Endocrine Abstracts

Introduction: Vitamin D (vitD) deficiency is a worldwide epidemic health problem, with a prevalence of about 70–100% in general Indian population. The objective of this cross-sectional, clinico-epidemiological, Pan-India study was to evaluate the prevalence of vitD deficiency in patients with Type-2 diabetes mellitus (T2DM) or hypertension (HT) or both T2DM and HT and to understand the management practices in Indian real-world setting.

Methods: Adults with a diagnosis of T2DM or HT or both (established/newly diagnosed), visiting physician for routine check-up, were enrolled. Percentage of patients with vitD deficiency in those with T2DM/HT/or T2DM+HT and prevailing management practices were assessed. VitD insufficiency and deficiency was defined as serum 25(OH)D levels 21–29 ng/ml and ≤20 ng/ml, respectively.

Results: A total of 1501 (99.5%) patients completed the study (T2DM:500 [99.2%]; hypertension:499 [99.6%]; both T2DM and HT: 502 [99.8%]). Mean (±S.D.) age of the study population was 52.9±12.49 years. Mean age at diagnosis of vitD deficiency was 52.5±10.77 years; mean vitD level at the time of diagnosis was 16.9±12.78 ng/ml. Overall prevalence of patients with low vitD levels (vitD deficiency and insufficiency) was 1257 (83.7%); 1231 (82%) were newly diagnosed cases. Out of 1257 (83.7%) patients with low vitD levels, 60.9% patients had vitD deficiency and 22.9% patients had vitD insufficiency. Prevalence of low vitD levels amongst patients with T2DM (n=500), HT (n=499) and T2DM+HT (n=502) was 84.2%, 82.6% and 84.5%, respectively. Out of 1257 patients with low level of vitD, 84.8% received vitD supplementation. Preferred dose of vitD was 60,000IU (70.2%); route of administration was oral for majority of patients (79.6%). Preferred frequency of dose was once in a week (76.7%). Average duration of treatment was 7.6±3.49 weeks. Factors considered by physician to prescribe vitD supplements were vitD deficiency (26.9%), vitD insufficiency (34.5%), symptoms of vitD deficiency (10.4%) and co-morbid condition (1.8%). Out of 126 patients with low vitD levels and T2DM, 84.37% patients had abnormal HbA1c levels.

Conclusion: Prevalence of vitD deficiency was higher amongst newly diagnosed cases, which indicates that vitD deficiency may have been missed in a large proportion of patients with T2DM, HT, or both T2DM and HT. This study emphasizes on the magnitude of overlap between these diseases and the need for routine vitD screening and appropriate management in Indian patients with T2DM and HT.