Most Patients With Type 2 Diabetes Have Vitamin D Deficiency, Study Suggests

Nearly half of patients with type 2 diabetes (T2D) lack key vitamins and nutrients, with most patients having vitamin D deficiency, according to new research published in BMJ Nutrition, Prevention & Health.¹

To come to this conclusion, researchers analyzed data from 132 studies published from 1998 to 2023 with 52,501 total participants. The pooled prevalence of multiple micronutrient deficiency—including vitamins, minerals and electrolytes—was 45.3%, with a higher prevalence among women with T2D (48.62%) than men (42.53%).

Vitamin D deficiency was the most common among patients, affecting 60.45% of the study cohort. This was followed by magnesium deficiency (41.95%) and vitamin B12 deficiency (23.78%), the latter of which affected patients on metformin even more (28.72%).

Data suggest almost half the type 2 diabetes population is micronutrient deficient. | Image credit: mi_viri – stock.adobe.com

The prevalence of micronutrient deficiencies also varied across World Health Organization regions, indicating potential geographic and dietary influences on nutrient status in patients with T2D. The researchers explained that genetic factors, environmental influences, a sedentary lifestyle, poor dietary habits, and obesity contribute to the risk of developing T2D, with previous studies suggesting that micronutrients may play a crucial role in T2D by influencing glucose metabolism and insulin signaling pathways.

“Increasing clinical evidence supports the notion that a lack of micronutrients, such as biotin, chromium, thiamine, vitamin D and vitamin C, may have metabolic effects,” the authors said. “Deficiency of these vitamins is notably prevalent among individuals who have both obesity and diabetes.”

While not a causal link, these findings underscore the complex relationship between nutrient deficiencies and chronic metabolic diseases, reinforcing the idea that T2D is not only a disorder of glucose metabolism but also one of overall nutritional imbalance. While diabetes management often emphasizes macronutrient intake and glycemic control, experts say the widespread prevalence of vitamin and mineral deficiencies highlights the need for a more comprehensive approach that prioritizes optimizing micronutrient levels.

“This systematic review exemplifies the double burden of malnutrition in action, whereby nutritional deficiencies and diet-related non-communicable diseases, such as type 2 diabetes, co-exist,” said Shane McAuliffe, visiting senior academic associate, NNEdPro Global Institute for Food, Nutrition and Health, in a news release.² “The treatment of type 2 diabetes often tends to focus on energy metabolism and macronutrients, but the identification of a higher prevalence of specific micronutrient deficiencies in those affected is a reminder that optimising overall nutrition should always be a priority.”

The authors noted that most data were collected from cross-sectional studies conducted in hospitals, making it difficult to determine whether micronutrient deficiencies are a cause or a consequence of poor glycemic control, therefore limiting the generalizability of the findings.¹ Potential selection bias and the lack of population-based studies also limit the ability to compare prevalence rates between patients with and without T2D.

Interestingly, micronutrient deficiency was more prevalent in hospital-based studies (46%) than in community-based ones (22%), though only 5 community studies were analyzed compared with 124 hospital studies. However, they noted that the strengths lie in the 25-year timespan of the review, which covered multiple databases without language or geographic restriction.

“The study findings with help address the escalating issue of hidden hinger of micronutrient deficiencies among T2D patients and their long term medical consequences,” the authors said.

References

1. Mangal DK, Shaikh N, Tolani H, et al. Burden of micronutrient deficiency among patients with type 2 diabetes: systematic review and meta-analysis. BMJ Nutrition, Prevention & Health. 2025;0:e000950. doi:10.1136/ bmjnph-2024-000950
2. BMJ Group. Lack of essential vitamins and minerals common in people with type 2 diabetes. EurekAlert. January 28, 2025. Accessed January 28, 2025. https://www.eurekalert.org/news-releases/1071644