Vitamin D and diabetes mellitus: an update 2013 / Vitamin D e diabetes melito: uma atualização 2013

Vitamin D deficiency and diabetes mellitus are two common conditions and they are widely prevalent across all ages, races, geographical regions, and socioeconomic conditions. Epidemiologic studies have shown association of vitamin D deficiency and increased risk of chronic diseases, such as cancer, cardiovascular disease, type 2 diabetes, and autoimmune diseases, such as multiple sclerosis and type 1 diabetes mellitus. The identification of 1,25(OH)2D receptors and 1-α-hydroxilase expression in pancreatic beta cells, in cells of the immune system, and in various others tissues, besides the bone system support the role of vitamin D in the pathogenesis of type 2 diabetes. Observational studies have revealed an association between 25(OH) D deficiency and the prevalence of type 1 diabetes in children and adolescents. This review will focus on the concept of vitamin D deficiency, its prevalence, and its role in the pathogenesis and risk of diabetes mellitus and cardiovascular diseases.

A deficiência de vitamina D e o diabetes melito são enfermidades comuns na população e são altamente prevalentes em todas as raças, idades, regiões geográficas e situação socioeconômica. Estudos epidemiológicos mostram uma associação entre hipovitaminose D com o aumento do risco de doenças crônicas, tais como câncer, doença cardiovascular, diabetes melito do tipo 2 e doenças autoimunes como a esclerose múltipla e o diabetes mellitus do tipo 1. A identificação de receptores da 1,25(OH)2 D e da expressão da 1 α-hidroxilase nas células betapancreáticas, em células do sistema imunológico e em uma variedade de células do organismo além do tecido ósseo, suporta o papel da vitamina D na patogênese do diabetes tipo 2 e do tipo 1. Esta revisão apresenta e discute o conceito de deficiência de vitamina D, sua prevalência e seu papel na patogênese e no risco de desenvolvimento do diabetes melito e doenças cardiovasculares.

Clinical and biochemical features of malnutrition related diabetes mellitus

The aims of this study were to characterize clinically and biochemically malnutrition related diabetes mellitus (MRDM) as it presents in Jamaica (J-type or phasic insulin dependent diabetes mellitus) and to examine the food toxin (linamarin)/malnutrition hypothesis as a possible aetiological factor in the onset of MRDM. The study was broadly divided into two major areas: (i) Clinical or patient study and (ii) Animal model study. The patient population consisted of thirty-four, (23 females, 17 males) who attend the Diabetic Outpatient Clinic of the University Hospital of the West Indies. This group consisted of 14 phasic insulin dependent diabetes mellitus (PIDDM) (8 females, 6 males) 10 non-insulin dependent diabetes mellitus (IDDM), (6 females, 4 males). Ten (10) normal (4 females, 6 males) subjects also participated. The diabetic and normal subjects were matched for age, body mass index and duration of diabetes (among diabetics). Comparitive studies were performed on insulin receptor binding, hormonal profile, glucose tolerance, blood status, renal, hepatic and pancreatic function. The results show a significantly decreased white and red blood cell binding to insulin (P<0.05), extensive kidney damage (P<0.05) and increased pancreatic echogenicity in PIDDM. These findings support a separate identity of the latter syndrome from Types 1 and 11 diabetes mellitus. In the animal model study, the dogs (male and female) were maintained on a diet of cornmeal cooked with chicken, fortified with Purina laboratory chow and water ad libitum. Malnutrition was induced by restricting the diet to a very small quantity of cornmeal only for a period of 7-10 days. The recovered dogs were re-fed the normal diet with added milk and multi-vitamin supplement. Linamarin dosage of 20 mg per kg body weight induced abnormally high glucose levels, and in two cases the hyperglycaemia was sustained for several days. There was an associated decrease in binding of insulin to erythrocytes and mononuclear leucocytes, as well as prevailng hypoinsulinaemia in the limarin-induced hyperglycaemic conditions. This animal study presents a possible aetiological model for malnutrition related diabetes mellitus (Summary)

Clinical and biochemical features of malnutrition related diabetes mellitus

The aims of this study were to characterize clinically and biochemically malnutrition related diabetes mellitus (MRDM) as it presents in Jamaica (J-type or phasic insulin dependent diabetes mellitus) and to examine the food toxin (linamarin)/malnutrition hypothesis as a possible aetiological factor in the onset of MRDM. The study was broadly divided into two major areas: (i) Clinical or patient study and (ii) Animal model study. The patient population consisted of thirty-four, (23 females, 17 males) who attend the Diabetic Outpatient Clinic of the University Hospital of the West Indies. This group consisted of 14 phasic insulin dependent diabetes mellitus (PIDDM) (8 females, 6 males) 10 non-insulin dependent diabetes mellitus (IDDM), (6 females, 4 males). Ten (10) normal (4 females, 6 males) subjects also participated. The diabetic and normal subjects were matched for age, body mass index and duration of diabetes (among diabetics). Comparitive studies were performed on insulin receptor binding, hormonal profile, glucose tolerance, blood status, renal, hepatic and pancreatic function. The results show a significantly decreased white and red blood cell binding to insulin (P<0.05), extensive kidney damage (P<0.05) and increased pancreatic echogenicity in PIDDM. These findings support a separate identity of the latter syndrome from Types 1 and 11 diabetes mellitus. In the animal model study, the dogs (male and female) were maintained on a diet of cornmeal cooked with chicken, fortified with Purina laboratory chow and water ad libitum. Malnutrition was induced by restricting the diet to a very small quantity of cornmeal only for a period of 7-10 days. The recovered dogs were re-fed the normal diet with added milk and multi-vitamin supplement. Linamarin dosage of 20 mg per kg body weight induced abnormally high glucose levels, and in two cases the hyperglycaemia was sustained for several days. There was an associated decrease in binding of insulin to erythrocytes and mononuclear leucocytes, as well as prevailng hypoinsulinaemia in the limarin-induced hyperglycaemic conditions. This animal study presents a possible aetiological model for malnutrition related diabetes mellitus (Summary)