title: Role of vitamin D in the pathophysiology and treatment of type 2 diabetes.
abstract: The secosteroid vitamin D is best known for its role in calcium regulation and bone metabolism. Recently, however, an emerging body of evidence has suggested that vitamin D may have previously-unrecognized effects on a variety of physiologic processes, including those relating to glucose homeostasis. Indeed, vitamin D insufficiency has been linked with type 2 diabetes (T2DM). In this review, the potential association between vitamin D and T2DM will be evaluated from both a pathophysiologic and clinical perspective. We consider the biologic evidence in support of a mechanistic contribution of vitamin D insufficiency to insulin resistance and beta-cell dysfunction, the two main pathophysiologic defects underlying T2DM. We also evaluate the clinical data linking vitamin D with these metabolic defects and dysglycemia. Finally, interventional studies addressing the effect of vitamin D supplementation on glucose homeostasis are considered. At present, this evolving literature is marked by many conflicting results and methodologic limitations, such that definitive conclusion on the role of vitamin D in T2DM remains elusive. Nevertheless, in light of the widespread prevalence of both vitamin D insufficiency and T2DM, this potential relationship could hold enormous public health implications and hence demands further study to address its unresolved questions.
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, 60 Murray Street, Suite L5-039, Mailbox 21, Toronto, ON, Canada M5T3L9.
authors.forename: Erica
authors.initials: E
authors.lastname: Stivelman
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
mesh_terms: D002118:Calcium / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005786:Gene Expression Regulation; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D011634:Public Health; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002118:Calcium