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Pic courtesy: The Telegraph
Pic courtesy: The Telegraph
  • Up to 70-90% of Indians are vitamin D deficient, and the deficiency can have adverse consequences for skeletal development in babies and children, and bone health in adults. Moreover, the deficiency is linked to chronic disease, including diabetes, hypertension and cardiovascular disease.
  • A 2019 pan-India study shows the link between vitamin D deficiency and hypertension and diabetes. The study found that 84.2% of type 2 diabetes patients were vitamin D deficient, as were 82.6% of hypertension patients.
  • The findings underscore the need for screening, diagnosis and treatment of this widespread deficiency to help reduce the burden and risks of non-communicable disease.

A 2019 pan-India study authored by PG Talwalkar, Vaishali Deshmukh, M.C. Deepak and Dinesh Agrawal has found that vitamin D deficiency was significantly associated with type 2 diabetes and hypertension.

In India, multiple studies have estimated that the prevalence of vitamin D deficiency is between 70% to 90% of the population, with almost undetectable vitamin D levels during winter.

In Mumbai, a study has found 88% prevalence of vitamin D deficiency in urban adults.  Vitamin D is a critical micronutrient that helps regulate the amount of calcium and phosphorus in the body. These, in turn, are required to keep bones, teeth and muscles healthy.

Deficiency is associated with cardiovascular disease, diabetes, cancer and infectious diseases such as tuberculosis.

Though vitamin D can be synthesised endogenously i.e., produced entirely by the body with adequate exposure to sunlight, it remains the most under-diagnosed and under-treated nutrient deficiency in the world.

Dr Srirupa Das, Medical Director, Abbott, explained, “Pregnant women in India have up to 84% prevalence of vitamin D deficiency, which also correlates with the level of vitamin D deficiency in their newborns.

Children of mothers with suboptimal vitamin D are at risk of reduced prenatal and postnatal skeletal development, which affects both height and bone-health.”

The 2019 pan-India study authored by P.G. Talwalkar et. al. found that Vitamin D deficiency was significantly associated with type 2 diabetes and hypertension. In this cross-sectional study, the overall prevalence of patients with low Vitamin D levels (deficiency and insufficiency) was 83.7%.

Out of this, 82% were newly diagnosed cases. This high prevalence of vitamin D deficiency in newly diagnosed cases indicates that vitamin D deficiency may have been missed in a large proportion of patients with type 2 diabetes, hypertension, or both conditions.

Dr PG Talwalkar of Talwalkar Diabetes Clinic observed, “More than 84% of type 2 diabetes patients were Vitamin D deficient, as were 82% of hypertension patients.  Similarly, 84% of patients with both type 2 diabetes and hypertension were deficient.

The study also investigated co-occurence of deficiency with hypothyroidism and obesity or overweight condition. A majority (76%) of hypothyroid patients had low levels of vitamin D.

Moreover, 82% of patients were obese or overweight, indicating that there may be a link between the deficiency, its comorbidities and body-weight.

These findings highlight the need for routine screening to ensure early diagnosis and effective management of Vitamin D deficiency to help reduce the burden and risks associated with non-communicable disease.

Deficiency can fuel complications in patients with chronic disease. For example, prior population studies have found there is a 3-fold increased risk of ischemic stroke associated with low vitamin D levels in patients with hypertension.

Dr PG Talwalkar stated, “Typically, a dose of 60,000 IU administered weekly for 8 weeks is the norm , though such treatment needs to take factors such as age, development stage, pregnancy and seasonal variations into account.”

Dr Talwalkar informed, “Once sufficiency is restored, sustaining it may require a combination of sunlight exposure for 30 to 45 minutes around noon hours, a diet rich in vitamin D and calcium as well as on-going supplementation, depending on patient compliance and circumstances. Dietary sources of vitamin D include cod liver oil, salmon fish, mackerel, sardines, tuna, egg yolk and mushrooms exposed to sunlight.”

Dr Srirupa Das commented, “Given its high prevalence and the consequences of deficiency, there is a need to recognise vitamin D sufficiency as a health priority. Abbott is committed to raising awareness of the importance of this micronutrient, the use of preventive and treatment methods to ensure sufficiency and to providing innovations to ensure its optimal absorption in the body.”

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