Vitamin D and diabetes

well a warm welcome to today's talk Tuesday the 7th of February now there's a public health emergency going on in most of our countries for example in the United States over 11 of the whole population is diabetic in the UK it's just over seven percent of the whole population is diabetic and this is associated with so many disease processes people are much more likely to die earlier much more likely to get heart failure renal failure cardiac cardiac problems like myocardial myocardial infarction so many risks associated with this diabetic blindness all sorts of problems and the evidence is now in as far as I can see on the protective effects of vitamin D it's not being done because it's dirt cheap and big Pharma can't make any money out of it so it's not being pushed but I'm going to give a meta-analysis this morning that shows a 76 level of protection between higher levels of vitamin D and lower levels of vitamin D so stick with this because it is a really quite huge International import and it's not it's not just in the Western countries this is all over the world India is terrible for diabetes for example first paper I'm going to look at is this one annals of internal medicine diabetes and risk for type 2 uh so basically this is people with uh pre-diabetes people that are going to develop diabetes in the next few years how can we stop them developing diabetes so um references there as always it's quite nice this one actually although uh unacceptably uh this paper is paper walled uh the annals of internal medicine do provide a nice summary for uh people uh well for for anyone to read sort of plain Language summary which of course is always good um vitamin D has many functions in the body including a role in insulin secretion and glucose metabolism so insulin of course is the hormone produced by the pancreas that lowers blood sugar levels now observational studies of Sona shown an association between low vitamin D levels and increased risk for developing diabetes so if we look at lots of people we find that the people with the lower vitamin D levels develop more diabetes but of course this is a correlation is it causal and that's what this study does it actually looks at three Interventional studies where vitamin D was actually given and the benefit was actually observed so this is an Interventional study it takes from takes it from observation which is a correlation which may or may not be related to actually demonstrating that no if we do improve vitamin D levels the amount of diabetes does go down so it's Interventional that's why this is so important so does giving vitamin D uh to people who are at risk of diabetes reduce the risk looked at three databases data going up to the ninth of December 2022 so pretty up to date compare the use of vitamin D versus placebo which of course is classic technique uh classic Interventional double-blind technique in adult in adults with pre-diabetes people that are going to develop diabetes often described as a sort of a glucose intolerance these people won't be diabetic now but without intervention they will be pretty soon a meta-analysis have pulled data now it's it's a three-year follow-up um so that's good and the vitamin D group the new one set of diabetes was in 22.7 of patients at the placebo group it was at 25 now it doesn't sound like a big difference but that translates into a 15 reduction when you look at the uh the figures so given the huge numbers that the tens of millions of people with diabetes this is absolutely huge 15 reduction but it actually gets better than that uh numbers needed to treat to prevent one case of diabetes is 30. so this means if we give 30 people with three pre-diabetes The increased amounts of vitamin D if we give them that as a supplement 30 people treated will prevent one case of diabetes Now that might not sound like much either but we've been looking at data recently for the uh the Autumn boosters for example for the uh covert mRNA vaccines and we found that you need some some cases tens of thousands and younger fitter people hundreds of thousands need to be treated to prevent one hospitalization so 30 as a number needed to treat is actually quite excellent especially as this is the study found this to be safe and especially as it's Dirt Cheap vitamin D can be bought from the supermarket for essentially nothing and we could make it a lot cheaper than that and give it out if we wanted to if the political will was there political will is not there of course because um politicians seem to be interested in uh making money and there's no money in vitamin D because of course it's out of patent uh reduced risk reduction by blood levels so people who had at least 125 Nano moles per liter and that's the same as a greater than 50 nanograms per ml uh compared to 50 to 74 Nana moles per liter so this is the higher group with higher levels this is the lower group with uh lower levels that's the vitamin D3 reduce the risk for Diabetes by 76 Hazard ratio 0.24 70 76 reduction this is absolutely huge 76 reduction for a simple cheap safe intervention of as as much as we can use the word safe it's a it's this study is certainly found to be safe very few people will have difficulties uh taking vitamin D of course I have to tell you to go to your doctor first um before taking anything don't take anything on my recommendations there are a few people people with sarcoidosis for example that can't take uh vitamin D but it is very rare most of us are deficient most of the time in Winters in the northern hemisphere um three year absolute risk reduction of 18.1 percent so this is the absolute risk reduction this is absolutely incredible looking at the whole population so the 76 percent um this uh 76 reduction was for people with pre-diabetes the absolute risk reduction for the whole population is 18.1 percent this is a massive benefit why is this not being done I believe it's negligent of the medical authorities not to do this because we have an absolute epidemic pandemics of diabetes now the dose used one study used 20 000 units of uh vitamin D3 a week call it calciferol per week 20 000 units a week and one study used four thousand units a day now personally I take 4 000 units a day that's a hundred same as 100 micrograms of vitamin D that's what I take personally and I also take a hundred micrograms of the K2 with it because the K2 sequesters the calcium released by the vitamin D and puts it into the bones and takes it out of the tissues so that's what I'm taking personally can't tell you what to take but that's what I'm taking uh personally 4 000 units a day um now another study took a 0.75 micrograms