Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum vitamin D has recently been inversely associated with risk for type 2 diabetes. Recent literature suggests that many more individuals than generally thought suffer from vitamin D deficiency. Southeast Alaskan Natives are at an increased risk due to limited sunlight exposure and possible inadequate vitamin D intake. Therefore, the relationship between vitamin D and glucose should be investigated specifically in the southeast Alaska Native population. A review of lab records yielded 83 charts of patients found to have a serum 25-hydroxyvitamin D during a 2-year period. Upon review of these charts, only nine of 83 vitamin D levels were found to exceed the 32 ng/mL (80 nmol/L) threshold. Age and vitamin D levels were associated in a positive linear relationship (r=0.354, P=0.028). The patients in the lowest vitamin D quartile were younger in age compared to the highest quartile (14.6 years, 95% confidence interval: 4.9, 24.29; P=0.004). The high rate of deficiency noted in this sample suggests this population should be further assessed for vitamin D deficiency. Future studies are needed to confirm the association between a vitamin D deficiency and diabetes incidence in this population.
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PMID:Vitamin D deficiency in a nonrandom sample of southeast Alaska Natives. 1875 24

This study aimed to explore the relationship between insufficient renal 1-alpha hydroxylase (IRH) and bone homeostasis in type 2 diabetes mellitus (T2DM) or insulin resistance (IR) and to investigate whether IR plays a major role in the pathogenesis of both IRH and bone loss in T2DM. The experimental animal models of T2DM, IR, IR treated with vitamin D (VD), IR treated with 1-alpha hydroxyvitamin D (1alpha(OH) D, the product of renal 1-alpha hydroxylase), T2DM treated with VD, and T2DM treated with 1alpha(OH) D were established on 18-month-old male Wistar rats. For rats in each animal model and normal control rats, IR was detected by euglycemic insulin clamp technique (EICT) and glucose infusion rate (GIR, an index of IR) was calculated. Levels of serum 25-hydroxyvitamin D (25(OH)D) and serum active vitamin D (1,25(OH)(2)D) were determined by radioimmunoassay (RIA), and 1,25(OH)(2)D/25(OH)D ratio (1,25-25-R, an index of renal 1-alpha hydroxylase activity in vivo) was calculated; and bone mineral density (BMD) in femoral bone and lumbar vertebrae was measured by dual-energy X-ray absorption (DEXA). No significant difference was observed among the levels of 25(OH)D in all the rats. In IR rats, 1,25(OH)(2)D level, 1,25-25-R, and BMD level were significantly higher than those in T2DM rats and were lower than those in normal control rats. In the aged rats with T2DM or IR, administration of VD had no effect on 25(OH)D level, 1,25(OH)(2)D level, 1,25-25-R, and BMD level. Administration of 1alpha(OH) D had also no effect on 25(OH)D level but increased 1,25(OH)(2)D level, 1,25-25-R, and BMD level. For the aged rats with T2DM or IR, GIR positively correlated with both levels of 1,25(OH)(2)D and BMD, and 1,25-25-R positively and significantly correlated with levels of BMD. In T2DM or IR, IRH is a precipitating factor for bone loss. IR seems to play a major role in the pathogenesis of both IRH and bone loss in T2DM.
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PMID:Insufficient renal 1-alpha hydroxylase and bone homeostasis in aged rats with insulin resistance or type 2 diabetes mellitus. 1897 55

Evidence from different directions, including observational and experimental studies, points to a role of vitamin D status in low-intensity chronic inflammation and insulin resistance in type 2 diabetes mellitus (T2DM). It has been recognised that insulin resistance and low-intensity chronic inflammation are risk factors for T2DM. Thus, vitamin D status can be implicated in the aetiology of TD2M. It is suggested that the relationship between vitamin D and low-intensity chronic inflammation and insulin resistance in T2DM can be mediated in part by the immune-modulating properties of the active form of vitamin D (1-alpha,25-dihydroxyvitamin D3; 1,25(OH)2D3), which is able to down regulate the production of pro-inflammatory cytokines - particularly TNF-alpha, and IL-6. However, an association between vitamin D status and these features, which is independent of BMI, has been also reported. Non-calcaemic effects of vitaminD can be associated with health outcomes other than those traditionally attributed to the vitamin.
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PMID:A role of vitamin D in low-intensity chronic inflammation and insulin resistance in type 2 diabetes mellitus? 1907 3

