Diabetes in Ghana: Orthodox Medicine Losing the War (2)

•The Relationship Between Vitamin D and Insulin Resistance.

Vitamin D is a steroid hormone that influences virtually every cell in your body, which is why maintaining a healthy level is so important. Low vitamin D levels are widely known to harm your bones, leading them to become thin, brittle, soft or misshapen.

But vitamin D is equally important for your heart, brain, immune function and much more. For example, there's an important connection between insufficient vitamin D and insulin resistance and/or diabetes, both type 11 and type 2. Research suggests that sun avoidance may play a major role in the development of insulin dependent diabetes. The further you move away from the equator the greater your risk of being born with, or developing type 1 diabetes. A major key to preventing type 1 diabetes in children is to ensure that pregnant mothers have optimal vitamin D stores. There is also strong evidence that this can decrease your child's risk of autism. Once your child is born, ensuring he or she gets optimal sun exposure (and/or wise use of oral vitamin D supplementation) could virtually eliminate the risk for type 1 diabetes.

Vitamin D Deficiency May Influence Your Type 2 Diabetes Risk

According to recent research, vitamin D deficiency affects your glucose metabolism and may actually be more closely linked to diabetes than obesity. In a study of 118 people, those with low vitamin D levels were more likely to have type 2 diabetes, pre-diabetes or metabolic syndrome, regardless of their weight.

Among obese people, those without metabolic disorders had higher levels of vitamin D than those with such disorders, and among lean people, those with metabolic disorders were more likely to have low levels of vitamin D. According to one of the study's authors:

"The study suggests that vitamin D deficiency and obesity interact synergistically to heighten the risk of diabetes and other metabolic disorders. The average person may be able to reduce their risk by maintaining a healthy diet and getting enough outdoor activity."

It's not the first time vitamin D has been shown to play a role in diabetes. One Indian study found that vitamin D and calcium supplementation, in combination with exercise, can prevent pre-diabetes from progressing into full-blown diabetes. For every unit increase in vitamin D levels, the risk of progression to diabetes in people with pre-diabetes went down by 8 percent.

Another study published in 2013 found that type 2 diabetics given 50,000 IUs of oral vitamin D3 per week for eight weeks experienced "a meaningful reduction" in fasting plasma glucose and insulin. Other research showing this link includes but is not limited to the following:

i. Animal studies have shown vitamin D is a foundational factor necessary for normal insulin secretion, the study was conducted by Tanaka et al and published in the Journal Clinical and Translational endocrinology and that vitamin D improves insulin sensitivity. The study was conducted by Cade C and Norman AW in 1986 in the journal Endocrinology.

ii. One study involving nearly 5,680 individuals with impaired glucose tolerance showed that vitamin D supplementation increased insulin sensitivity by 54 percent. The study was published by Inzucchi et al 1998 in the New England Journal of Medicine. The authors randomly assigned 29 patients to receive either metformin or troglitazone for three months, after which they were given both drugs for another three months. Plasma glucose concentrations during fasting and postprandially and glycosylated hemoglobin values were measured periodically during both treatments. Endogenous glucose production and peripheral glucose disposal were measured at base line and after three and six months

iii. The mechanisms by which vitamin D reduces insulin resistance include its effect on calcium and phosphorus metabolism and by upregulating the insulin receptor gene. The research was published by Maestro 2002 in the Journal Cell Biochemistry and Function.

Vitamin D May Lower Risk of Hyperglycemia in Those Taking Atypical Antipsychotics

Certain drugs can raise your risk of metabolic dysfunction. For example, statin drugs can trigger drug-induced diabetes. Atypical antipsychotics such as quetiapine, a bipolar medication, have also been linked to an increased risk of hyperglycemia and diabetes. In the latter case, research suggests vitamin D3 may counteract these effects. As reported by The American Journal of Managed Care:

"Atypical antipsychotics have long been associated with an increased risk of hyperglycemia — which can lead to new-onset diabetes, diabetic ketoacidosis, coma and even death.

Some proposed mechanisms for this effect include weight gain, decreased insulin secretion from pancreatic beta cells and insulin resistance. To determine whether there were any medications that could decrease this likelihood of hyperglycemia, researchers analyzed the FDA's Adverse Event Reporting (FAERS) system — a database that logs self-reported adverse effects or medication errors submitted by patients.

By cross-referencing atypical antipsychotics and hyperglycemia, the study authors found that patients who had been simultaneously prescribed to take vitamin D and quetiapine were somehow less likely to have hyperglycemia."

Subsequent animal studies produced similar results. Mice given vitamin D and quetiapine had significantly lower blood sugar levels compared to mice given quetiapine alone. According to lead author Takuya Nagashima, vitamin D inhibits quetiapine from reducing an enzyme that causes hyperglycemia.

Based on these results, the authors suggest combining antipsychotics with vitamin D supplementation to "efficaciously safeguard against antipsychotic-induced hyperglycemia accompanied by insulin resistance."

Other benefit of Vitamin D
Researchers have pointed out that raising levels of vitamin D among the general population could prevent chronic diseases that claim nearly 1 million lives throughout the world each year.

Incidence of several types of cancer could also be slashed in half, or more. Recent research reveals raising your serum 25-hydroxyvitamin D to 40 ng/ml can slash your risk of invasive cancers by 67 percent!

In the interview above, Dr. Michael Holick — a well-known vitamin D researcher — expands on these and many other health benefits of vitamin D. For instance, optimizing your vitamin D levels can help protect against:

What's the Best Way to Optimize Your Vitamin D Level?

