BMJ Nutrition, Prevention & Health 2025;0:e000950. doi:10.1136/bmjnph-2024-000950
Daya Krishan Mangal1. Nida Shaikh2, Himanshu Tolani2 Diksha Gautam2 Anuj Kumar Pandey2 Yeshwanth Sonnathi1
Background Micronutrient deficiencies are a significant issue worldwide, particularly in South Asia and sub-Saharan Africa. These deficiencies can impact glucose metabolism and insulin signaling pathways, potentially leading to the beginning and advancement of type 2 diabetes (T2D). This study is a comprehensive assessment of the burden of multiple micronutrient deficiencies among T2D patients. The aim of the study is to resolve conflicting evidence from previous studies that mainly focused on one specific micronutrient.
Methods The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook. This comprehensive literature search explored Embase, ProQuest, PubMed, Scopus, Cochrane Library, Google Scholar, LILACS and the grey literature, and studies that met the inclusion criteria. A pre-piloted data extraction sheet was used to extract data for relevant study outcomes and characteristics. Results were produced by R V.4.3.2 (R Core Team 2023 using general packages such as tidyverse, and specific packages such as meta and metafor.
Results The analysis included 132 studies with 52 501 participants. The pooled prevalence of multiple micronutrient deficiency (vitamins, minerals and electrolytes) was 45.30% (95% CI 40.35% to 50.30%) among T2D patients. The pooled prevalence (48.62%, 95% CI 42.55 to 54.70) was higher in women with T2D than in men.
- Vitamin D was the most prevalent micronutrient deficiency (60.45%, 95% CI 55% to 65%),
- followed by magnesium (41.95%, 95% CI 27% to 56%).
- B12 deficiency (28.72%, 95% CI 21.08% to 36.37%) was higher in the metformin-consuming group.
The prevalence of micronutrient deficiency varied across WHO regions.
Conclusions Micronutrient deficiencies were common in T2D patients, the most common being vitamin D deficiency. Women were more likely to be affected by micronutrient deficiency than men. These studies were hospital based and the findings of this systematic review may be used with caution due to inherent selection bias. Diversity of foods, lifestyle choices and cultural practices may contribute to geographic variations in micronutrient deficiency.
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41+ VitaminDWiki Magnesium category pages have DIABETES in the title
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408+ VitaminDWiki Diabetes category pages have VITAMIN D in the title
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Items found: 409
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Diabetes not prevented or treated if give only modest amount of vitamin D or for short period of time – meta-analysis July 2014 |
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26 Jul, 2014 |
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Type 1 diabetes starting to decrease in Finland, they started Vitamin D fortification in 2003 – July 2013 |
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26 Jul, 2014 |
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Diabetic children often need more than 7,000 IU of vitamin D – June 2014 |
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04 Jul, 2014 |
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Type 1 diabetes is increasing, vitamin D deficiency may be one of the reasons – Aug 2013 |
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14 Jun, 2014 |
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Diabetes onset at age 76 was weakly associated with low vitamin D - June 2014 |
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03 Jun, 2014 |
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Diabetes after giving birth was associated with low vitamin D combined with high PTH – May 2014 |
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31 May, 2014 |
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T1DM, toll-like receptors and vitamin D in rats – May 2014 |
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21 May, 2014 |
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Type 1 diabetes patients may be pissing away vitamin D – Jan 2011 |
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14 May, 2014 |
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140,000 IU vitamin D monthly reduced probability of diabetes – Nov 2011 |
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05 May, 2014 |
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Blood pressure in diabetics reduced by 12 weekly doses of 50,000 IU vitamin D – RCT Jan 2014 |
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10 Apr, 2014 |
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Diabetics with 8ng less vitamin D had a 50 percent increase chance of DHCR7 gene variation – Jan 2014 |
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29 Jan, 2014 |
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Prediabetics 60 percent less likely to become diabetic if given some vitamin D – Jan 2014 |
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25 Jan, 2014 |
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27 percent less likely to develop diabetes if prediabetic and have adequate vitamin D – Mar 2012 |
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25 Jan, 2014 |
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Metabolic Syndrome 10% less likely for every 4 ng increase in Vitamin D – Jan 2013 |
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27 Dec, 2013 |
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Vitamin D decreases incidence of disease |
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29 Nov, 2013 |
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Cardiometabolic markers indicate that 11-14 ng is enough vitamin D – Nov 2013 |
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24 Nov, 2013 |
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25 ng Vitamin D reduced chance of diabetes by 43 percent -review July 2011 |
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20 Oct, 2013 |
