The correlation between vitamin D deficiency and the severity of painful diabetic neuropathy in patients with type 2 diabetes mellitus (T2DM)

https://doi.org/10.22146/ijcn.53924

Rizaldy Taslim Pinzon(1*), Putu Clara Shinta Gelgel(2)

(1) Faculty of Medicine, Duta Wacana Christian University, Yogyakarta
(2) Faculty of Medicine, Duta Wacana Christian University, Yogyakarta
(*) Corresponding Author

Abstract


Background: Diabetes and its complications are the major burden health problem worldwide, and diabetic neuropathy is one of the major complications. Vitamin D levels found to be significantly lower in people with painful diabetic peripheral neuropathy compared with healthy people. The data about the vitamin D levels and severity of the neuropathy in Indonesia are very limited.

Objective: This study aims to investigate the possible relationship between vitamin D levels and the severity of diabetic peripheral neuropathy.

Methods: A cross-sectional study was carried out during the period from October 2019 to December 2019 on 53 subjects with diabetic peripheral neuropathy. The patient’s clinical profile including age, gender, and duration of diabetes, HbA1c, and associated microvascular complications was documented. The treatment history was recorded from electronic prescribing data. The severity of neuropathy was measured with the Toronto Clinical Neuropathy Scoring System. Serum 25-OH vitamin D levels were measured by enzyme immunoassays for the quantitative measurement of total serum 25-OH Vitamin D level in ng/mL.

Results: Vitamin D levels based on the severity of neuropathy are divided into mild, moderate, and severe. At mild neuropathy severity, the average patient's vitamin D level was 19±8.85ng/mL, at moderate severity the patient's vitamin D level was 16.25±6.08 ng/mL, and for severe neuropathy, the average vitamin D level was 13.35±6.20 ng/mL. Spearman correlation test obtained r value= -0.439 and p value=0.001.

Conclusions: There is a moderate, significant, and negative patterned correlation between vitamin D level and diabetic peripheral neuropathy severity


