,p<0.000), but not associated with gender. With reference levels defined as ‘deficient’ (<20ng/ml), ‘low’ (21-29ng/ml), and ‘normal’ (30-80ng/ml), 55% of untreated patients were deficient, 27% had low values, and 18% had normal values. Among treated patients 17% were still deficient, 32% had low values, and 50% had normal values. Multivariate regression analysis with vitamin D status, BMI, and gender as predictors showed HbA1c levels was significantly lower in Vit. D ‘normal’ patients (β= 0.48,se=0.16,p<0.003) when compared to ‘deficient’ patients. Only 18% of diabetes patients had normal Vitamin D. It is cost effective to maintain normal levels in the majority with just monthly once supplementation of 60,000 units. However, 5 out of every 25 subjects may have a normal Vitamin D level and hence full supplementation in all T2D without estimating the serum Vit D levels may prove hazardous.

Higher Vit D levels in the elderly may be attributed to more exposure to sunlight compared to younger generation. Patients with normal Vitamin D levels had a trend toward lower A1c, which is of high clinical significance and need to be confirmed in prospective studies.