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Vitamin D significantly lowers macrophage adhesion to prevent arterial clots (in diabetics)– Nov 2012 |
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07 Oct, 2013 |
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T1 Diabetes independent of vitamin D for levels (disagrees with other studies) – Sept 2013 |
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14 Sep, 2013 |
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Vertebral fracture 7X more likely in diabetic men who were vitamin D deficient – Oct 2012 |
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14 Sep, 2013 |
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Will 1600 IU vitamin D prevent gestational diabetes – no, not enough, July 2013 |
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31 Aug, 2013 |
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Pre-diabetes was not helped by conventional vitamin D loading for 12 weeks – Jan 2013 |
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29 Aug, 2013 |
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Diabetes 10X less frequent among people getting lots of vitamin D - Aug 2013 |
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13 Aug, 2013 |
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Type 2 diabetes 1.5X more likely if low vs high vitamin D – meta-analysis Feb 2013 |
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01 Jun, 2013 |
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3X increase Diabetes if low vitamin D AND Arsenic in urine – May 2013 |
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25 May, 2013 |
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Hypothesis: Obesity causes vitamin D deficiency and type 2 diabetes - 2012 |
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17 May, 2013 |
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4 percent less type 2 diabetes for every 4 ng more vitamin D – meta-analysis May 2013 |
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28 Apr, 2013 |
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44 percent less Type 1 diabetes if high level of vitamin D – white skinned military – March 2013 |
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13 Apr, 2013 |
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Insulin sensitivity in obese adolescents greatly improved with 4000 IU of vitamin D - RCT April 2013 |
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20 Mar, 2013 |
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Insulin improvement in obese teens with 4000 IU of vitamin D – RCT Feb 2013 |
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11 Mar, 2013 |
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Insulin resistance helped with 50000 IU of vitamin D weekly – Feb 2013 |
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11 Mar, 2013 |
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Diabetics who were low on vitamin D were 2X more likely to become obese – Feb 2013 |
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24 Feb, 2013 |
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No association between diabetes level and vitamin D insufficiency in obese youth – Jan 2013 |
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24 Jan, 2013 |
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Role of vitamin D in insulin resistance – Sept 2012 |
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17 Jan, 2013 |
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Metabolic Syndrome in children is associated with low vitamin D – review Jan 2013 |
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09 Jan, 2013 |
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Type II Diabetes not reduced by 3 months of 5000 IU of vitamin D – RCT Jan 2013 |
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08 Jan, 2013 |
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2000 IU of vitamin D helped Type 2 diabetic women, but was not enough – July 2012 |
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19 Dec, 2012 |
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Scientific explanation of vitamin D relationship to insulin resistance– Dec 2012 |
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08 Dec, 2012 |
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Hyperglycemia 2.5X more likely when vitamin D less than 10 ng – Oct 2011 |
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29 Nov, 2012 |
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Probability of Type I diabetes reduced 29 percent with vitamin D – systematic review July 2012 |
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27 Nov, 2012 |
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Diabetes and gene clinical trial with 1000 IU of vitamin D |
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17 Nov, 2012 |
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Gestational diabetes 2.2X more likely below 10 ng of vitamin D – June 2012 |
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15 Nov, 2012 |
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Vitamin D level higher than 30 ng reduces diabetic blood clotting – Nov 2012 |
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13 Nov, 2012 |
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Studies linked low vitamin D and dark skin to Obesity, Diabetes, and heart – June 2011 |
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10 Nov, 2012 |
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Pancreatic cancer vitamin D smoking and diabetes – Aug 2010 |
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10 Nov, 2012 |
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Synergism between vitamin A and vitamin D – Masterjohn June 2010 |
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26 Oct, 2012 |
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Diabetes 3.5X less likely if more than 25 ng Vitamin D – Sept 2012 |
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29 Sep, 2012 |