Keywords


diabetic peripheral neuropathy severity; type 2 diabetes mellitus; vitamin D

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References

  1. Boulton A, Malik R, Arezzo J, Sosenko J. Diabetic somatic neuropathies. Diabetes Care. 2004;27(6):1458–86. doi: 10.2337/diacare.27.6.1458
  2. National Institute of Health and Research Development (Balitbangkes). Laporan nasional Riskesdas 2018. [series online] 2019 [cited September 27 2019]. Available from: URL: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf
  3. Dang C, Boulton A. Changing perspectives in diabetic foot ulcer management. Int J Low Extrem Wounds. 2003;2(1):4–12. doi: 10.1177/1534734603002001002
  4. Tesfaye S, Boulton A, Dyck P, Freeman R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285–93. doi: 10.2337/dc10-1303
  5. Tahrani A, Ball A, Shepherd L, Rahim A, Jones A, Bates A. The prevalence of vitamin D abnormalities in South Asians with type 2 diabetes mellitus in the UK. Int J Clin Pract. 2010;64(3):351–5. doi: 10.1111/j.1742-1241.2009.02221.x
  6. Usluogullari C, Balkan F, Caner S, Ucler R, Kaya C, Ersoy R, et al. The relationship between microvascular complications and vitamin D deficiency in type 2 diabetes mellitus. BMC Endocr Disord. 2015;15:33. doi: 10.1186/s12902-015-0029-y
  7. Lee J, Oh S, Ha W, Kwon H, Sohn T, Cha B, et al. Serum 25-hydroxyvitamin D concentration and arterial stiffness among type 2 diabetes. Diabetes Res Clin Pract. 2012;95(1):42–7. doi: 10.1016/j.diabres.2011.09.006
  8. Al-Timimi DJ, Ali AF. Serum 25(OH) D in diabetes mellitus type 2: relation to glycaemic control. J Clin Diagn Res. 2013;7(12):2686–8. doi: 10.7860/JCDR/2013/6712.3733
  9. Olt S. Relationship between vitamin D and glycemic control in patients with type 2 diabetes mellitus. Int J Clin Exp Med. 2015;8(10):19180–3.
  10. Qu GB, Wang LL, Tang X, Wu W, Sun YH. The association between vitamin D level and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus: an update systematic review and meta-analysis. J Clin Transl Endocrinol. 2017;9:25–31. doi: 10.1016/j.jcte.2017.04.001
  11. Shillo P, Selvarajah D, Greig M, Ghandi R, Rao G, Tesfaye S, et al. Reduced vitamin D level in painful diabetic peripheral neuropathy. Diabet Med. 2019,36(1):44–51. doi: 10.1111/dme.13798
  12. Maijer JWG, Bosma E, Lefrandt JD, Links TP, Smit AJ, Hoogenberg K, et al. Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores. Diabetes Care. 2003;26(3):697–701. 10.2337/diacare.26.3.697
  13. Bril V, Perkins B. Validation of the Toronto clinical scoring system for diabetic polyneuropathy. Diabetes Care. 2002;25(11):2048–52. doi: 10.2337/diacare.25.11.2048
  14. Arneson WL, Arneson DL. Current methods for routine clinical laboratory testing of vitamin D levels. Laboratory Medicine. 2013;44(1):e38–42. doi: 10.1309/LMONQZQ27TIN7XFS
  15. Bayani MA, Akbari R, Banasaz B, Saeedi F. Status of vitamin-D in diabetic patients. Caspian J Intern Med. 2014;5(1):40–2.
  16. Talwalkar PG, Deshmukh V, Deepak MC, Agrawal D, Patel I, Hegde R. Prevalence and clinico-epidemiology of vitamin D deficiency in patients with type 2 diabetes mellitus and hypertension - a Pan-India study. Endocrine Abstracts. 2018;56:P218. doi: 10.1530/endoabs.56.P218
  17. IWA Dalia, MA Abdelmula, Zeinab AE, AbdElkarim AA. Association of vitamin D with diabetic neuropathy among Sudanese patients with type 2 diabetes mellitus. Niger J Basic Clin Sci. 2019;16(2):79–82. doi: 10.4103/njbcs.njbcs_8_19
  18. Ahmadieh H, Azar S, Lakkis N, Arabi A. Hypovitaminosis D in patients with type 2 diabetes mellitus: a relation to disease control and complications. ISRN Endocrinol 2013;2013:641098. doi: 10.1155/2013/641098
  19. Shehab D, Al-Jarallah K, Mojiminiyi OA, Al Mohamedy H, Abdella NA. Does vitamin D deficiency play a role in peripheral neuropathy in type 2 diabetes? Diabet Med. 2012;29(1):43–9. doi: 10.1111/j.1464-5491.2011.03510.x
  20. Bilir B, Tulubas F, Bilir B, Atile N, Kara S, Yildirim T, et al. The association of vitamin D with inflammatory cytokines in diabetic peripheral neuropathy. J Phys Ther Sci. 2016;28(7):2159–63. doi: 10.1589/jpts.28.2159
  21. Ghadiri-Anari A, Mozafari Z, Gholami S, Khodaei SA, Aboutorabi-Zarchi M, Namiranian N, et al. Dose vitamin D supplementations improve peripheral diabetic neuropathy? a before-after clinical trial. Diabetes Metab Syndr. 2019;3(1):890–3. doi: 10.1016/j.dsx.2018.12.014
  22. Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med. 2008;168(7):771–2. doi: 10.1001/archinte.168.7.771
  23. Verdoia M, Schaffer A, Barbieri L, Di Giovine G, Marino P, De Luca G, et al. Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Nutr Metab Cardiovasc Dis. 2015;25(5):464–70. doi: 10.1016/j.numecd.2015.01.009
  24. Sudoyo AW, Setiyohadi B, Alwi I. Buku ajar ilmu penyakit dalam; Jilid III, Edisi V. Jakarta: Interna Publishing; 2009.
  25. Afzal S, Nordestgaard BG. Low vitamin D and hypertension: a causal association?. Lancet Diabetes Endocrinol. 2014;2(9):682–4. doi: 10.1016/S2213-8587(14)70119-6
  26. Mozos I, Marginean O. Links between vitamin D deficiency and cardiovascular diseases. Biomed Res Int. 2015;2015:109275. doi: 10.1155/2015/109275
  27. Nada AM, Shaheen DA. Cholecalciferol improves glycemic control in type 2 diabetic patients: a 6-month prospective interventional study. Ther Clin Risk Manag. 2017;13:813–20. doi: 10.2147/TCRM.S132344



DOI: https://doi.org/10.22146/ijcn.53924

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