Basic and pleiotropic effects of vitamin D in patients with diabetes mellitus type 1 and 2
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Abstract
Vitamin D, being initially biologically inactive, turns into an active form in the body that interacts with the nuclear receptors of many tissues and organs. Because of this, today vitamin D is recognized as a D-hormone, although, following historical tradition, it continues to be called vitamin. The main role of vitamin D is reduced to the regulation of calcium homeostasis, which is largely due to the effect on the intestinal absorption of calcium ions and bone remodeling (formation and resorption). However, in recent decades at least 5 other areas of physiology have been identified in which vitamin D confidently shows its functions: innate immunity; adaptive immunity; insulin secretion in β-cells and other aspects of maintaining glucose homeostasis; heart function and blood pressure regulation; brain and fetal development. Our article deals with the third of these areas — the use of vitamin D for the prevention and treatment of type 1 and type 2 diabetes mellitus (DM-1 and DM-2). In experimental studies, it was demonstrated that vitamin D is important for adequate secretion of insulin and normalization of blood glucose levels. In clinical studies, a relationship has been established between low levels of vitamin D in serum and the risk of developing both types of diabetes mellitus. Vitamin D has been shown to be effective in the prevention and treatment of diabetes mellitus, although larger, longer, well-planned, randomized clinical trials are required. It is important that vitamin D exhibits additional pleiotropic effects found in patients with DM-2: it normalizes blood pressure, blood lipids, body mass index, fights chronic inflammation, and prevents the development of retinopathy and diabetic peripheral neuropathy. The administration of vitamin in high doses (2000–4000 IU/day or more) leads to the development of the desired effect in short-term treatment regimens (3–6 months). If the doctor is dealing with DM-1, the same high doses of vitamin A should be used.
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