Is diabetic neuropathy associated with vitamin D status? A meta-analysis

2021 ◽  
pp. 1-35
Author(s):  
Kaissar Yammine ◽  
Joelle Abi Kharma ◽  
Theodore Kaypekian ◽  
Chahine Assi ◽  
Nadine Zeeni
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Diabetic Neuropathy ◽  
Vitamin D Deficiency ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Random Effects Models

Abstract Several studies have been conducted to investigate the relation between 25-hydroxyvitamin D [25(OH)D] level and diabetic neuropathy (DN). However, there is still no clear conclusion due to differences in study design and cut-off values used in the published work, in addition to the absence of a comprehensive meta-analysis on the topic. The present systematic review and meta-analysis therefore aims at clarifying the association between vitamin D level and peripheral DN in patients with type 2 diabetes mellitus. Primary research studies that explored the association between 25(OH)D level and diabetic peripheral neuropathy in type 2 diabetes were located from Medline, EMBASE, Web of Science, Cochrane Library, CINHAL, and Google Scholar. Twenty-six studies met the inclusion criteria with 6277 participants where 2218 were diabetic with DN, 2959 were diabetic without DN and 406 were healthy. Diabetic patients with DN showed significantly lower serum 25(OH)D compared to patients without DN (standardized mean difference (SMD) of −0.92 (95% CI = −1.18 to −0.65, I2 = 93.3%, p < 0.0001). The pooled OR value of vitamin D deficiency was higher in patients with DN, 1.84 (95% CI = 1.46 to 2.33, p < 0.0001) and 2.87 (95% CI = 1.10 to 7.52, p = 0.03) when using fixed-effects and random-effects models, respectively. Vitamin D deficiency has been found to be highly prevalent among diabetic patients with neuropathy. Since 25(OH)D has been implicated in glucose hemostasis and showed benefit in reducing neuropathy symptoms, its supplementation is warranted for this population of patients.

scholarly journals Association of serum vitamin D and parathormone levels in patients of type 2 diabetes mellitus with diabetic retinopathy

2017 ◽  
Vol 10 (2) ◽  
pp. 61
Author(s):  
Mohammad Shiblee Zaman ◽  
Md. Matiur Rahman ◽  
Subrata Kumar Biswas ◽  
Md. Mozammel Hoque ◽  
Khondakar Alwan Nahid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Vitamin D Deficiency ◽  
Diabetic Patients ◽  
Control Serum ◽  
25 Hydroxy Vitamin D

<p>The present study was aimed to evaluate the association of serum 25-hydroxy vitamin D and parathormone in 46 patients of type 2 diabetes mellitus with diabetic retinopathy [non-proliferative, (n=27); proliferative (n=19)]. Twenty one diabetic patients without retinopathy were taken as control. Serum 25-hydroxy vitamin D and intact parathyroid hormone were measured by chemiluminescence microparticle immunoassay. Concentration of 25-hydroxy vitamin D differed significantly among groups (p=0.018) and it was significantly lower in proliferative diabetic retinopathy than no diabetic retinopathy (p=0.003). Logistic regression analysis revealed that vitamin D deficiency [25-hydroxy vitamin D &lt;20 ng/mL] was indepen-dently associated with development of diabetic retinopathy (p=0.007, OR 20.90, 95%CI 2.33-187.23). In conclusion, vitamin D deficiency is associated with diabetic retinopathy complicating type 2 diabetes mellitus.</p>

scholarly journals A Meta-Analysis of the Impact of Resveratrol Supplementation on Markers of Renal Function and Blood Pressure in Type 2 Diabetic Patients on Hypoglycemic Therapy

Molecules ◽  
2020 ◽  
Vol 25 (23) ◽  
pp. 5645
Author(s):  
Tawanda M. Nyambuya ◽  
Bongani B. Nkambule ◽  
Sithandiwe E. Mazibuko-Mbeje ◽  
Vuyolwethu Mxinwa ◽  
Kabelo Mokgalaboni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Total Protein Content ◽  
Diabetic Patients ◽  
Hypoglycemic Therapy ◽  
The Impact

