Vitamin D Deficiency Linked to Mortality for Those With Diabetes  

Vitamin D deficiency is correlated with higher death rates, but research into the causes must continue. 

Vitamin D complications and deficiency amongst persons with diabetes may often result in mortality. Multiple studies pinpoint the potentially high risks and links associated with Vitamin D deficiency in diabetes patients. Other studies confirm the correlation between high death rates and diabetes patients with Vitamin D deficiencies through in-depth questioning formulated by the Cochrane Collaboration. However, information is limited regarding the younger generation’s connection to Vitamin D deficiency and death rates, and more evidence is needed to draw conclusive results. 

The analysis of over 70,000 patients with Vitamin D deficiencies was conducted from 1991 to 2011. Participants ranged in gender and age, with 51 being classified as the mean age. Comparisons between data from the United States and Australia were made to determine death lengths and rates. Deaths that took place during the first three years of the study were not included in data collection, along with research and data collection being continuous as long as 20 years after the initial research was conducted. Data collected determines normal Vitamin D levels “as a level below 50 nmol/L; low and high vitamin D levels were calculated at 10 nmol/L and 90 nmol/L, respectively.” In order to properly hypothesize potential death risks and rates based on vitamin D level, the researchers focused specifically on sex, age and year and month of blood draw. Fine-Gray regression models were useful methods that draw accurate estimates and conclusions.  

During this study and after, over 11,000 patients died. The participants who did possess Vitamin D deficiency disorders had equally measured low levels of Vitamin D, being under 10 nmol/L, and were determined to be over two times more expected to die earlier than those who did not have the deficiency. However, mortality risks and factors have the potential to contribute to the mortality rate. “The HR for mortality was 2.7 (95% CI, 2.1-3.4) for adults younger than 45 years, 2.9 (95% CI, 2.6-3.4) for adults aged 45 to 60 years, and 2 (95% CI, 1.8-2.3) for adults aged 60 to 75 years.” Persons with normal Vitamin D levels that were measured at least 90 nmol/L had lesser risks, susceptibility and significantly lower rates for mortality in all conditions. 

“HRs for 0.7 for adults aged 45 years and younger were (95% CI, 0.6-0.9), 0.6 for adults aged 45 to 60 years (95% CI, 0.5-0.7) and 0.7 for adults aged 60 to 75 years (95% CI, 0.7-0.8)”. Studies aimed to determine like factors between HR levels and cause of death reveal the “HR of 4.4 (95% CI, 3.1-6.3),” as the securest outcome size specified for diabetes. 

This study is essential to examine and evaluate the effects of Vitamin D deficiency amongst patients with type 2 diabetes. It is also necessary because it provides insight into efforts to create possible reversal methods and to directly link fatal and non-fatal diabetes with ranging Vitamin D levels. With a direct focus on the risks associated with cardiovascular disease, potential death in connection with cancer and cardiovascular disease was not cohesive. The link was not considered strong regarding being a significant cause of death in diabetes patients. This study showed that multiple other contributing factors resulted in the death of diabetes patients, aside from low levels of Vitamin D in said patients. Investigation into the effect of ranging levels of Vitamin D deficiency in diabetes patients did not definitely define the deficiency as either the major cause of death for diabetes patients, nor the primary reason for the death of diabetes patients. The levels of Vitamin D measurement in patients solely reflect the implications presented within this study.  

Results did not pinpoint high levels of Vitamin D to be mortality related, which does show possible benefits that persons who do contain high levels have access to. Higher levels of Vitamin D are typically higher than 100 nmol/L. Weaknesses of the presented study surround questions about the younger generation and the effect of Vitamin D deficiency on younger patients with early-onset diabetes. Expansions of these studies need to be implemented to gain a broader perspective and more knowledge on the possibly fatal effects of Vitamin D deficiency. Further reviews and more thorough research should be conducted and adapted based on the need for information explicitly adhering to Vitamin D deficiency and the younger generation with diabetes and pre-diabetes.  

Practice Pearls:  

• Participants who possess Vitamin D deficiency disorders had equally measured low levels of Vitamin D than those who did not contain the deficiency. 
• Results did not pinpoint high levels of Vitamin D to be mortality related. 
• Expansions of these studies need to be implemented to gain a broader perspective and more knowledge on the possibly fatal effects of deficiency in Vitamin D. 

Marculescu, R et al. Abstract 325. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 16-20, 2019; Barcelona, Spain 

Alayna Marteal Wyre, Pharm. D. Candidate, South College School of Pharmacy