Bharti Jayshankar
January 31, 2025: A recent meta-analysis published in BMJ Nutrition Prevention & Health reveals that more than 45% of patients with type 2 diabetes (T2D) suffer from micronutrient deficiencies, with vitamin D deficiency being the most prevalent.
The study, led by Dr. Daya Krishan Mangal from the Indian Institute of Health Management Research in Jaipur, highlights the significant burden of micronutrient deficiencies among type 2 diabetes patients and their potential role in worsening the condition.
The research analyzed 132 studies involving 52,501 participants globally, providing a comprehensive assessment of micronutrient deficiencies in T2D patients. The findings indicate that 45.30% of T2D patients have multiple micronutrient deficiencies, with women (48.62%) being more affected than men (42.53%). Vitamin D deficiency was the most common (60.45%), followed by magnesium deficiency (41.95%). Additionally, the study found that patients taking metformin, a widely prescribed diabetes medication, had a higher prevalence of vitamin B12 deficiency (28.72%).
“Micronutrient deficiencies may influence glucose metabolism and insulin signaling pathways, leading to the onset and progression of T2D,” the authors write.
Micronutrient deficiencies and diabetes: A two-way relationship
The study underscores the complex relationship between micronutrient deficiencies and T2D. According to the authors, deficiencies in essential vitamins and minerals can disrupt glucose metabolism and insulin signaling pathways, potentially contributing to the onset and progression of diabetes. For instance, vitamin D is known to play a role in insulin secretion and sensitivity, while magnesium is crucial for carbohydrate metabolism. Deficiencies in these nutrients may exacerbate insulin resistance, a hallmark of T2D.
Dr. Mangal and his team also noted regional variations in micronutrient deficiency prevalence. These disparities may be influenced by dietary habits, sunlight exposure (for vitamin D synthesis), and access to healthcare resources.
Role of metformin in Vitamin B12 deficiency
The study highlights a concerning link between metformin use and vitamin B12 deficiency. Metformin, a first-line medication for T2D, has been previously associated with reduced B12 absorption. This deficiency can lead to complications such as anemia, neuropathy, and cognitive impairment, further complicating diabetes management. Experts recommend regular monitoring of B12 levels in patients on long-term metformin therapy and supplementation if necessary.
Implications and recommendations
The findings have significant implications for diabetes care worldwide. With over 537 million adults living with diabetes globally, as reported by the International Diabetes Federation (IDF ) in 2021, addressing micronutrient deficiencies could be a critical component of effective diabetes management. Nutrition-focused interventions, such as dietary modifications and supplementation, may help mitigate these deficiencies and improve patient outcomes.
Dr. Mangal emphasized the need for healthcare providers to integrate nutritional assessments into routine diabetes care. “Addressing micronutrient deficiencies should be a priority in diabetes management, as it can potentially improve metabolic control and reduce complications,” he stated.
This meta-analysis sheds light on the widespread prevalence of micronutrient deficiencies among T2D patients and their potential impact on disease progression. As diabetes continues to rise globally, addressing these deficiencies through targeted nutritional strategies could play a role in improving patient outcomes and reducing the burden of this chronic condition.
For individuals living with T2D, dietary adjustments and potential supplementation may be helpful.
Disclosure: It is worth noting that the study received funding from Abbott, a global healthcare company and one of the study authors has disclosed ties to Abbott.
The full study can be accessed here.