Evidence on the beneficial effects of resveratrol supplementation on cardiovascular disease-related profiles in patients with type 2 diabetes (T2D) is conflicting, while its impact on renal function and blood pressure measurements remains to be established in these patients. The current meta-analysis included randomized controlled trials (RCTs) reporting on the impact of resveratrol supplementation on markers of renal function and blood pressure in patients with T2D on hypoglycemic medication. Electronic databases such as MEDLINE, Cochrane Library, Scopus, and EMBASE were searched for eligible studies from inception up to June 2020. The random and fixed effects model was used in the meta-analysis. A total of five RCTs met the inclusion criteria and involved 388 participants with T2D. Notably, most of the participants were on metformin therapy, or metformin in combination with other hypoglycemic drugs such as insulin and glibenclamide. Pooled estimates showed that resveratrol supplementation in patients with T2D lowered the levels of fasting glucose (SMD: −0.06 [95% CI: −0.24, 0.12]; I2 = 4%, p = 0.39) and insulin (SMD: −0.08 [95% CI: −0.50, 0.34], I2 = 73%, p = 0.002) when compared to those on placebo. In addition, supplementation significantly lowered systolic blood pressure (SMD: −5.77 [95% CI: −8.61, −2.93], I2 = 66%, p = 0.02) in these patients. Although resveratrol supplementation did not affect creatinine or urea levels, it reduced the total protein content (SMD: −0.19 [95% CI: −0.36, −0.02]; I2 = 91%, p = 0.001). In all, resveratrol supplementation in hypoglycemic therapy improves glucose control and lowers blood pressure; however, additional evidence is necessary to confirm its effect on renal function in patients with T2D.

The role of vitamin D deficiency and elevated inflammatory biomarkers as risk factors for the progression of diabetic nephropathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 19 (1) ◽  
pp. 1183-1192
Author(s):  
Ahmad El Askary ◽  
Amal F. Gharib ◽  
Mazen Almehmadi ◽  
Maha Mahfouz Bakhuraysah ◽  
Abdulaziz Ali Al Hajjiahmed ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Vitamin D Deficiency ◽  
Diabetic Patients ◽  
Tnf Α

Abstract Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Albuminuria is the most sensitive marker for the early recognition of DN. Therefore, we aimed to study the risk factors of albuminuria as a marker of DN among diabetic patients. The study included 41 patients with type 2 diabetes mellitus (T2DM), 50 type 2 diabetic nephropathy (T2DN) patients with macroalbuminuria, 43 T2DN patients with microalbuminuria and 38 healthy controls. Logistic regression was used to detect the most significant risk factors for albuminuria. A high statistically significant difference was found between the groups regarding age, sex, body mass index (BMI), diabetes mellitus (DM) duration, glucose, glycated haemoglobin (HbA1c), creatinine, glomerular filtration rate (GFR), lipid profile, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), the albumin–creatinine ratio (ACR), vitamin D, total parathyroid hormone (PTH), urea, total calcium and chemerin (p < 0.001). It was found that the duration of DM, BMI, glucose, GFR, total cholesterol (TC), low-density lipoprotein (LDL), TNF-α, IL-6, CRP, ACR, vitamin D, PTH and chemerin are significant albuminuria risk factors in DN. Vitamin D deficiency and associated inflammatory mediators such as chemerin, TNF-α, IL-6 and CRP are the most essential risk factors for albuminuria in T2DM patients.

scholarly journals Reversal of the Symptoms of Diabetic Neuropathy through Correction of Vitamin D Deficiency in a Type 1 Diabetic Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
David S. H. Bell
Keyword(s):  
Vitamin D ◽  
Diabetic Neuropathy ◽  
Diabetic Patient ◽  
Vitamin D Deficiency ◽  
Diabetic Patients ◽  
Lower Pain ◽  
Microvascular And Macrovascular Complications ◽  
Lower Pain Threshold

