Vitamin D and inflammation in the prevention of type 2 diabetes: Public health relevance

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a major health problem in Qatar. The prevalence of T2DM in the adult population of Qatar is approximately 16% (twice that in the USA) and the country is ranked sixth in the world for diabetes prevalence. The number of cases of childhood diabetes in Qatar has doubled in ten years. The rapid rise of T2DM cases is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. Recent evidence suggests that lack of vitamin D and inflammation may also play a role. Methods: We examined the current knowledge from literature linking T2DM to the chronic low-grade inflammation and the possible role of vitamin D in attenuating the inflammatory factors and, thereby, preventing T2DM. Results: Low-grade inflammation resulting from imbalances in the innate immune system has been associated with an array of chronic disorders that predispose to the later development of T2DM (e.g., obesity, metabolic syndrome, and insulin resistance). As a result, inflammation may contribute to the pathogenesis of T2DM. Therefore, attenuation of this inflammatory response via modulating the innate immune system could lead to improved insulin sensitivity and delayed disease onset. Dietary supplementation with vitamin D, may present a novel strategy toward the prevention and control of T2DM at the population level due to its anti-inflammatory and antioxidant properties. Conclusion: The concept that vitamin D, via attenuating inflammation, could be employed as a novel preventative measure for T2DM, is evaluated in the context of its relevance to healthcare and public health practices. Overall, to reduce the disease risk and burden at the population level, preventative strategies can be developed to include vitamin D supplementation into the traditional intervention protocols (e.g., exercise, life-style modification, etc.).