of a synthetic one but basically these are the sort of figures that we are looking at four thousand years actually four thousand units a day is not that high um of course it should be titrated on an individual basis but most doctors in the UK won't do vitamin D levels unfortunately mine won't unfortunately so we're left to guess that's why I guess that the best amount is probably four to eight thousand for me but because I'm a bit conservative and I don't know I just take four thousand if I was able to get the blood my blood levels tested as I should be able to but I can't but if we could then we could titrate that up or down a little bit I suspect I would need to titrate it up a bit but of course I don't know because I can't see my blood we need tests um I think if we want to spend money effectively on a public health intervention we should be testing the whole population for vitamin D levels that will be a really cost effective intervention whereas other massive Public Health interventions that are going on at the moment are less cost effective in my view adverse reactions um so they look for kidney stones high blood calcium how high calcium in the euro in the Euro and they didn't find it that didn't draw any definitive conclusions about safety because the numbers were so low so they didn't get an increase in kidney stones it didn't get an increase in this is hyper this is calcium in the blood and they didn't get an increase in calcium in the urine which is good their implications in adults with free diabetes vitamin D was effective in lowering the risk for developing diabetes the case is in my in my opinion made now why is this important let's look at data here from the Centers for Disease Control in the states so one in five people with diabetes don't know they have it let's look at the figures here this is by the Numbers CDC we're not great fans of the CDC of course but we assume they can collect diabetes numbers this is from uh total diabetes from uh 2001 to 2020 diabetes increased significantly amongst over 18s at the moment 37.3 million people have diabetes absolutely incredible 11 of the US population absolutely incredible now normally over 90 of these would be a diabetes mellitus type 2. dm1 diabetes mellitus type 1. that is the uh normally comes on when you're younger that's caused by a disorder of the pancreas with insulin deficiency whereas Diabetes Type 2 used to be called maturity onset but sadly a lot of people are getting it now and it's the Diabetes Type 2 that we're talking about so um 37 million people with diabetes 28.7 people have been diagnosed 8.5 million of diabetes have not been diagnosed and in this 8.5 million people in the states um they are developing pathology every day as a result of the chronic hyperglycemia in a country like the United States this is simply not acceptable 8.5 million of your citizens have diabetes and don't know it we'll see the UK is not a lot better in a minute um total pre-diabetes 96 million people so we can reduce that by 18 percent oh heck that's going to be about 50 million cases over the three year period and presumably over the next three years it'll be another 15 million cases prevented the economic costs uh 327 billion this was in 2017. um absolutely incredible for the individuals concern 9000 601 dollars per year and of course some people simply do not have this money massive economic costs now this the UK is not a lot better a bit better but not a lot these are the figures from diabetic diabetes at UK let's look at those in a bit of detail now as well um UK prevalence of diabetes 4.8 million that's seven percent of the population still quite incredible uh 3.9 million diagnosed that one million don't know they have it so one million people in this clever sophisticated the United Kingdom have diabetes is damaging their organs it's damaging their heart vessels it's damaging their kidneys it's damaging their eyes it's damaging their peripheral circulation and they don't even know they have it because no one's bothered to look this is quite uh ridiculous we should have public health screening for blood sugar levels and we should have public health screening for vitamin D levels um but it's lacking as far as these one million people are concerned and this is so so so simple you just do a finger prick to test for sugar I mean okay it's better to do blood levels for hpa1c for glycosylated hemoglobin um but it's a simple blood test why is this not being done um it's a real failure of Primary Health Care in the UK don't we care about our people or something what is what's going on here quite annoying really um it's going to go up to 5.3 million people by 2025. people with type 2 diabetes 50 more likely to die prematurely two and a half times more likely to develop heart failure horrible disease heart failure people with heart failure suffer terribly horrible disease twice as more likely to have a heart attack that's a myocardial infarction an MI twice as likely to have one of those factors now diabetes UK do stress obesity is the main factor but of course vitamin D deficiency is more prevalent in people that are obese because vitamin D is fat soluble it absorbs into the fatty tissues so when you give an obese person some vitamin D it doesn't go into the blood it goes into the fatty tissues so the way more short of vitamin D you have to supplement them with higher doses for longer to get the vitamin D levels up in the blood but eating too many sugars reading too many carbohydrates or eating too many processed foods we don't exercise enough and we don't get enough vitamin D or correctable but the vitamin D one is just correctable with a few tablets obesity is hard work cutting down on sugars is is a bit more complicated carbohydrates is a bit more complicated processed foods are just everywhere in a cheap one fortunately we need to eat a lot more fruit and vegetables especially a wide variety of plants and and more more fat containing food as long as it's not processed fats um but the vitamin D one it would be easy test the levels give a simple supplement and we would eradicate that variable and presumably reduce the risk by 76 percent with an absolute risk reduction for the whole population of over 18 this is absolutely huge and in my view it's a scandal that is not being done so there we go in my view it's now definitive intervening to give Vitamin D supplements reduces the development of type 2 diabetes over a three-year period thank you for watching

Channel: Dr. John Campbell

Views: 1,512,867

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: KqzaKro5Bt0

Length: 15min 18sec (918 seconds)

Published: Tue Feb 07 2023