| Titre : | Effect of Vitamin D and Magnesium supplementation on glycemic response and insulin sensitivity in type 2 diabetic patients in wilaya of Saïda |
| Auteurs : | Nasr-Eddine KEBIR, Directeur de thèse ; Siham Naar, Auteur |
| Type de document : | texte imprimé |
| Editeur : | Dr. Moulay Tahar Université Saida, Faculté des Sciences Naturelles et de la Vie, 2023/2024 |
| Format : | 131 p / 29 CM |
| Accompagnement : | CD |
| Langues: | Français |
| Langues originales: | Français |
| Mots-clés: | Diabetes ; Type 2 diabetes (T2D) ; Magnesium ; Vitamin D ; Insulin sensitivity ; Insulin resistance ; Glycemic control |
| Résumé : |
Diabetes is common disease occuring around the world , diabetes type
2is the most common it represent 90 to 95% ; Magnesium is a co-factor involved in glycolysis and activation of insulin use. Vitamin D is a pro hormone Vitamin D may play a role in defense against type 2 diabetes, it is an essential component of human health and is mainly produced in the skin under the influence of sunlight. Vitamin D and magnesium are important regulators of glucose homeostasis and, in turn, play a crucial role in the management of T2DM, and play role in improving insulin sensitivity and promoting glycemic control, This research investigated if magnesium and vitamin D had an association with glycemic response and insulin sensetivity in type 2 diabetes and effect of their dificiency and supplementation on type 2 diabetics patients . The aim of our work is to evaluate the vitamin D status in diabetic patients and population in wilaya of Saida and distinguish the different factors influencing its deficiency, then to establish correlations between vitamin D status and the involvement of diabetes disease. The results obtained in our prospective study show that 64% of our diabetic patients have a vitamin D deficiency, the majority of whom are women (68%). Our results also showed that our patients do not consume enough foods rich in vitamin D . But data on the relationship between levels of Insulin, vitamin D and magnesium are insufficien. |
| Note de contenu : |
INTRODUCTION ................................................................................................................................ 1
PARTIE II CHAPITRE I : GENERALITIES ............................................................................................... 4 I.1.1. Vitamin D ........................................................................................................................ 5 I.1.1.1. Breif history............................................................................................................................ 5 I.1.1.2. Definition of vitamin D:........................................................................................................... 6 I.1.1.3. Types of vitamin D: ................................................................................................................. 6 I.1.1.4. Chemical and physical characteristics of vitamin D: ................................................................. 8 I.1.1.5. Vitamin D dosage: .................................................................................................................. 9 I.1.1.6. Vitamin D genetics: .............................................................................................................. 10 I.1.1.7. Vitamin D receptor (VDR): ................................................................................................... 10 I.1.1.8. Metabolism of vitamin D: ..................................................................................................... 12 I.1.1.9. Vitamin D sources:................................................................................................................ 25 I.1.1.10. Vitamin D toxcity: ............................................................................................................... 29 I.1.1.11. vitamin D deficiency ........................................................................................................... 31 I.1.1.12. Vitamin D supplementation ................................................................................................ 31 I.1.2. Magnesium: .................................................................................................................. 33 I.1.2.1. Brief history : ........................................................................................................................ 33 I.1.2.2. Description of Magnesium: ................................................................................................... 33 I.1.2.3.Chemical and physiological characteristics of Magnesium: ..................................................... 34 I.1.2.4. Magnesium consumption: .................................................................................................... 35 .5.2.1.5 Magnesium metabolism:..................................................................................................... 36 I.1.2.6. Magnesium sources: ............................................................................................................. 40 .5.2.1.I Role of Magnesium in human body: .................................................................................... 41 I.1.2.8. Magnesium Deficiency : ........................................................................................................ 44 I.1.2.9. Interactions Between Magnesium And Vitamin D Metabolism: .............................................. 45 I.1.2.10. MagnesiumSupplements types :.......................................................................................... 47 I.1.3. Insulin : ......................................................................................................................... 49 I.1.3.1. Breif history: ........................................................................................................................ 49 I.1.3.2. Insulin definition: ................................................................................................................. 49 I.1.3.3. Insulin structure : ................................................................................................................. 49 I.1.3.4. Insulin synthesis: .................................................................................................................. 51 xTable of contents I.1.3.5. Insulin secretion mechanism:................................................................................................ 52 I.1.3.6. insulin signaling pathway: ..................................................................................................... 53 I.1.3.7. Insulin functions : ................................................................................................................. 55 I.1.3.8. Insulin sensitivity: ................................................................................................................. 58 I.1.3.9. Insulin resistance (IR): .......................................................................................................... 58 I.1.4. The glycemic response: ................................................................................................. 61 I.1.4.1. Definition : .......................................................................................................................... 61 I.1.4.2. Glycaemic index (GI): ........................................................................................................... 