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It appears that Vitamin D reduces diabetes by reducing monocyte stress – Sept 2012 |
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27 Sep, 2012 |
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Diabetes reduces vitamin D levels which reduces cognition – June 2012 |
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26 Sep, 2012 |
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Link between diabetes and Alzheimers is probably low vitamin D |
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26 Sep, 2012 |
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8 weeks of 7000 IU vitamin D was not enough for seniors to improve insulin resistance – July 2012 |
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08 Aug, 2012 |
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Probability of T2 diabetes increased almost 3X with smoking and low vitamin D – Oct 2010 |
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20 Jul, 2012 |
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Review was not happy with 1000 papers on hyperglycaemia and vitamin D – Jan 2012 |
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27 Jun, 2012 |
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Diabetics helped with food fortified with 1000 IU vitamin D and Calcium – March 2012 |
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24 Jun, 2012 |
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Like their diabetic mothers, infants had low vitamin D and were slightly diabetic – May 2012 |
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23 Jun, 2012 |
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Patients having both Diabetes and TB treated by vitamin D – June 2012 |
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20 Jun, 2012 |
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Diabetes and vitamin D – June 2012 |
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15 Jun, 2012 |
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12700 IU daily vitamin D3 did not stop prediabetic minorities from becoming diabetic – June 2012 |
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10 Jun, 2012 |
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Diabetics with darker skin were more vitamin D deficient – May 2012 |
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17 May, 2012 |
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4000 IU vitamin D not enough to treat diabetes in overweight blacks in 3 months – May 2012 |
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02 May, 2012 |
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Type II diabetes and vitamin D – review Jan 2012 |
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03 Apr, 2012 |
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Low vitamin D associated with obesity-related diseases for ethnic minorities – Sept 2011 |
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18 Feb, 2012 |
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Type 1 diabetes epidemic not correlated with vitamin D in womb – Aug 2011 |
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15 Feb, 2012 |
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Vitamin D deficiency might cause diabetes and cardiovascular diseases – Jan 2012 |
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01 Feb, 2012 |
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Diabetes down 13 percent if more than 500 IU of vitamin D – meta-analysis July 2011 |
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12 Jan, 2012 |
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No diabetes if more than 30 ng of vitamin D – Dec 2011 |
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29 Dec, 2011 |
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25 percent reduction in diabetes risk if vitamin D great than 30 ng - June 2011 |
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05 Dec, 2011 |
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Vitamin D deficient Type 1 diabetics 3X more likely to have calcification problems – Feb 2011 |
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28 Oct, 2011 |
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Vitamin D relationship with HDL and LDL is uncertain – Oct 2011 |
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17 Oct, 2011 |
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type I diabetes increased death if very low vitamin D - May 2011 |
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17 Oct, 2011 |
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Diabetes not TREATED statistically with 5700 IU of vitamin D – Sept 2011 |
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14 Sep, 2011 |
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Table of outcomes for seniors vs vitamin D level |
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04 Sep, 2011 |
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Vitamin D deficiency and diabetes – rheumatoid arthritis – lupus – Oct 2010 |
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06 Aug, 2011 |
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Possible reasons that vitamin D deals with diabetes – Aug 2010 |
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03 Aug, 2011 |
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Vitamin D genes and insulin resistance – MS Aug 2010 |
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02 Jun, 2011 |
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70 year-olds got T2 Diabetes 2X more often when less than 20 ng of vitamin D – April 2011 |
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04 May, 2011 |
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Diabetes risk reduced 24 percent for every 10 ng increase in vitamin D – Mar 2011 |
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26 Mar, 2011 |
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Not yet certain that vitamin D reduces cardiovascular and diabetes in blacks – Mar 2011 |
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13 Mar, 2011 |
