The effects of vitamin D supplementation on indices of glycemic control in Iranian diabetics: A systematic review and meta-analysis

Reza Sahebi; Majid Rezayi; Maryam Emadzadeh; Maryam Salehi; Maryam Tayefi; Seyed Mostafa Parizadeh; Negin Behboodi; Azam Rastgar-Moghadam; Jasmin Kharazmi Khorassani; Sara Kharazmi Khorassani; Akbar Mohammadi; Gordon A Ferns; Majid Ghayour Mobarhan

doi:10.1016/j.ctcp.2018.12.009

The effects of vitamin D supplementation on indices of glycemic control in Iranian diabetics: A systematic review and meta-analysis

Complement Ther Clin Pract. 2019 Feb:34:294-304. doi: 10.1016/j.ctcp.2018.12.009. Epub 2018 Dec 19.

Affiliations

¹ Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
² Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁴ Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵ Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁶ Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁷ Department of Chemistry, Ferdowsi University, Mashhad, Iran.
⁸ Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
⁹ Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran.
¹⁰ Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK.
¹¹ Category 2 Institutes and Centers Under the Auspices of UNESCO, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: GhayourM@mums.ac.ir.

PMID: 30712741
DOI: 10.1016/j.ctcp.2018.12.009

Abstract

Background and purpose: This systematic review and meta-analysis aimed to assess the effects of vitamin D supplements on indices of glycemic control [homeostatic model assessment-insulin resistance (HOMA-IR), hemoglobin A1C (HbA1C), fasting blood glucose (FBG), and quantitative insulin-sensitivity check index (QUICKI) and lipid profile in diabetic patients.

Methods: Eight databases were searched, for randomized controlled trials (RCTs) or cross-sectional and cohort studies that have been published up to December 2017. We used the comprehensive meta-analysis (CMA) software for all statistical analysis and used the I² index for assessing heterogeneity. A p value of <0.05 was considered as statistically significant.

Results: We found 621 articles, and after the exclusion of ineligible publications, 82 studies remained to be assessed of which 37 were used for meta-analysis. Vitamin D supplementation was associated with a significant improvement in FBG (p = 0.001 and 95% CI: -0.526 to -0.136) and HbA1C (p = 0.003 and 95% CI: 1.719 to -0.361) in individuals with type 2 diabetes mellitus (T2DM); while in women with gestational diabetes mellitus (GDM) the reduction in FBG (p = 0.071 and 95% CI: -0.873 to -0.035) and HbA1C (p = 0.199 and 95% CI: 3.270 to 0.681) failed to reach statistical significance. Treatment with vitamin D supplements was associated with an improvement in HOMA-IR in pregnant diabetic women (p = 0.028 and 95% CI: 0.924 to -0.053) and for individuals with diabetes mellitus (p = 0.005 and 95% CI: 1.772 to -0.319). The pooled result of the cross-sectional meta-analysis indicated that serum vitamin D concentrations were significantly lower in diabetic patients than in healthy controls (p = 0.018 and 95% CI: 0.587 to -0.054).

Conclusion: This meta-analysis suggests that vitamin D supplementation improves indices of glycemic control (FBG, HOMA-IR, and HbA1C) in patients with diabetes mellitus. Hence, vitamin D supplements may be of potential therapeutic value in diabetic patients, as an adjuvant therapy along with other treatments.

Keywords: 25(OH)D; Iran; Meta-analysis; Serum lipid profile; Type 2 diabetes.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Blood Glucose / drug effects*
Diabetes Mellitus, Type 2*
Humans
Iran
Randomized Controlled Trials as Topic
Vitamin D* / administration & dosage
Vitamin D* / pharmacology

Substances

Blood Glucose
Vitamin D