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Vitamin D and Type 2 Diabetes Mellitus

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Prof (Dr) CV HARINARAYAN, Bengaluru    01 February 2018

Normal 25(OH)D levels are important for fully normal calcium absorption efficiency in the gut. Calcium absorption in the gut plateaus at 25(OH)D levels of 30 ng/ml. Vitamin D influences pancreatic β-cell synthesis, secretion and insulin sensitivity. Vitamin D may mediate the levels of extracellular and intracellular calcium [(Ca2+)i] through a rapid response involving flux through β cells. Vitamin D deficiency affects insulin secretion and sensitivity by its effects on (Ca2+)i. It plays a key role in ensuring preservation of extracellular calcium levels and intracellular cytosolic calcium concentration. Vitamin D supplementation - Correction of deficiency: 10,000 IU daily or 60,000 IU weekly for 8-12 weeks; 6,00,000 by IM injections once with a gap of 2 months. Vitamin D maintenance dose:1,000-2,000 IU daily or 10,000 IU weekly or 60,000 IU once a month. This should be accompanied by calcium intake of 1 g/day in adults. Casual exposure to the mid-day sun for 15-30 minutes exposing 12% of body surface area without sunscreen will synthesize enough vitamin D for the day. Exposure of larger skin surface area is required in the elderly.

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