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Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes, (7th Feb 2023) https://www.acpjournals.org/doi/10.7326/M22-3018?utm_source=cmpnr&utm_campaign=lfa_230207_a&utm_content=3&cmp=1&utm_medium=email HTTPS://WWW.ACPJOURNALS.ORG/DOI/10.7326/P22-0031?UTM_SOURCE=CMPNR&UTM_CAMPAIGN=LFA_230207_A&UTM_CONTENT=3&CMP=1&UTM_MEDIUM=EMAIL Vitamin D has many functions in the body, including a role in insulin secretion and glucose metabolism. Observational studies, association between low level of vitamin D in the blood, and high risk for developing diabetes. So, does giving vitamin D to people who were at high risk for diabetes reduce the risk? Authors searched 3 databases, through 9 December 2022 Compare the use of vitamin D versus placebo for diabetes prevention, in adults with prediabetes. Meta analysis and reanalysis of pooled data Trials were at low risk for bias Results Over 3 years of follow-up Vitamin D group New-onset diabetes occurred in 22.7% Placebo group New-onset diabetes occurred in 25% Translates to being 15% reduction Number needed to treat to prevent one case of diabetes 30 adults with prediabetes to prevent 1 person from developing diabetes. Risk reduction by blood levels At least 125 nmol/L (≥50 ng/mL) group 50 to 74 nmol/L (20 to 29 ng/mL) group Cholecalciferol reduced risk for diabetes by 76% (hazard ratio, 0.24) 3-year absolute risk reduction of 18.1% Vitamin D increased the likelihood of regression to normal glucose regulation by 30% Doses used 20,000 units of cholecalciferol (vitamin D3) weekly 4000 units of cholecalciferol daily 0.75 micrograms of eldecalcitol, (synthetic analogue of vitamin D) Adverse events Rare, study could not draw any definite conclusions about safety kidney stones hypercalcemia hypercalciuria Implications In adults with prediabetes, vitamin D was effective in lowering the risk for developing diabetes. By the Numbers: Diabetes in America https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html Total Diabetes From 2001 to 2020, diabetes prevalence significantly increased among over 18s 37.3 million people have diabetes (11.3% of the US population). 28.7 million people have been diagnosed with diabetes. 8.5 million people who have diabetes have not been diagnosed (do not know they have it) Total Prediabetes 96 million US adults have prediabetes. Cost of Diabetes (2017) $327 billion, $237 billion direct medical costs $90 billion in lost productivity Excess medical costs, $9,601 per person https://www.diabetes.org.uk/professionals/position-statements-reports/statistics/diabetes-prevalence-2019 UK prevalence 4.8 million (7%) 3.9 million diagnosed 1 million undiagnosed 5.3 million by 2025 People with type 2 diabetes 50% more likely to die prematurely Two-and-a-half times more likely to. Develop heart failure Twice more likely to have a heart attack Obesity, sugars, carbohydrates, processed foods, exercise, vitamin D

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