Diabetes is one of the most common diseases that has had devastating effects on the general population. It is also among the most popular research trends in modern medicine. Thus, due to the complexity and desirability of this particular affliction, there is a lot of demand towards understanding this disease better, so that it can pave the way towards better solutions in combating diabetes. The aim of this review is to provide a categorization of the risk factors leading to Type II Diabetes. In order to provide a justification for the type of diabetes, an explanation is provided which covers the other types of diabetes and their relative infliction rate. Once the basics understanding of diabetes established, the various aspects that increase the risk of Type II Diabetes (T2D) can be classified. Several different facets are studied in order to come up with a novel classification of the disease. The classification divides the risk factors into sociodemographic and pathophysiological attributes. The major affecting attribute is identified to be genetics, as it is intertwined with other attributes. With the use of bioinformatics, advanced gene sequencing techniques can be applied that would enable the identification of patterns more closely affecting Type II Diabetes. These patterns can be cross-analyzed with pre-existing conditions in order to identify similarities and possible risk factors from other diseases. Ultimately, this classification provides a deeper understanding of the factors affecting Type II Diabetes.

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A Systematic Mapping Study on the Risk Factors Leading to Type II Diabetes Mellitus

The World Health Organization (WHO) predicts that Diabetes Mellitus (DM) would be the seventh leading cause of mortality by the year 2030. The incidence of diabetes is rising, from 4.7% in 1980 to 8.5% in 2014. Type 2 DM accounts for 90% of diabetic patients. It is due to the body’s inefficient use of insulin which is caused by insulin resistance1. Glucose and lipids (triglycerides including cholesterol) metabolism are affected in diabetic patients.

The Level of Vitamin D among Diabetic Patients

Vitamin D deficiency is common worldwide. Presence of vitamin D receptors on various tissues, explains its diversity of actions. Reduced levels of vitamin D is associated with insulin resistance (IR), diabetes, arterial stiffness and Cardio vascular disease (CVD) risk. This study was done to find out the association between hypovitaminosis D, IR and arterial stiffness. 50 normal healthy individuals, between 18 – 60 yrs of age (males & females ) were selected randomly, as study subjects . Blood pressure was recorded by sphygmomanometer. Fasting plasma and serum samples were collected for estimating Glucose, Total cholesterol, triglycerides , Insulin, 25 (OH) D, Insulin resistance calculated by HOMAIR .Arterial stiffness was measured by Sphygmo Cor analyser. Indices of arterial stiffness were Augmentation Index (AIx), Pulse wave velocity (PWV), Sub Endocardial Viability ratio (SEVR). The subjects were divided into 2 groups based on 25(OH) D levels. group 1 (</= 20 ng/ml ) , group 2 (>20ng/ml). All the parameters were compared between the groups. Statistical analysis was done by Students t test, Pearson’s correlation. 58% of the subjects were having Vitamin D deficiency. p value was significant for iPTH ( 0.03) and AIx (0.02). Inverse correlation was found between 25(OH) D and HOMIR (r = 0.134). Our study concludes that vitamin D deficiency is common in normal healthy individuals. Hypovitaminosis D may lead to increased arterial stiffness & IR which will increase the future risk for CAD. Supplementation with Vitamin D may be beneficial for preventing CAD.

/pdf/vitamin-d-status-insulin-resistance-and-arterial-stiffness-wz9ks8ogxu.pdf

Vitamin D Status, Insulin Resistance and Arterial Stiffness in Normal Healthy Subjects

OBJECTIVE Vitamin D deficiency may be responsible for endothelial dysfunction which in turn affects the onset and progression of vascular disease including coronary artery disease and its risk factor, directly or indirectly through various mechanisms. This study was undertaken to find out association between vitamin D and endothelial dilatation of brachial artery, which may help to suggest possible underlying mechanisms and may be of clinical importance in planning preventive and therapeutic strategies. MATERIAL AND METHODS 50 cases of type 2 diabetes mellitus aged 40-60 years were taken. 50 cases without type 2 diabetes mellitus matched for confounding factors were taken as controls. Venous blood samples were collected for the investigations including vitamin D levels. Then Participants were subjected to ultrasound examination for measurement of flow mediated dilatation (FMD) and endothelial independent dilatation after ingestion of glyceryl tri-nitrate (GTN). Unpaired student T test and correlation coefficient analysis were used to find out association between different variables. RESULTS The mean values of FMD were 18.85 ± 5.39% and 10.29 ± 4.91% in controls and cases respectively (p<0.001). The dilatation after GTN was observed to be 26.16 ± 4.25% and 18.74 ± 5.72% in controls and cases respectively (p<0.001). The mean levels of vitamin D among controls and cases were 25.41 ± 12.18 and 14.52 ± 8.28 ng/ml respectively. The correlation between endothelial dependent dilatation (FMD), endothelial independent dilatation (after GTN) and vitamin D was found to be more positive in cases (r=0.870, r=0.798) than controls (r=0.079, r=0.158). CONCLUSIONS Vitamin D deficiency state is higher among cases of type 2 DM. Endothelial dependent dilatation (FMD) was found to be lower among the patients of type 2 DM. The study gives us an insight to identify the diabetics with vitamin D deficiency which may be at higher risk of vascular complications including coronary artery disease.

Vitamin D: A Critical Micronutrient for Vascular Health in Type 2 Diabetes Mellitus.

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Vitamin D: A Critical Micronutrient for Vascular Health in Type 2 Diabetes Mellitus.