Assessment of vitamin D status and its association with insulin resistance among type 2 diabetic subjects

Jaitra Bhattacharya


Background: The 21st century has seen the rise of diabetes mellitus as one of the major metabolic issues as is vitamin D deficiency which has been found to be pandemic worldwide. The present study is an endeavor to study the status of serum vitamin D levels in relation to the glycemic and insulin resistance status in type 2 diabetes mellitus patients.

Methods: The present is a cross-sectional study with a sample size of 100 type 2 diabetic subjects in the age group of 30-60 years. Serum vitamin D and Insulin levels were estimated using the ELISA technique. HbA1c levels were measured using immunoturbidimetric assays and plasma glucose levels were determined using glucose oxidase- peroxidase method.

Results: The fasting plasma glucose, HbA1c and serum insulin levels were found to be significantly higher in those with vitamin D levels below the normal cut-off value of less than 30ng/ml (p value <0.01). Also, the insulin resistance calculated using HOMA-IR was found to be higher in those subjects having vitamin D deficiency or insufficiency.

Conclusions: Hence, the study suggests that vitamin D deficiency contributes to further insulin resistance and poorer long-term diabetic control in type 2 diabetes mellitus subjects.


Insulin, Insulin resistance, Type 2 diabetes, Vitamin D

Full Text:



International Diabetes Federation. IDF Diabetes Atlas, 7th Edition, 2015. Available at: Accessed 3 November 2017.

McPherson RA, Pincus MR. Henrys clinical diagnosis and management by laboratory methods. 23rd ed. 2017.

Chang L, Chiang SH, Saltiel AR. Insulin signalling and the regulation of glucose transport. Molecular medicine. 2004 Jul;10(7-12):65-71.

Gin H, Morlat P, Ragnaud JM, Aubertin J. Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients. Diabetes Care. 1992 Apr 1;15(4):546-8.

Alberts B. Intracellular compartments and transport. In: Alberts B, Bray D, Hopkin K, Johnson AD, Lewis J, Raff M. Essential Cell Biology. Fourth Edition. New York: Garland Science;2013:515-516.

Duckworth WC, Bennett RG, Hamel FG. Insulin degradation: progress and potential. Endocrine reviews. 1998 Oct 1;19(5):608-24.

Holick MF. Phylogenetic and evolutionary aspects of vitamin D from phytoplankton to humans. Vertebrate endocrinology: fundamentals and biomedical implications. 1989;3:7-43.

Holick MF. Vitamin D: A millennium perspective. J Cell Biochem. 2003;88:296-307.

Sniadecki SJ, Sniadecki J. on the cure of rickets.(1840) Cited by W. Mozolowski. Nature. 1939;143:121-4.

DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutri. 2004 Dec 1;80(6):1689S-96S.

Harinarayan CV, Joshi SR. Vitamin D status in India-Its implications and Remedial Measures. J Assoc Physicians India. 2009;57:40-8.

Harinarayan CV. Prevalence of vitamin D insufficiency in postmenopausal South Indian women. Osteoporos Int. 2005;16:397-402.

Bachhel R, Singh NR, Sidhu JS. Prevalence of vitamin D deficiency in north-west Punjab population: A cross-sectional study. Inter J App Basic Med Res. 2015 Jan;5(1):7.

Van Schoor NM, Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25:671-80.

Van der Meer IM, Middelkoop BJ, Boeke AJ, Lips P. Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: An overview. Osteoporos Int. 2011;22:1009-21.

Gadre S, Yadav K, Gomes M. Vitamin D status in Indian population: Major Health concern. World J Pharma Res. 2015;5(1):362-78.

Modi KD, Ahmed MI, Chandwani R, Kumar KH. Prevalence of vitamin D deficiency across the spectrum of glucose intolerance. J Dia Meta Dis. 2015 Dec;14(1):54.

Sollid ST, Hutchinson MY, Fuskevag OM, Figenschau Y, Joakimsen RM, Schirmer H, et al. No effect of high-dose vitamin d supplementation on glycemic status or cardiovascular risk factors in subjects with prediabetes. Diabetes Care. 2014;37:2123-31.

Erdönmez D, Hatun S, Çizmecioğlu FM, Keser A. No relationship between vitamin D status and insulin resistance in a group of high school students. J Clin Res Pediatr Endocrinol. 2011;3:198-201.

Zittermann A. Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol. 2006;92:39-48.

Bland R, Markovic D, Hills CE, Hughes SV, Chan SL, Squires PE, et al. Expression of 25-hydroxyvitamin D3-1alpha-hydroxylase in pancreatic islets. J Steroid Biochem Mol Biol. 2004;89-90(1-5):121-5.

Maestro B, Davila N, Carranza MC, Calle C. Identification of a Vitamin D response element in the human insulin receptor gene promoter. J Steroid Biochem Mol Biol. 2003;84(2-3):223-30.

Simpson RU, Thomas GA, Arnold AJ. Identification of 1, 25-dihydroxyvitamin D3 receptors and activities in muscle. J Biological Chemistry. 1985;260(15):8882-91.

Zeitz U, Weber K, Soegiarto DW, Wolf E, Balling R, Erben RG. Impaired insulin secretory capacity in mice lacking a functional vitamin D receptor. FASEB J. 2003 Mar;17(3):509-11.

Maestro B, Molero S, Bajo S. Transcriptional activation of the human insulin receptor gene by 1, 25-dihydroxyvitamin D(3). Cell bio-Chem Funct. 2002;20:227-32.

Dunlop TW, Vaisanen S, Frank C, Molnar F, Sinkkonen L, Carlberg C, et al. The human peroxisome proliferator-activated receptor δ gene is a primary target of 1α, 25-dihydroxyvitamin D3 and its nuclear receptor. J Mole Biol. 2005;349(2):248-60.

Cohen-Lahav M, Douvdevani A, Chaimovitz C, Shany S. The anti-inflammatory activity of 1,25 dihydroxy vitamin D3 in macrophages. J Steroid Biochem Mol Biol. 2007;103:558-62.

Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Euro J Clin Nutri. 2011 Sep;65(9):1005.

Song Y, Wang L, Pittas AG, Del Gobbo LC, Zhang C, Manson JE, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes care. 2013 May 1;36(5):1422-8.

Mitri J, Dawson-Hughes B, Hu FB, Pittas AG. Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial. Am J Clin Nutri. 2011 Jun 29;94(2):486-94.

Davidson MB, Duran P, Lee ML, Friedman TC. High-dose vitamin D supplementation in people with prediabetes and hypovitaminosis D. Diabetes care. 2013 Feb 1;36(2):260-6.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes: a systematic review and meta-analysis. J Clin Endo Meta. 2007;92:2017-29.

Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, Hu FB. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;9:650-6.

Scragg R, Sowers MF, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third National Health and Nutrition Examination Survey. Diabetes Care. 2004;27:2813-8.

Forouohi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25-hydroxyvitamin D is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely prospective study, 1990-2000. Diabetes. 2008;57:2619-25.

Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB, et al. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010;5:225-36.

Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC, et al. Association of vitamin D with insulin resistance and β-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes Care. 2010;33:1379-81.

US, Department of Health and Human Services, Centers for Disease Control and Prevention: National Health and Nutrition Examination Survey data: survey operations manuals, brochures, and consent documents: 2003-2006, 2018. Available at:

McGill AT, Stewart JM, Lithander FE, Strik CM, Poppitt SD. Relationships of low serum vitamin D 3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutrition J. 2008 Dec;7(1):4.