Shining a light on vitamin D’s role in tackling diabetes [Interview]

It has been estimated that globally, over 450 million adults suffer from type 2 diabetes mellitus (T2DM), previously called non-insulin dependent diabetes. In the UK alone, type 2 diabetes and its complications cost the National Health Service an estimated £14 billion in 2018, equating to 10% of the annual NHS budget for England and Wales.

“The prelude to diabetes is known as prediabetes,” explains Dr Christie. “The global prevalence of prediabetes is thought to be more than 374 million adults, with approximately five million adults at risk of diabetes in the UK (7%).”

Focus on prediabetes

As a post-doctoral researcher with over 20 years’ expertise in consumer healthcare, Dr Christie has helped to develop a number of innovative, non-pharmacological, over-the-counter approaches to health and well-being. Collaborative projects have included innovative approaches to microvascular health, premenstrual syndrome, skin photo-ageing, and travellers’ diarrhoea.

Another key area of focus has been studying the impacts of vitamin D and adult type 2 diabetes among prediabetics. This is the theme of Dr Christie’s presentation at Vitafoods 2023.

“Observational studies have provided strong and consistent evidence to support the inverse association between blood 25-hydroxyvitamin D levels and risk for T2DM,” says Dr Christie. “In effect, as blood levels of vitamin D rise, the risk of T2DM falls.”

This type of evidence cannot prove cause and effect, however. Until now, whether vitamin D reduces the risk of progression from prediabetes to T2DM diabetes has not been fully answered.

More clarity on vitamin D supplementation

In her presentation, Dr Christie will share new data that she believes gives significantly more clarity on vitamin D and the risk of progression to T2DM. She also intends to explain why some previous interventions using vitamin D have failed to show positive outcomes.

“The effects of vitamin D have not been easy to assess in the past,” she says. “Sometimes it has worked - but not always. This has led to a lack of confidence in clinical settings - and this in turn hasn't helped policy making.”

Furthermore, where pharmacological doses of vitamin D (known as bolus doses) have been used and these studies then assessed alongside those where lower dose daily vitamin D regimes have been employed, i.e., in meta-analyses, the resultant data has looked weak. “There are reasons to explain this lack of clarity, which I will uncover during the presentation,” adds Dr Christie.

Dr Christie will also discuss the causal associations that are thought to exist between obesity, unhealthy diet, physical inactivity and pre-diabetes mellitus, although the pathophysiological changes here are far from being fully understood.

“Many authorities think that the prelude to T2DM reflects the weaknesses in our modern way of living,” says Dr Christie. “This includes our eating habits, the quality and amount of exercise, the degree of stress that we are under, our range of immune challenges, and also the polluted environment in which we live.”

In her presentation, Dr Christie hopes to make clear that methodological details need to be carefully assessed in all studies. In addition, the latest individual patient data (IPD) meta-analysis provides compelling evidence and greater clarity on the protective effect of vitamin D on reducing risk of T2DM in adults.

“I hope that participants are able to take away from my presentation greater confidence in safe daily doses of vitamin D, for protection against type 2 diabetes mellitus among those with pre-diabetes,” she says.

Dr Sam Christie’s presentation at Vitafoods 2023 is entitled ‘Gaining clarity on vitamin D and adult type 2 diabetes among prediabetics’.