Correlation of vitamin D level with prediabetes status_Dr Ahmed Al Montasir_final-1.pptx

Correlation of vitamin D level with prediabetes status

1. Correlation of vitamin D level with prediabetes status Ahmed Al Montasir 1 , Azizur Rahman 2 , Zakir Hossain 3 , Kaoser Bin Siddique 4 , Minhaz Uddin 5 , Zilker Nime Apurbo 6 1.Resident physician, Department of Medicine, TMSS Medical College, Bangladesh 2.Professor of Endocrinology, Department of Medicine, TMSS Medical College, Bangladesh 3.Professor of Medicine, Department of Medicine, TMSS Medical College, Bangladesh 4.Coordinator (Research & Training), TMSS Health Sector, bangladesh 5.Registrar,  Department of Medicine, TMSS Medical College, Bangladesh 6.Final year MBBS student, TMSS Medical College, Bangladesh 10th International Public Health Conference -2024

2. Background Prediabetes is a term used to define the biochemical condition where the blood glucose level is between normal and diabetic range 1,2 . The frequency of prediabetes is increasing 1 . Up to 70% of individuals with prediabetes will eventually develop diabetes by 5 years 2,3 . Besides genetic factors, there are multiple cofactors influencing the development of diabetes mellitus as well as prediabetes. Several of these co-factors can be modified 1,2,4 .

3. Background Low blood vitamin D3 levels have been linked to an increased risk of diabetes in different observational studies 2,4,5 . One meta-analysis found that vitamin D reduced the risk of diabetes in adults with prediabetes by 15% 5 . Vitamin D supplementation may increase the reversion rate of prediabetes to normoglycemia 4,5 .

4. Objective The objective of this study is to look at the connection between prediabetes and vitamin D levels.

5. Materials and method Study period: 01 July 2023 to 30 June 2024 Type of study: Cross sectional Place of the study: outpatient department of medicine, Rafatullah Community Hospital (RCH), at TMSS Medical College, Bangladesh. Inclusion criteria: 1. Prediabetic patients 2. Patients having similar job Exclusion criteria: 1. Presence of other co-morbid conditions 2. Recovering from acute illness 3. Family history of diabetes mellitus 4. Taking any vitamin, herbal supplements

6. Materials and method Number of study population: 50 patients with prediabetes and 50 healthy controls Data collection: Clinical & biochemical data collection Data were collected in a semi-structured pretested questionnaire including sociodemographic factors, comorbid conditions. Height, weight, waist circumference and blood pressure were measured as per standard methods. OGTT, HbA1c, Vitamin D3, S. electrolyes, S. creatinine, S. ALT measured in RCH lab.

7. Materials and method Operational definitions: Prediabetes was diagnosed by American Diabetes Association 2023 criteria Categories of prediabetes were described by oral glucose tolerance test (OGTT) as IGT, IFG and their combination group (IGT+IFG)

8. Results 60% of patients were in 36-40 years age group. 54% and 62% were male in case and control group respectively. Prediabetic patients' serum vitamin D3 levels were much lower than those of controls. Among the prediabetic group 55% were in vitamin D3 deficient group and 40% were in the insufficient group.

9. 39 21 4.5 35 7 5 20 6 38 18 9 6 Prediabetic group Group having normal OGGT & HbA1c Fig 1: Comparison of different parameters of prediabetic and control group

10. Results There was an inverse association found between vitamin D3 levels with fasting blood glucose and blood glucose two hours after 75 grams glucose and also HbA1c level.

11. Fig 2: HbA1c and vitamin D3 distribution

12. Fig 3 (a) Vitamin D3 level in female prediabetic patients Fig 3 (b) Vitamin D3 level in male prediabetic patients

13. Conclusion Prediabetics have noticeably reduced vitamin D levels. The levels of vitamin D3, prediabetic blood glucose values are significantly inversely correlated.

14. Recommendations Large-scale clinical trials are essential to explore the association between vitamin D and prediabetes. Testing vitamin D3 level may be included in special investigation pannel of health checkup.

15. References International Diabetes Federation. IDF Diabetes Atlas, 10th edition, Brussels, Belgium 2021. American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes-2023. Kalra S. Recent advances in pathophysiology of diabetes: beyond the dirty dozen. J Pakistan Med Assoc 2013;63(2):277-280. Islam N. Bangladesh national conservation strategy: urbanization, housing and settlement planning 2013. http://bforest.portal.gov.bd/sites/default/files/ files/bforest.portal.gov.bd/notices/c3379d22_ee62_4dec_9e29_75171074d885/9.%20Urbanization_NCS.pdf. Accessed Apr 27th 2020. Fei S, Fan J, Cao J, Chen H, Wang X, Pan Q. Vitamin D deficiency increases the risk of diabetic peripheral neuropathy in elderly type 2 diabetes mellitus patients by predominantly increasing large-fiber lesions. Diabetes Res Clin Pract. 2024 Mar;209:111585. doi: 10.1016/j.diabres.2024.111585. Epub 2024 Feb 15. PMID: 38364910.

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