Pregled izidov raziskav o vlogi vitamina D pri sladkorni bolezni tipa 2

Vodolšak, Sanja (author), Mravljak, Janez (mentor)

Ozadje: Sladkorna bolezen tipa 2 (SB2) je zelo razširjena in pogosta bolezen odraslih. Ker se lahko razvijejo nevarni zapleti, je zdravljenje sladkorne bolezni zelo pomembno, zato so raziskovalci začeli raziskovati učinke vitamina D, ki bi lahko imel pomembno vlogo pri terapiji sladkorne bolezni tipa 2 zaradi ugodnega učinka na glikemične parametre. Podporno zdravljenje z vitaminom D naj bi torej lahko izboljšalo kakovost življenja sladkornih bolnikov. Namen: Namen magistrske naloge je bil pregledati literaturo in izdelati sistematični pregled raziskav ter tako ugotoviti, ali v njej navedeni podatki dokazujejo, da dodatek vitamina D izboljša nadzor glikemije pri sladkornih bolnikih. Metode: Z uporabo vnaprej določenega iskalnega profila smo v podatkovnih bazah PubMed in Web of Science poiskali raziskave v angleškem jeziku, objavljene med leti 2001 in 2021. Raziskave smo izbrali s pomočjo vključitvenih in izključitvenih kriterijev, v skladu s smernicami PRISMA. Raziskave so morale poročati o vsaj enem od izbranih parametrov, in sicer o glikiranem hemoglobinu, plazemski glukozi in inzulinu na tešče, inzulinski rezistenci in občutljivosti na inzulin. Vključili smo tudi nekaj raziskav, ki so poročale o jemanju kombinacije vitamina D s kalcijem pri bolnikih s sladkorno boleznijo tipa 2. Rezultati: V sistematični pregled smo vključili 30 raziskav, ki so ustrezale vključitvenim kriterijem in predstavili njihove glavne značilnosti. Raziskovalci so ugotovili, da pri večini preiskovancev ni bilo zaznati ugodnega učinka vitamina D na glikemične parametre, je pa dodatek vitamina D pri večini ugodno vplival na serumske koncentracije 25-hidroksivitamina D (25(OH)D). V nobeni raziskavi ni prišlo do zastrupitve z vitaminom D, kar pomeni, da noben uporabljen odmerek ni bil previsok. Vključili smo tudi tiste raziskave, v okviru katerih so preučevali učinke jemanja vitamina D s kalcijem, vendar jih je bilo premalo, da bi lahko sklepali, ali bi ta kombinacija lahko ugodno vplivala na glikemične parametre pri sladkornih bolnikih. Sklep: V večini raziskav dodatek vitamina D ni izboljšal glikemičnih parametrov pri bolnikih s SB2, čeprav obstajajo tudi nekatere, ki so poročale o njegovih ugodnih učinkih. Dodatek vitamina D lahko izboljša koncentracije 25(OH)D v serumu, zlasti pri sladkornih bolnikih z nezadostno ali s pomanjkljivo koncentracijo vitamina D v krvi. Ni pa dovolj dokazov, da bi lahko vitamin D uporabljali za podporno zdravljenje sladkorne bolezni tipa 2, čeprav je to še vedno možna izbira. Zato je treba takšne hipoteze preveriti in dokazati s študijami z več preiskovanci, zadostnimi odmerki vitamina D in z daljšim časom intervencije.

• Language: Slovenian
• Keywords: vitamin D, ergokalciferol, holekalciferol, kalcitriol, sladkorna bolezen tipa 2, inzulinska rezistenca, občutljivost na inzulin
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2022
• PID: 20.500.12556/RUL-143245
• Publication date in RUL: 09.12.2022

Secondary language

• Language: English
• Title: A review of research outcomes on the role of vitamin D in type 2 diabetes

Abstract

Background: Type 2 diabetes mellitus is a widespread and common disease of adults. Because of the dangerous complications that can develop, the treatment of diabetes is very important, and researchers have started to investigate the effects of vitamin D, which could play an important role in the treatment of type 2 diabetes due to its beneficial effect on glycaemic parameters. Supportive treatment with vitamin D should therefore be able to improve the quality of life of diabetic patients. Aim: The aim of this thesis was to review the literature and to conduct a systematic review of the studies to determine whether the data reported in the literature provide evidence that vitamin D supplementation improves glycaemic control in diabetic patients. Methods: Using a predefined search profile, we searched PubMed and Web of Science databases for English-language studies published between 2001 and 2021. Studies were selected using inclusion and exclusion criteria, according to PRISMA guidelines. Studies had to report on at least one of the selected parameters, namely glycated haemoglobin, fasting plasma glucose and insulin, insulin resistance and insulin sensitivity. We also included some studies reporting on the use of vitamin D combined with calcium in patients with type 2 diabetes. Results: We included 30 studies that met the inclusion criteria and presented their main characteristics in this systematic review. The investigators found that in most subjects there was no beneficial effect of vitamin D on glycaemic parameters, but in most vitamin D supplementation had a beneficial effect on serum 25-hydroxyvitamin D (25(OH)D) concentrations. No studies reported vitamin D intoxication, meaning that no dose used was too high. We also included those studies that investigated the effects of vitamin D supplementation with calcium, but there were too few to conclude whether this combination could have a beneficial effect on glycaemic parameters in diabetic patients. Conclusion: In most studies, vitamin D supplementation did not improve glycaemic parameters in diabetic patients, although there are some that have reported beneficial effects. Vitamin D supplementation may improve serum 25(OH)D concentrations, especially in diabetic patients with insufficient or deficient blood vitamin D concentrations. However, there is insufficient evidence to support the use of vitamin D for the supportive treatment of type 2 diabetes, although it is still a possible option. Therefore, such hypotheses need to be tested and proven by studies with more subjects, sufficient doses of vitamin D and longer intervention times.

• Keywords: vitamin D, ergocalciferol, cholecalciferol, calcitriol, type 2 diabetes, insulin resistance, insulin sensitivity