Our specific aims were to determine whether low serum 25 (OH) vitamin D (D2 + D3) (<32 ng/mL) was associated with myalgia in statin-treated patients and whether the myalgia could be reversed by vitamin D supplementation while continuing statins. After excluding subjects who took corticosteroids or supplemental vitamin D, serum 25 (OH) D was measured in 621 statin-treated patients, which consisted of 128 patients with myalgia at entry and 493 asymptomatic patients. The 128 myalgic patients had lower mean +/- standard deviation (SD) serum vitamin D than the 493 asymptomatic patients (28.6 +/- 13.2 vs 34.2 +/- 13.8 ng/mL, P < 0.0001), but they did not differ (p > 0.05) by age, body mass index (BMI), type 2 diabetes, or creatine kinase levels. By analysis of variance, which was adjusted for race, sex, and age, the least square mean (+/- standard error [SE]) serum vitamin D was lower in the 128 patients with myalgia than in the 493 asymptomatic patients (28.7 +/- 1.2 vs 34.3 +/- 0.6 ng/mL, P < 0.0001). Serum 25 (OH) D was low in 82 of 128 (64%) patients with myalgia versus 214 of 493 (43%) asymptomatic patients (chi(2) = 17.4, P < 0.0001). Of the 82 vitamin-D-deficient, myalgic patients, while continuing statins, 38 were given vitamin D (50,000 units/week for 12 weeks), with a resultant increase in serum vitamin D from 20.4 +/- 7.3 to 48.2 +/- 17.9 ng/mL (P < 0.0001) and resolution of myalgia in 35 (92%). We speculate that symptomatic myalgia in statin-treated patients with concurrent vitamin D deficiency may reflect a reversible interaction between vitamin D deficiency and statins on skeletal muscle.
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PMID:Low serum 25 (OH) vitamin D levels (<32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients. 1910 Sep 53

We examined the cross-sectional association between plasma 25-hydroxyvitamin D [25(OH)D] and markers of the insulin resistant phenotype. Plasma 25(OH)D concentrations were measured in 808 nondiabetic participants of the Framingham Offspring Study. Outcome measures included fasting and 2-h post 75-g oral glucose tolerance test (OGTT) glucose and insulin; these were used to calculate the homeostatic model assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI(0,120)). We also measured plasma adiponectin, triacylglycerol, and HDL cholesterol concentrations as markers of the insulin-resistant phenotype. After adjusting for age, sex, BMI, waist circumference, and current smoking status, plasma 25(OH)D concentration was inversely associated with fasting plasma glucose and insulin concentrations, and HOMA-IR. Compared with the participants in the lowest tertile category of plasma 25(OH)D, those in the highest tertile category had a 1.6% lower concentration of fasting plasma glucose (P-trend = 0.007), 9.8% lower concentration of fasting plasma insulin (P-trend = 0.001), and 12.7% lower HOMA-IR score (P-trend < 0.001). After adjusting for age and sex, plasma 25(OH)D was positively associated with ISI(0,120), plasma adiponectin, and HDL cholesterol and inversely associated with plasma triacylglycerol, but these associations were no longer significant after further adjustment for BMI, waist circumference, and current smoking status. 25(OH)D and 2-h post-OGTT glucose were not associated. Among adults without diabetes, vitamin D status was inversely associated with surrogate fasting measures of insulin resistance. These results suggest that vitamin D status may be an important determinant for type 2 diabetes mellitus.
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PMID:Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. 1910 28

