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High Serum Calcium Linked to Type 2 Diabetes Incidence

In patients at high risk of cardiovascular disease, the risk of diabetes was over three times higher in those with increased serum calcium levels…

Calcium is needed for the release of insulin to respond to higher amounts of blood glucose. It is possible that if serum calcium is not well regulated, it could lead to the development of diabetes. Previous studies have shown that diabetes patients are more likely to have higher serum calcium levels. They have also shown elevated calcium to be associated with insulin resistance and fasting blood glucose.

In a prospective study, researchers examined the association between serum calcium levels and type 2 diabetes incidence in high cardiovascular risk subjects. The subjects used were from a previous study, PREDIMED which followed Mediterranean subjects who were at high risk for cardiovascular disease. A total of 707 subjects were included for the analysis. Serum calcium levels were measured at baseline and on a yearly basis during follow-up. Cox regression models were employed to monitor the association.

Based on baseline serum calcium levels, the subjects were divided into tertiles. Those in the lowest tertile had a baseline serum concentration of 9.01mg/dl while those in the highest had a concentration of 10.20mg/dl. A total of 77 new cases of type 2 diabetes were found using the American Diabetes Association’s criteria for diabetes diagnosis. The median follow-up was 4.78 years. Those in the highest tertile (+0.52 + 0.13mg/dL) were at increased risk for diabetes when compared to those in the lowest tertile (-0.78 + 0.29mg/dL) (HR 3.48, 95% CI 1.48-8.17, P for trend <0.01).

The results of this study show the association between increased serum calcium levels and the increased risk of type 2 diabetes. The risk of diabetes was over three times higher in those subjects with increased serum calcium levels. While the results of this study support previous research of this association, they are limited by the population used. Only elderly patients of Mediterranean descent at high risk of cardiovascular disease were used. This could clearly have an impact on the generalizability of the results.

Practice Pearls:

  • Calcium is needed for the release of insulin when blood glucose levels are elevated in the human body.
  • Increased serum calcium levels have been documented as more common in diabetes patients based on previous research.
  • Those with an increasing serum calcium level where found to have a greater association of type 2 diabetes incidence.


Becerra-Tomas N, Estruch R, Bullo M, Casas R, Dias-Lopex A et al. Increased Serum Calcium Levels and Risk of Type 2 Diabetes in Individuals at High Cardiovascular Risk. Diabetes Care. Oct, 2014. http://www.ncbi.nlm.nih.gov/pubmed/?term=24578358