J Vet Sci.  2017 Sep;18(3):261-266. 10.4142/jvs.2017.18.3.261.

Calcium homeostasis in diabetes mellitus

• Ahn C
• Kang JH
• Jeung EB

• KMID: 2412442
• DOI: http://doi.org/10.4142/jvs.2017.18.3.261

Abstract

Diabetes mellitus (DM) is becoming a lifestyle-related pandemic disease. Diabetic patients frequently develop electrolyte disorders, especially diabetic ketoacidosis or nonketotic hyperglycemic hyperosmolar syndrome. Such patients show characteristic potassium, magnesium, phosphate, and calcium depletion. In this review, we discuss a homeostatic mechanism that links calcium and DM. We also provide a synthesis of the evidence in favor or against this linking mechanism by presenting recent clinical indications, mainly from veterinary research. There are consistent results supporting the use of calcium and vitamin D supplementation to reduce the risk of DM. Clinical trials support a marginal reduction in circulating lipids, and some meta-analyses support an increase in insulin sensitivity, following vitamin D supplementation. This review provides an overview of the calcium and vitamin D disturbances occurring in DM and describes the underlying mechanisms. Such elucidation will help indicate potential pathophysiology-based precautionary and therapeutic approaches and contribute to lowering the incidence of DM.

Keyword

calcium; calcium channels; diabetes mellitus

MeSH Terms

Animals
Calcium/*metabolism/physiology
Cat Diseases/metabolism/physiopathology
Cats
Diabetes Mellitus/metabolism/physiopathology/*veterinary
Dog Diseases/metabolism/physiopathology
Dogs
*Homeostasis
Hypocalcemia/metabolism/physiopathology/veterinary
Vitamin D/metabolism/physiology
Vitamin D
Calcium

Figure

• 

  Fig. 1 Schematic summary illustrating the relationship between calcium and diabetes. Hyperparathyroidism is related to long-term insulin resistance and relative insulin insufficiency and can lead to overt diabetes mellitus (DM) or deterioration of glycemic control in established DM. Patients with DM have an increased risk for development of acute renal failure due to volume depletion. In particular, parathyroid hormone (PTH) secretion in DM patient tends to decrease. Disrupted calcium homeostasis facilitates renal failure. In DM patients, cellular calcium depletion occurs. In type 1 DM, not only is there diminishment of pancreatic β cells, but both intracellular and intra-endoplasmic reticulum (ER) calcium are depleted. In type 2 DM intra-ER calcium is depleted, which induces ER stress.

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