The consumption of calcium, vitamin D, and dairy products may be associated with a reduced risk of type 2 diabetes mellitus. However, whether this reduction is due to calcium, vitamin D, or other components of dairy products is not clear. We examined intakes of total calcium and vitamin D, and plasma concentrations of 25 hydroxyvitamin D [25(OH)D] in relation to fasting plasma concentrations of C-peptide in 2 cross-sectional studies among healthy men from the Health Professionals Follow-up Study and among healthy women from the Nurses' Health Study I. Intake of total calcium was modestly inversely associated with C-peptide concentration in women (P-trend = 0.05); however, the inverse association was not significant in men (P = 0.7). Concentrations of C-peptide were 20% lower among men who had plasma concentrations of 25(OH)D in the highest quartile compared with those in the lowest quartile (P-trend = 0.08); there was no association in women (P = 0.3). The inverse association between calcium intake and the plasma C-peptide concentration was stronger in hypertensive individuals of both sexes. The difference in the C-peptide concentrations between extreme quartiles of calcium intake was 17% in men and 20% in women. Plasma concentrations of C-peptide for the combination of the highest tertiles of calcium intake and plasma 25(OH)D compared with the opposite extreme were 35% lower (P = 0.03) in men and 12% lower (P = 0.01) in women. The results suggest that calcium intake or systemic vitamin D status, after adjustment for intake of dairy products, is associated with decreased insulin secretion.
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PMID:Plasma C-peptide is inversely associated with calcium intake in women and with plasma 25-hydroxy vitamin D in men. 1914 3

Prevention, or at least delay in onset of type 2 diabetes is possible by intensive lifestyle intervention. This is costly and labour intensive, and alternative methods of preventing diabetes have been sought. Vitamin D has important physiological effects aside from its effects on bone metabolism, including an important role in glucose homeostasis, insulin release and response. Observational data strongly support the role of vitamin D deficiency in the pathogenesis of type 2 diabetes. The time is ripe for a well conducted randomised controlled trial of vitamin D in high risk individuals to test the hypothesis that vitamin D delays the onset of type 2 diabetes.
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PMID:Vitamin D and type 2 diabetes: Is there a link? 1939 31

Recent metaanalyses have revealed both type 1 and type 2 diabetes mellitus (DM) are associated with an increased risk of hip fracture. In type 1 DM, decreased bone mineral density (BMD) and diabetic vascular complications are associated with an increased risk of fracture. Hence, strict metabolic control with intensive insulin therapy combined with earlier BMD assessment is important to prevent osteoporotic fractures. In type 2 DM, fracture risk is increased despite increased BMD. Presence of diabetic vascular complications, advanced glycation of bone collagen, deranged bone turnover, and possibly certain types of anti-diabetic medications are related to an increased risk of fracture. Comprehensive management, including calcium and vitamin D rich diet, exercise together with tight metabolic control would be important to prevent fractures in type 2 DM. Special care may be necessary in the use of thiazolidinediones toward high fracture risk individuals, such as postmenopausal women.
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PMID:[Management of osteoporosis in diabetes mellitus]. 1943 24

The growing incidence of prediabetes and clinical type 2 diabetes, in part characterised by insulin resistance, is a critical health problem with consequent devastating personal and health-care costs. Vitamin D status, assessed by serum 25-hydroxyvitamin D levels, is inversely associated with diabetes in epidemiological studies. Several clinical intervention studies also support that vitamin D, or its active metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D), improves insulin sensitivity, even in subjects with glucose metabolism parameters classified within normal ranges. The mechanisms proposed which may underlie this effect include potential relationships with improvements in lean mass, regulation of insulin release, altered insulin receptor expression and specific effects on insulin action. These actions may be mediated by systemic or local production of 1,25(OH)2D or by suppression of parathyroid hormone, which may function to negatively affect insulin sensitivity. Thus, substantial evidence supports a relationship between vitamin D status and insulin sensitivity; however, the underlying mechanisms require further exploration.
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PMID:Vitamin D: emerging new roles in insulin sensitivity. 1955 19

This commentary reviews the current state of knowledge regarding the role of vitamin D in the pathogenesis of diabetes mellitus. In type 1 diabetes mellitus or in adult onset latent autoimmune diabetes (LADA), vitamin D exhibits immunomodulatory actions, influencing the activity of lymphocytes and interleukins. In type 2 diabetes mellitus vitamin D appears to act through different mechanisms, affecting insulin secretion and insulin sensitivity through its effects on the beta cells, mediators of inflammation and parathyroid hormone. Much work remains to be done in this new field of knowledge before the role of vitamin D in the pathogenesis of diabetes mellitus is completely understood.
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PMID:Vitamin D in diabetes mellitus-a new field of knowledge poised for D-velopment. 1956 22


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