There is no doubt that vitamin D is imperative for good health and disease prevention. It may even help counteract some of the deleterious metabolic effects caused of certain drugs. But there's no lack of controversy when it comes to the issue of how to optimize your vitamin D. Most of the researchers specializing in vitamin D agree that sensible sun exposure is the ideal way though.

First of all, vitamin D3 supplements do not confer the identical effects as the vitamin D your skin generates in response to UV exposure. Secondly, sun exposure has additional health benefits that are unrelated to vitamin D production.

For example, UVA exposure produces nitric oxide (NO), which has a blood pressure-lowering effect. In fact, the entire solar spectrum is important for optimal health. We're not dependent solely on the narrowband wavelength of about 295 nanometers (nm), which is where vitamin D is made.

However, unless you make a concerted effort, chances are you're simply not getting enough sun exposure to raise your vitamin D level. As noted in a recent British study, adolescent Britons are not getting enough sun exposure even in the middle of summer to elevate their vitamin D to a healthy level, prompting the authors to suggest changes to the U.K.'s vitamin D guidelines.

As reported by Endocrine Today,14 "more than one-quarter of the adolescents in the study had inadequate vitamin D levels even during summer, the period when participants spent the most time outdoors." According to the authors:

"Current U.K. national guidance on vitamin D acquisition assumes those aged 4 to 64 years gain their vitamin D requirements from sunlight alone, thus there is no recommended nutrient intake. Meanwhile, substantial proportions of the global population, including the U.K., are reported to have low vitamin D status, and rickets has returned as a clinical concern ...

As U.K. current sun exposure patterns do not provide an adequate source of vitamin D, amendments are required to recommendations on vitamin D acquisition in this age group. While wider skin surface area exposure to sunlight might safely increase vitamin D status, oral vitamin D supplements may be beneficial during this critical time for bone development."

When to Take a Vitamin D3 Supplement
Indeed, while sun exposure is the ideal route, it can be difficult for many to achieve an optimal vitamin D level this way. Your lifestyle, location, age, ethnicity, time of year, weather conditions and a number of other factors influence how much vitamin D your skin will make in response to sun exposure. The fact that vitamin D insufficiency and deficiency is widespread even in sundrenched areas like India attests to this difficulty.

In some cases, making changes to your routine in order to get more regular sun exposure may do the trick. Key points to remember is that you need to expose large areas of skin to the sun, and on a frequent basis (ideally daily). However, under ideal conditions you may not need more than a few minutes of exposure.

The worst thing you could do is to bake in the sun for hours on end on the weekends. You definitely want to avoid burning your skin, as this will only cause skin damage that could potentially increase your risk for skin cancer.

If sensible sun exposure is either not feasible or isn't sufficient to raise your vitamin D to a healthy level, then taking an oral vitamin D3 supplement is a wise choice. If you decide to supplement with vitamin D please consider using one that also has vitamin K2, as it works synergistically with vitamin D to maximize the benefits.

The only way to know how your sun exposure is affecting your vitamin D level is to get your vitamin D tested. I recommend doing this twice a year, in January and June/July, to get a reading on your lowest and highest levels. This will tell you whether you might be in need of a supplement. It will also guide you in terms of dosage.

In short, your ideal dosage is one that will help you maintain a clinically relevant vitamin D level of 40 to 60 ng/ml year-round. For some this may be 2,000 IUs a day. For others, it could be 8,000 IUs a day or more.

The Role of Vitamin D in Disease Prevention
A growing body of evidence shows that vitamin D plays a crucial role in disease prevention and maintaining optimal health. There are about 30,000 genes in your body, and vitamin D affects nearly 3,000 of them, as well as vitamin D receptors located throughout your body.

According to one large-scale study, optimal Vitamin D levels can slash your risk of cancer by as much as 60 percent. Keeping your levels optimized can help prevent at least 16 different types of cancer, including pancreatic, lung, ovarian, prostate and skin cancers.

How Vitamin D Performance Testing Can Help Optimize Your Health

Is it any wonder then that no matter what disease or condition is investigated, vitamin D appears to play a crucial role? This is why I am so excited about the D*Action Project by GrassrootsHealth. Dr. Robert Heaney is the research director of GrassrootsHealth and is part of the design of the D*action Project as well as analysis of the research findings.

GrassrootsHealth shows how you can take action today on known science with a consensus of experts without waiting for institutional lethargy. It has shown how by combining the science of measurement (of vitamin D levels) with the personal choice of taking action and, the value of education about individual measures that one can truly be in charge of their own health.

In order to spread this health movement to more communities, the project needs your involvement. To participate, simply purchase the D*Action Measurement Kit and follow the registration instructions included. (Please note that 100 percent of the proceeds from the kits go to fund the research project. I do not charge a single dime as a distributor of the test kits.)

As a participant, you agree to test your vitamin D levels twice a year during a five-year study, and share your health status to demonstrate the public health impact of this nutrient. There is a $65 fee every six months for your sponsorship of this research project, which includes a test kit to be used at home, and electronic reports on your ongoing progress. You will get a follow up email every six months reminding you "it's time for your next test and health survey."

• Abnormal gut flora. An excessive focus on a germ-free environment is another potential contributing factor that impairs immune function. In 2008, animal research13 suggested that beneficial bacteria could protect against the development of type 1 diabetes. There is a good deal of evidence that a contributor to the rising rates of type 1 diabetes is raising our children in too sterile an environment. Many parents religiously use antibacterial soaps and keep their children away from the natural dirt, germs, viruses and other grime of childhood.

Antibiotics, which kill all of the good and bad bacteria in the gut, are also overused in childhood. The lesson here is, it's okay to let your child get dirty. Use plain soap and water for washing. Avoid antibiotics unless absolutely necessary, and feed them naturally fermented foods such as yogurt, pickles and sauerkraut.