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Wonder which political party afflication would believe in vitamin D – March 2011 |
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04 Mar, 2011 |
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Confirmed - need more than 400 IU vitamin D to prevent diabetes – 2008 |
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03 Mar, 2011 |
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Vitamin D with or without Calcium helped glycemic status – Feb 2011 |
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04 Feb, 2011 |
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Overview of Vitamin D and Insulin – 2010 |
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04 Feb, 2011 |
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Diabetes not TREATED by a single 200000 IU of vitamin D – Jan 2011 |
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08 Jan, 2011 |
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Less than 30 ng vitamin D greatly increased hazard of dying and diabetes – Nov 2010 |
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20 Nov, 2010 |
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4000 IU vitamin D improved glycemic control for type 1 diabetes – Nov 2010 |
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11 Nov, 2010 |
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Vitamin D deficiency and insulin insensitivity in African Americans - 2010 |
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05 Nov, 2010 |
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Vitamin D Levels at Birth May Predict Obesity Risk at age 3 - Oct 2010 |
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18 Oct, 2010 |
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Vitamin D deficiency prevalent with Lupus R-Arthritis and Diabetes – Oct 2010 |
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17 Oct, 2010 |
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Low vitamin D predicts all cause mortality in Type 2 Diabetes – Oct 2010 |
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29 Sep, 2010 |
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Type 2 Diabetes and vitamin D – Aug 2010 |
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29 Sep, 2010 |
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People with high level of vitamin D were 40% less likely to get Type 2 diabetes – June 2010 |
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29 Sep, 2010 |
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Diabetes in Japan Vitamin D Helped - 2009 |
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26 Sep, 2010 |
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Diabetes 2X less likely for those with median 34 ng of vitamin D – Sept 2010 |
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02 Sep, 2010 |
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Vitamin D reduced insulin resistance – Feb 2010 |
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30 Aug, 2010 |
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Review of vitamin D deficiency and diabetes – Aug 2010 |
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28 Aug, 2010 |
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Take Charge of Your Diabetes 2007 book with lots of vitamin D information |
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01 Aug, 2010 |
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4000 IU vitamin D3 improves insulin resistance – Feb 2010 |
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01 Aug, 2010 |
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Technical details of how vitamin D reduces diabetes in rats – July 2010 |
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01 Aug, 2010 |
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300000 IU of vitamin D every 3 months may not have been enough – July 2010 |
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22 Jul, 2010 |
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Low vitamin D levels linked to poor blood sugar control in type 2 diabetes – June 2010 |
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18 Jul, 2010 |
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Vitamin D Improves Insulin Sensitivity and Helps Prevent Diabetes – March 2010 |
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20 Jun, 2010 |
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Twice as likely to die of type 2 diabetes if severely vitamin D deficient - Mar 2010 |
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20 Jun, 2010 |
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More obese had less vitamin D, and after low calorie diet, vitamin D went up – June 2010 |
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12 Jun, 2010 |
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Vitamin D deficiency associated with many diseases – Greece April 2010 |
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09 Jun, 2010 |
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Insulin resistance correlated with low vitamin D levels in Arab Americans – June 2010 |
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09 Jun, 2010 |
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The impact of vitamin D deficiency on diabetes and cardiovascular risk -April 2010 |
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16 May, 2010 |
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Diabetics are 2X more likely to die if severely vitamin D deficient -May 2010 |
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14 May, 2010 |
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Vitamin D and Obesity from vitamin D council newsletter of Nov 2006 |
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06 May, 2010 |
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Cuban-Americans with type 2 diabetes have lower vitamin D levels April 2010 |
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30 Apr, 2010 |
Vitamin D and Magnesium fight Diabetes independently - have not seen a trial that used both of them