61 I.1.5. Diabetes :...................................................................................................................... 62 I.1.5.1. Definition : ........................................................................................................................... 62 I.1.5.2. Diabetes classification: ......................................................................................................... 62 I.1.5.3. Methods to detect diabetes .................................................................................................. 65 I.1.5.4. Organestrageted by type 2 diabetes:..................................................................................... 65 I.1.5.5. Type 2 diabetes Causes : ....................................................................................................... 66 CHAPITRE II : .................................................................................................................................. 70 EFFECT OF VITAMIN D AND MAGNESIUM IN TYPE 2 DIABETES ....................................................... 70 I.2. EFFECT OF VITAMIN D ON GLYCEMIC RESPONSE AND INSULIN SENSITIVITY: ............................................... 71 I.2.1. Role of Vitamin D in insulin secretation : ........................................................................ 71 I.2.2.Vitamin D and insulin sensitivity : ................................................................................... 72 I.2.3. Vitamin D and systemic inflammation: .......................................................................... 73 I.3. VITAMIN D AND TYPE 2 DIABETES : ............................................................................................... 73 I.3.1. The genetic component of vitamin D and diabetes: ........................................................ 74 I.3.2. Vitamin D mechanism action in Type 2 Diabetes : .......................................................... 75 I.3.3. Defficiency of Vitamin D and Type 2 Diabetes : .............................................................. 77 I.3.3.1. Vitamin D deficiency and Insulin Secretion: .......................................................................... 77 I.3.3.2. Vitamin D deficiency and metabolic Pathways: ..................................................................... 77 I.3.3.3. Vitamin D deficiency Calcium Dependence: .......................................................................... 77 I.3.3.4. Vitamin D deficiency Clinical Implication : ............................................................................. 77 I.3.4. Vitamin D supplemetation and Type 2 Diabetes ............................................................ 78 I.3.4.1. Vitamin D supplemetation and Inflammatory Cytokines: ....................................................... 78 5.3.4.1. Vitamin D supplemetation and 5nsulin Sensitivity and β-Cell Function: .................................. 78 I.3.4.3. Vitamin D supplemetation and Clinical Implications: ............................................................. 78 I.4. EFFECT OF MAGNESIUM ON GLYCEMIC RESPONSE AND INSULIN SENSITIVITY ............................................. 79 I.4.1. Regulatory role of Mg+2 in the insulin secretion from pancreatic beta cells .................... 79 I.4.2. Regulatory role of Mg2+ on insulin sensitivity: .............................................................. 80 I.4.2.1. Mechanism of action : .......................................................................................................... 80 xiTable of contents I.5. EFFECT OF MAGNESIUM DEFICIENCY IN TYPE 2 DIABETES:.................................................................... 81 I.5.1. Effect of Magnesium defficiency on insulin secretation: ................................................. 81 I.5.2. Effect of Magnesium deficiency on insulin sensitivity: .................................................... 82 I.6. EFFECT OF MG SUPPLEMENTATION INTYPE 2 DIABETES ...................................................................... 82 I.6.1. Mg supplementationand Insulin Receptor and Intracellular Signaling: ............................ 82 I.6.2. Mg supplementationand Gene Expression and Protein Synthesis: ................................... 83 I.6.3. Mg supplementation and Glucose Transport and Metabolism: ...................................... 83 I.6.4. Mg supplementation and Metabolic Pathways: ............................................................ 83 I.6.5. Mg supplementation Clinical Evidence: ......................................................................... 83 I.7. ASSOCIATION OF VITAMIN D AND MAGNESIUM IN INSULIN AND GLYCEMIC CONTROL: ................................ 84 I.7.1. Interrelation of vitamin D and magnesium in the regulation of insulin synthesis and release from pancreatic β-cells: ........................................................................................................ 84 I.7.2.Interrelation of vitamin D and magnesium in the action of insulin at target organs: ........ 85 I.8.ASSOCIATION OF VITAMIN D AND MAGNESIUM IN TYPE 2 DIABETES: ..................................................... 86 PARTIE IV .CHAPITRE III :MATERIAL AND METHOD......................................................................... 88 I.9. RESEARCHMETHODOLOGY : ......................................................................................................... 89 I.10. STUDY DOMAIN : ..................................................................................................................... 89 I.10.1. Temporal domain : ...................................................................................................... 89 .2.01.I Spatial domain: ......................................................................................................... 89 I.10.3. Parts of study: ............................................................................................................. 89 I.10.4. The objective of the study: ........................................................................................... 89 I.10.5. Materials and Methods: .............................................................................................. 90 I.10.5.1. Calculate vitamin D dosage: ............................................................................................... 90 I.10.5.2. calculates the blood sugar level:.......................................................................................... 91 I.10.6. Target population and sampling : ................................................................................ 94 I.10.6.1. Target population : ............................................................................................................. 94 I.10.6.2. Sampling method and sample size:...................................................................................... 94 I.10.7. Statistical processing of data : ..................................................................................... 95 CHAPITREIII : RESULTS AND DISCUSSION........................................................................................ 96 CONCLUSION ET PERSPECTIVES .................................................................................................... 112 REFERENCES BIBLIOGRAPHIQUES ................................................................................................. 115 |
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