THE EFFECT OF SUN LIGHT EXPOSURE ON PREDIABETIC PATIENTS IN SOUTH INDIAN POPULATION
Keywords:
Sunlight light exposure, Vitamin D, Prediabetes, Metabolic changesAbstract
Objective: Type 2 diabetes evolves through a phase of normoglycemia and impaired glucose tolerance due to vitamin D deficiency. It was believed that sun light exposure is the natural way to improve the blood 25 (OH) D levels which delay or prevent disease progression. The study was to assess the effect of sunlight exposure in South Indian prediabetic population.
Methods: Data of the subjects were retrospectively collected in three continuous intervals. Total 160 subjects were identified as prediabetes based on inclusion and exclusion criteria. Age between 30 to 65 years subjects was randomly recruited for the study. Subjects were assigned into two groups based on sunlight exposure. All anthropometric and metabolic parameters were measured and interpreted.
Results: Between the group and within the group variation was assessed. In Comparative analysis sun light exposure group showed significant improvement in BMI (P=0.0309), glucose (P<0.0001), HbA1c (P<0.0001) and systolic BP (P=0.0042) were showed significant effect but not in diastolic BP (p>0.2893). In lipid profile, cholesterol (P=0.0002) and triglyceride (P=0.0019) showed significant improvement, but no significant effect was observed in HDL (P= 0.131), LDL (P=0.4735) level in sun light exposure group.
Conclusion: Daily exposure of sunlight can improve the disease condition. Along with sunlight exposure, intensive life style changes and appropriate vitamin D supplementation may need to prevent or delay the disease progression.
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References
Londhey V. Vitamin D deficiency: indian scenario. J Assoc Physicians India 2011;59:695-6.
Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, et al. Expert committee on the diagnosis and classification of diabetes mellitus. follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26(11):3160-7.
Barr EL, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 2007;10;116(2):151-7.
Stene LC, Joner G. Norwegian childhood diabetes study group. Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 2003;78(6):1128-34.
Dalquist G, Patterson C, Soltesz G. The EURODIAB Sub study 2 Study Group. Vitamin D supplement in early childhood and risk for type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1999;42:51–4.
Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia 1995;38:1239‑45.
Orwoll E, Riddle M, Prince M. Effects of vitamin D on insulin and glucagon secretion in non‑insulin‑dependent diabetes mellitus. Am J Clin Nutr 1994;59:1083‑7.
Parekh D, Sarathi V, Shivane VK, Bandgar TR, Menon PS, Shah NS. Pilot study to evaluate the effect of short‑term improvement in vitamin D status on glucose tolerance in patients with type 2 diabetes mellitus. Endocr Pract 2010;16:600‑8.
Capes S, Anand S. What is type 2 diabetes? In: Gerstein HC, Haynes RB, eds. Evidence-based diabetes care. Hamilton, Ont. Decker; 2001. p. 151-63.
Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Finnish diabetes prevention study group. Prevention of type 2diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343-50.
Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The da qing IGT and diabetes study. Diabetes Care 1997;20(4):537-44.
Li X, Liao L, Yan X. Protective effects of 1-α-hydroxyvitamin D3 on residual β-cell function in patients with adult-onset latent autoimmune diabetes (LADA). Diabetes Metab Res Rev 2009;25(5):411–6.
Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25 hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care 2006;29:722-4.
Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J 2001;15(14):2579-85.
Binkley N, Novotny R, Krueger D, Kawahara Y, Daida YG, Lensmeyer B, et al. Low vitamin D status despite abundant sun exposure. J Clin Endocrinol Metab 2007;92:2130–5.
Wicherts IS, Boeke AJP, van der Meer IM, van Schoor NM, Knol DL. Lips Sunlight exposure or vitamin D supplementation for vitamin D-deficient non-western immigrants: a randomized clinical trial. Osteoporos Int 2011;22:873–82.
DeLuca HF. Overview of general physiologic featuresand functions of vitamin D. Am J Clin Nutr 2004;80(6Suppl):1689S-96S.
Ullah MI, Uwaifo GI, Nicholas WC, Koch CA. Does vitamin d deficiency cause hypertension? Current evidence from clinical studies and potential mechanisms. Int J Endocrinol 2010;2010:579-640.
Miksztowicz V, Siseles N, Machulsky NF, Schreier L, Berg G. Increase in MMP-2 activity in overweight and obese women is associated with menopausal status. Climacteric 2012;15:602–06.
Laimer M, Kaser S, Kranebitte M, Sandhofer A, Muhlmann G. Effect of pronounced weight loss on the nontraditional cardiovascular risk marker matrix metalloproteinase-9 in middle-aged morbidly obese women. Int J Obes 2005;29:498–501.
Wing RR, Goldstein MG, Acton KJ, Birch LL, Jakicic JM, Sallis JF Jr, et al. Behavioral science research in diabetes: lifestyle changes related to obesity, eating behavior, and physical activity. Diabetes Care 2001;24(1):117-23.
Mianowska B, Fendler W, Szadkowska A, Baranowska A, Grzelak-Agaciak E, Sadon J, et al. HbA(1c) levels in schoolchildren with type 1 diabetes are seasonally variable and dependent on weather conditions. Diabetologia 2011;54(4):749-56.
Carbone F, Mach F, Vuilleumier N, Montecucco F. Potential pathophysiological role for the vitamin D deficiency in essential hypertension. World J Cardiol 2014;26;6(5):260-76.
Ramankutty P, de Klerk NH, Miller M, Fenech M, O'Callaghan N, Armstrong BK, et al. Ultraviolet radiation exposure and serum vitamin D levels in young children. J Paediatr Child Health 2014;50(9):713-20.
Reis JP, von Mühlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 2007;30:1549-55.
Wareham NJ, Byrne CD, Carr C, Day NE, Boucher BJ, Hales CN. Glucose intolerance is associated with altered calcium homeostasis: a possible link between increased serum calcium concentration and cardiovascular disease mortality. Metabolism 1997;46:1171-7.
Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of 14. serum vitamin D and the metabolic syndrome among US adults. Diabetes Care 2005;28:1228-30.
Chel VG, Ooms ME, Popp-Snijders C, Pavel S, Schothorst AA, Meulemans CC, et al.Ultraviolet irradiation corrects vitamin D deficiency and suppresses secondary hyperparathyroidism in the elderly. J Bone Miner Res 1998;13:1238–42.
Harinarayan CV, Holick MF, Prasad UV, Vani PS, Himabindu G. Vitamin D status and sun exposure in India. Dermatoendocrinol 2013;5(1):130-41.
Shaw RJ, Green MJ, Popham F, Benzeval M. Differences in adiposity trajectories by birth cohort and childhood social class: evidence from cohorts born in the 1930s, 1950s and 1970s in the west of Scotland. J Epidemiol Community Health 2014 ;68(6):550-6.