Can low vitamin D worsen my diabetes?

Vitamin D is a potent anti-inflammatory factor, besides its  protective effects on the insulin-producing cells of the pancreas, its importance in calcium absorption and bone growth and its nourishing effects on the gut microbiome. 

Diabetes mellitus features inflammation as the process through which it damages the organism. Low vitamin D levels leave us vulnerable to the complications of diabetes mellitus, namely blood vessel and nerve damage. 

One of the first steps in diabetes management should be to correct vitamin D deficiency. 

What is the difference between type 1 and type 2 diabetes?

Diabetes mellitus is a condition characterized by high blood glucose levels. There are various forms of diabetes relating to the cause of the problem. Two major categories identified are known as type 1 and type 2 diabetes.

In type 1 diabetes the insulin-producing cells of the pancreas have been destroyed or are non-functional. These individuals do not make enough insulin to survive and rely on insulin injections for life. 

In type 2 diabetes the body is not responding well to the insulin produced and therefore glucose does not get properly absorbed by the cells in the body. We can use pills and/or insulin to improve blood glucose control for patients with type 2 diabetes..

Type 2 diabetes in its origin relates very much to lifestyle and heredity. 

Many factors, including the body's own antibodies may be responsible for beta cell destruction in type 1 diabetes. The role of heredity in the origins of type 1 diabetes is less clear. 

Don't Skip Breakfast

I regularly emphasize the importance of proper timing of meals in controlling weight, blood glucose and cholesterol levels among other health benefits. 

The maxim: 'Eat breakfast like a king, lunch like a prince and dinner like a pauper.'  acquires increased relevance in our modern society afflicted by the scourge of chronic degenerative illness we have come to label 'the metabolic syndrome'.

I published on the application of chrononutrition principles to diabetes mellitus management in 2018: 
Diabetes Spectrum 2018 Jul; ds180014.  https://doi.org/10.2337/ds18-0014

I recently viewed a very interesting video supportive of this message published by Dr. Michael Greger in his Nutrition Facts video series. You will find his message highly informatve. 
https://nutritionfacts.org/video/how-circadian-rhythms-affect-blood-sugar-levels/

With increasing awareness of the importance of meal timing in our health, the metabolic syndrome may soon be known as 'The Circadian Syndrome'.

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J Intern Med. 2019 Aug;286(2):181-191. doi: 10.1111/joim.12924. Epub 2019 Jun 10.

Q & A: Restful Sleep and Diabetes

Dr. Mezitis Replies to Your Questions: 


I work untimely hours. They are never consistent, so my sleep cycle is also different. Lately I have been feeling extremely tired and giddy when I don't eat on time. I went to the doctor and was diagnosed with type 2 diabetes. I have no family history of the disease. Could lack of sleep be the reason of my diabetes? I am not sure what to do.


Restful sleep in sync with the daily light-darkness cycle has been identified as a very important factor in preventing diabetes. Night shift work challenges the body's restorative mechanisms that operate in the evening and overnight. Problems are compounded by eating overnight when the digestive system is in rest mode. Preventing diabetes and 'reversing' diabetes depend on synchronizing our lifestyle with the day/night rhythm: generous breakfast, good lunch, light supper and early bedtime.

Q & A: Hypoglycemia in the Workplace

Dr. Mezitis Replies to Your Questions: 

I have a startup company, and I have 3 employees who are diabetic. As an employer, can you tell me the first aid steps I need to incorporate in case someone goes into hypoglycemia?

The company should have simple sugary snacks and drinks (e.g. orange juice) readily available for dealing with hypoglycemia symptoms. A glucagon kit should be stored in the refrigerator to be injected into muscle in emergencies where the employee or customer are poorly responsive and forcing liquids or foods into their mouth would be unsafe. More recently, an inhaled form of glucagon (Baqsimi) has become available. It may prove more convenient for staff who are unfamiliar or uncomfortable giving injections to administer.

Q & A : Diabetes Medications Losing Effectiveness

Dr. Mezitis Replies to Your Questions: 


My mother has been a diabetic for the past 20 years and has been taking the same medications over a long period of time. Will the medicines lose their effectiveness after some time?


Medications prescribed for diabetes target a variety of organs including the pancreas in order to improve blood glucose levels. If lifestyle changes are not made, the medications may either lose their efficacy or higher doses will be required to control blood glucose.

Q & A : Diabetes Medications and Weight Gain

Dr. Mezitis Replies to Your Questions: 


"My husband has been on diabetic medication for the past 3 months. Particularly after his morning medicine, Janumet, he feels very hungry, which is making him gain a lot of weight. What should I do?"



Many diabetes medications stimulate the appetite and promote weight gain and this may prove counterproductive in the management of the problem. In this situation a change to a medication such as a GLP-1 analogue (Victoza, Trulicity, Byetta, Ozempic) which curbs appetite while reducing blood glucose, may be considered. I prefer to introduce an appetite suppressant such as phentermine, early in the course of management for obese patients with diabetes, knowing that weight loss will solve many of their problems.