Vitamin D deficiency has been associated with both type 1 and type 2 diabetes as well as both the microvascular and macrovascular complications of diabetes. Vitamin D deficiency has been shown to be more common in diabetic patients who have symptoms of distal symmetrical polyneuropathy. In addition, vitamin D deficiency has been associated with a lower pain threshold which increases when vitamin D deficiency is corrected. Herein, I describe a type 1 diabetic patient with neuropathic symptoms so severe that he could not work and for which he needed narcotics for pain management and whose symptoms improved dramatically with correction of the vitamin D deficiency. To my knowledge, this is the first report of an improvement in severe symptoms of diabetic neuropathy with correction of vitamin D deficiency in a single patient.

scholarly journals Vitamin D Deficiency Increases the Risk of Diabetic Retinopathy: A Meta-Analysis of Observational Studies

2017 ◽  
Author(s):  
Xiang Zhang ◽  
Guo-Tao Pan ◽  
Zeng-Li Zhang ◽  
Shasha Tao
Keyword(s):  
Vitamin D ◽  
Diabetic Retinopathy ◽  
Vitamin D Deficiency ◽  
Observational Studies ◽  
Meta Analysis ◽  
Microvascular Complications ◽  
Final Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
The Cochrane Library

Background: Diabetic retinopathy (DR) is one of the most prominent pathological microvascular complications in diabetes. A series of studies reported that vitamin D deficiency was associated with increased prevalence of retinopathy in diabetic patients but the results were inconsistent. In this study we focused on evaluating the relationship between vitamin D deficiency and DR by conducting a meta-analysis of observational studies. Methods: Systematic computerized searches were performed in PubMed, MEDLINE, and the Cochrane Library for relevant original articles till November 20, 2016. The pooled odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated to assess the associated value of vitamin D deficiency to the risk of DR. 9 studies including 6332 participants were subjected to final analysis. Results: The results indicated that vitamin D deficiency increases the risk of DR (OR = 1.57, 95% CI 1.32-1.87) with a little heterogeneity (I2 = 23%). In addition, the subgroup analysis demonstrated that there were obvious heterogeneities in T2DM (I2 = 47.8%). Sensitivity analysis showed that the results were relatively stable and reliable. Conclusion: our meta-analysis demonstrated that vitamin D deficiency could increase the risk of DR.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

2017 ◽  
Vol 176 (1) ◽  
pp. R1-R14 ◽  
Author(s):  
Yvonne H M Krul-Poel ◽  
Marieke M ter Wee ◽  
Paul Lips ◽  
Suat Simsek
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glycaemic Control ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Cochrane Library

Objective Epidemiologic studies suggest that vitamin D status plays a role in glycaemic control in patients with type 2 diabetes. However, intervention studies yielded inconsistent results. The aim of this study is to systematically review the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. Methods Systematic review and meta-analysis. We searched Medline, Embase and the Cochrane Library for RCTs examining the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. A random-effects model meta-analysis was performed to obtain a summarized outcome of vitamin D supplementation on HbA1c, fasting glucose and homeostasis model assessment – insulin resistance (HOMA-IR). Results Twenty-three RCTs were included in this systematic review representing a total of 1797 patients with type 2 diabetes. Mean (± s.d.) change in serum 25-hydroxyvitamin D varied from 1.8 ± 10.2 nmol/L to 80.1 ± 54.0 nmol/L. Nineteen studies included HbA1c as outcome variable. Combining these studies no significant effect in change of HbA1c was seen after vitamin D intervention compared with placebo. A significant effect of vitamin D supplementation was seen on fasting glucose in a subgroup of studies (n = 4) with a mean baseline HbA1c ≥ 8% (64 mmol/mol) (standardized difference in means: 0.36; 95% CI: 0.12–0.61, P = 0.003). Conclusions Current evidence of RCTs does not support short-term vitamin D supplementation in a heterogeneous population with type 2 diabetes. However, in patients with poorly controlled diabetes, a favourable effect of vitamin D is seen on fasting glucose.

