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Introdução: Os benefícios ósseos da vitamina D são clássicos e bem conhecidos, mas em resultado da crescente atenção dada a esta vitamina foram recentemente propostos novos benefícios extra-esqueléticos, como por exemplo no controlo da diabetes mellitus tipo 2. Na teoria estão descritos mecanismos celulares que tornam possível este efeito, mas na prática os resultados são contraditórios. Os objetivos principais deste trabalho são estudar a relação entre os valores de vitamina D e o controlo glicémico em diabéticos tipo 2, e o efeito da suplementação com vitamina D neste controlo glicémico. Como objetivos secundários, foi estudada a relação entre a vitamina D e a idade, obesidade, duração da doença e a presença de complicações.
Metodologia: Neste estudo de investigação transversal e retrospetivo foram incluídos 116 dia-béticos do tipo 2 inscritos na consulta de Diabetologia do Hospital Sousa Martins, ULS da Guarda, entre 1 de janeiro a 31 de dezembro de 2016. Os critérios de exclusão utilizados foram neoplasia e patologias que cursam com hipercalcemia, inexistência de cálculo de IMC e de análises com valores de vitamina D.
Resultados: Na população em estudo, 75,86% apresenta défice de vitamina D. Existe uma rela-ção negativa entre a idade e os valores de vitamina D (p = 0,034). Os obesos apresentam valores de vitamina D ligeiramente superiores e o coeficiente de correlação de Spearman sugere uma relação positiva, não significativa (p = 0,887). Para a duração da doença, hemoglobina glicada e glicose em jejum, o coeficiente sugere uma relação negativa, não significativa. No grupo com défice de vitamina D, o valor médio de hemoglobina glicada é significativamente superior (p = 0,040). No grupo onde ocorreu suplementação, verificou-se um aumento significativo na vita-mina D (p = 0,000) e os valores de hemoglobina glicada e glicose em jejum diminuíram, mas a variação não foi significativa (p = 0,464 e p = 0,122, respetivamente).
Conclusão: Apesar de os diabéticos com défice de vitamina D apresentarem um pior controlo glicémico, os resultados não são suficientes para demonstrar a existência de uma relação in-versa entre os valores de vitamina D e o controlo glicémico, mas sugerem que esta relação poderá existir. A suplementação não favoreceu o controlo glicémico nesta população de diabé-ticos. A idade está inversamente relacionada com os valores de vitamina D. A nefropatia e retinopatia estão associadas a hipovitaminose D.
Introduction: The bone benefits of vitamin D are classical and well known, but as a result of the increased attention given to this vitamin, new extra-skeletal benefits have recently been proposed, for exemple in the control of type 2 diabetes mellitus. In theory, there are cellular mechanisms that explain this effect, but in practice the results are contradictory. The main objectives are to study the relationship between vitamin D and glycemic control in type 2 diabetics, and the effect of vitamin D supplementation in this glycemic control. As secondary objectives, the relationship between vitamin D and age, obesity, duration of disease and the presence of complications were studied. Material and Methods: Retrospective study of 116 type 2 diabetic patients, included in the consultation of diabetes, of Hospital Sousa Martins, ULS Guarda, between January 1, 2016 and December 31, 2016. Patients with neoplasia and pathologies that occurred with hypercalcemia, and patients without calculation of body mass index and analyzes with vitamin D values, were excluded from the study. Results: The vitamin D deficiency rate was 75,86%. A statistically significant negative correlation between age and vitamin D was found (p = 0,034). The obese patients had slightly higher vitamin D values and the Spearman correlation coefficient suggests a non-significant positive relationship (p = 0,887). It was found a non-significant negative relationship between vitamin D and diabetes duration, glycated hemoglobin and fasting glucose. In the group with vitamin D deficiency, the mean value of glycated hemoglobin is significantly higher (p = 0,040). In the group where supplementation occurred, there was a significant increase in vitamin D values (p = 0.000). The mean values of glycated hemoglobin and fasting glucose decreased, but the variation was not significant (p = 0.464 and p = 0.122, respectively). Conclusion: Although diabetics with vitamin D deficiency have poorer glycemic control, the results are not sufficient to demonstrate an inverse relationship between vitamin D values and glycemic control, but suggest that this relationship may exist. Supplementation did not improve glycemic control. Age is inversely related to vitamin D values. Vitamin D defeciency is associated wit nephropathy and retinopathy.
Introduction: The bone benefits of vitamin D are classical and well known, but as a result of the increased attention given to this vitamin, new extra-skeletal benefits have recently been proposed, for exemple in the control of type 2 diabetes mellitus. In theory, there are cellular mechanisms that explain this effect, but in practice the results are contradictory. The main objectives are to study the relationship between vitamin D and glycemic control in type 2 diabetics, and the effect of vitamin D supplementation in this glycemic control. As secondary objectives, the relationship between vitamin D and age, obesity, duration of disease and the presence of complications were studied. Material and Methods: Retrospective study of 116 type 2 diabetic patients, included in the consultation of diabetes, of Hospital Sousa Martins, ULS Guarda, between January 1, 2016 and December 31, 2016. Patients with neoplasia and pathologies that occurred with hypercalcemia, and patients without calculation of body mass index and analyzes with vitamin D values, were excluded from the study. Results: The vitamin D deficiency rate was 75,86%. A statistically significant negative correlation between age and vitamin D was found (p = 0,034). The obese patients had slightly higher vitamin D values and the Spearman correlation coefficient suggests a non-significant positive relationship (p = 0,887). It was found a non-significant negative relationship between vitamin D and diabetes duration, glycated hemoglobin and fasting glucose. In the group with vitamin D deficiency, the mean value of glycated hemoglobin is significantly higher (p = 0,040). In the group where supplementation occurred, there was a significant increase in vitamin D values (p = 0.000). The mean values of glycated hemoglobin and fasting glucose decreased, but the variation was not significant (p = 0.464 and p = 0.122, respectively). Conclusion: Although diabetics with vitamin D deficiency have poorer glycemic control, the results are not sufficient to demonstrate an inverse relationship between vitamin D values and glycemic control, but suggest that this relationship may exist. Supplementation did not improve glycemic control. Age is inversely related to vitamin D values. Vitamin D defeciency is associated wit nephropathy and retinopathy.
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Keywords
Controlo Glicémico Diabetes Mellitus Tipo 2 Hipovitaminose D Suplementação Vitamina D