Évaluation du statut vitaminique dans une population diabétique ambulatoire

Summary Some vitamin deficiencies are more frequent in diabetes. Among them, the deficit in vitamin D has aroused a particular interest for its possible role in the complications and the pathogenesis of the disease. Other deficiencies as that of the vitamin B12 were put in relation to the treatment by biguanide. Objective The goal of this study is to evaluate the concentrations in vitamins D, B12 and B9 in a diabetic outpatients’ clinic and to study the factors influencing the results. Patients and method One hundred and fifty-six patients with diabetes were studied and compared to 48 non-diabetic patients. The dosage of vitamin D, B12, B9 and of glucose was performed in all patients, as well as glycated haemoglobin (HbA1c), creatinine and haemoglobin in diabetic patients. Vitamins concentrations were correlated with several parameters including the type of diabetes, its control, age, sex, treatment, haemoglobin and creatinine. Results No significant difference in vitamin D, B12 and B9 concentrations was found between diabetic patients and controls. Nevertheless, there was a high percentage of patients severely ( P  = 0.021 and P  = 0.040, respectively). Within the type 2 diabetes, vitamins B12 concentrations were lower in patients treated with biguanide than patients not receiving this treatment. Sex, age, control of diabetes, haemoglobin and creatinine did not significantly correlate with the concentrations of vitamins. Conclusion A high rate of vitamin D deficiency has been highlighted in diabetic outpatients as well as in control patients without an influence of age and sex. Lower vitamin D concentrations were observed in secondary diabetes which could be linked with the malabsorption encountered in pancreatic diseases. Within the diabetic population, biguanide therapy given in type 2 diabetic patients may account for lower vitamin B12 concentrations. Lower vitamin B9 observed in the cardiological group might reflect a relative alimentary insufficiency. A systematic screening for the vitamin status is thus essential in diabetic patients as well in patients with cardiac disease.