The levels of vitamin d in type 2 diabetes mellitus patients, comparing the levels of vitamin d and its efficiency on blood glucose control

Introduction: Type 2 Diabetes Mellitus (DM) is a disease, which has an increasing incidence all over the world and in Turkey, with high mortality and morbidity because of its? micro- and macrovascular complications. In several studies of patients with diabetes, blood glucose, HbA1c values and 25 (OH) D3 level were found to be related. In patients with low vitamin D level, blood glucose and HbA1c levels were found to be high. In this study, our aim is to determine vitamin D level in patients with Type 2 DM and to evaluate the relationship between vitamin D level and glycemic control.Methods: In this study 107 women and 63 male patients with Type 2 DM whose mean age was 55 ± 0.81that admitted to internal medicine and diabetes outpatient clinic of Duzce University School of Medicine were included. Patients fasting blood glucose (FBG), postprandial blood glucose (PPBG), HbA1c and 25(OH)D3 level were measured. The cases were divided into three groups according to measured 25(OH)D3 level (Vitamin D value ? 20 ng/ml, between 20-30 ng/ml, ? 30 ng/ml). In this study patients with; diabetes of less than 6 months duration, diagnosed as diabetes but under the control without medical treatment, hypercalcemia or hypocalcemia, existing diagnoses of hyperparathyroidism or hypoparathyroidism, receving vitamin D treatment and body mass index (BMI)> 45 kg/m² were excluded.Results: Vitamin D level was found ? 20 ng/ml in 41 cases, between 20-30 ng/ml in 50 cases and ? 30 ng/ml in 79 cases. When all the cases were considered, mean 25(OH)D3 level was found as 38.10 ng/ml (11 to 68.7 ng/ml) in men and 24.20 ng/ml (5.8 to 70.7 ng/ml) in female. In men, the average vitamin D level was higher than in women (p = 0.001). Between the vitamin D groups, no significant difference was founding terms of the FBG, PPBG and HbA1c levels (p: 0.97, 0.96, 0.44). Between the vitamin D groups, in regard to age, BMI and waist circumference, significant differences were detected (p = 0.01, <0.001, 0.002). When there was not any significant differences in regard to parathyroid hormone (PTH), phosphorus (P), albumin, cholesterol levels, a significant difference between calcium (Ca) levels was detected between the vitamin D groups (p: 0.02). Although there is no significant difference according to HbA1c levels in mean vitamin D levels, the vitamin D level was higher in the group with HbA1c ? 7 than the group with HbA1c> 7 (p: 0.115). There was not any significant difference between the groups in terms of physical activity, diet, sun exposure. When evaluated in terms of covering vitamin D level was detected lower in covered grup and there was significant difference between the groups (p = 0.001).Conclusion: In our study, 53% of the patients with Type 2 DM was found to have vitamin D deficiency and insufficiency. Vitamin D deficiency was more evident in women than in men. Patients with vitamin D deficiency or insufficiency were found to be more obese than the patient without vitamin D deficiency. Vitamin D level was found to be lower in covered group than the uncovered ones. Although there was not any difference in terms of blood glucose regulations between the patients with Vitamin D deficiency or insufficiency and without deficiency, vitamin D level was found to be higher in patients with HbA1c?7.