scholarly journals Thyroid Autoimmunity in the Context of Type 2 Diabetes Mellitus: Implications for Vitamin D

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Konstantinos Toulis ◽  
Xanthippi Tsekmekidou ◽  
Evangelos Potolidis ◽  
Triantafyllos Didangelos ◽  
Anna Gotzamani-Psarrakou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Vitamin D Deficiency ◽  
Thyroid Autoimmunity ◽  
Diabetic Patients ◽  
Regression Analyses

Vitamin D deficiency has been associated with both type 2 diabetes mellitus (T2DM) and autoimmune disorders. The association of vitamin D with T2DM and thyroid autoimmunity (TAI) has not been investigated. Thus, we aimed to explore the putative association between T2DM and thyroid autoimmunity (TAI) focusing on the role of 25-hydroxy-vitamin D (25(OH)D). Study population included 264 T2DM patients and 234 controls. To explore the potential association between 25(OH)D and thyroid autoimmunity while controlling for potential confounders—namely, age, gender, body mass index, and presence of T2DM—multivariate logistic regression analyses were undertaken. Patients with T2DM were younger (P<0.001) and had significantly lower 25(OH)D levels (P<0.001) and higher anti-TPO titers (P=0.005). Multivariable logistic regression analyses suggested that T2DM and 25(OH)D levels were significantly associated with the presence of thyroid autoimmunity. In an elderly population of diabetic patients and controls with a high prevalence of vitamin D deficiency/insufficiency, a patient with T2DM was found to be 2.5 times more likely to have thyroid autoimmunity compared to a nondiabetic individual and the higher the serum 25(OH)D levels were, the higher this chance was.

scholarly journals The Effects of Exenatide Once Weekly (EXQW) and Exenatide Twice a Day (EXBID) on Beta-Cell Function in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Jie Wang ◽  
Xinye Jin ◽  
Ping An ◽  
Songyan Yu ◽  
Yiming Mu
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Cell Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Antidiabetic Agents ◽  
Significant Difference ◽  
Glucagon Like Peptide 1

Background. In patients with type 2 diabetes mellitus (T2DM) and poor glycemic control receiving metformin (MET), glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are recommended as the adjunctive therapy. However, there are only a few studies involving the comparative effects of exenatide twice a day (EXBID) and exenatide once weekly (EXQW) on HOMA-β. This meta assessed the comparative effects of EXQW and EXBID on HOMA-β among T2DM patients. Materials and Methods. PubMed, Cochrane Library, and Embase databases were searched to collect randomized controlled trials (RCTs). Network meta-analysis was performed, and network diagrams were constructed to evaluate the effects. The primary outcome is HOMA-β, and the secondary outcomes are fasting blood glycose (FBG), glycated hemoglobin (HbA1c), and weight loss. Results. A total of 8 studies with 3506 subjects were included. Compared with other antidiabetic agents, EXQW has a greater improvement in HOMA-β than EXBID (weight mean difference WMD=‐0.46, 95% confidence interval (CI) [-0.64, -0.28], P=0.001). The effect of EXQW on HbA1c is superior to that of sitagliptin (SITA) (WMD=0.51, 95% CI [0.03, 0.99], P=0.037). The significant reduction of weight was detected for EXBID in comparison with EXQW (WMD=‐0.73, 95% CI [-1.13, -0.33], P=0.001), and no significant difference was found between EXQW and MET. Conclusions. EXQW shows a greater improvement in HOMA-β than EXBID. Moreover, the efficacy of EXQW on glycemic control is similar to other antidiabetic agents including EXBID. It is an advisable treatment for diabetic patients to improve HOMA-β and has an advantage of fewer number of injections compared with EXBID, to increase patients’ adherence and quality of life.

scholarly journals Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1304
Author(s):  
Koji Mizutani ◽  
Prima Buranasin ◽  
Risako Mikami ◽  
Kohei Takeda ◽  
Daisuke Kido ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Periodontal Therapy ◽  
Periodontal Pocket ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Extensive Literature

This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated.

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