Shining the Light on Sunshine: A systematic review of the influence of sun exposure on type 2 diabetes mellitus-related outcomes

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dc.contributor.authorShore-Lorenti, Catherineen_AU
dc.contributor.authorBrennan, Sharonen_AU
dc.contributor.authorSanders, Kerrieen_AU
dc.contributor.authorNeale, Rachelen_AU
dc.contributor.authorEbeling, Peteren_AU
dc.contributor.authorLucas, Robynen_AU
dc.date.accessioned2015-12-13T22:34:27Z
dc.date.issued2014
dc.date.updated2015-12-11T09:21:15Z
dc.description.abstractProspective observational studies uniformly link vitamin D deficiency with the incidence of type 2 diabetes mellitus (T2DM), yet trials supplementing participants at risk of T2DM with vitamin D to reduce progression to T2DM have yielded inconsistent results. Inconsistencies between supplementation trials may be due to insufficient dosing or small sample sizes. Observational studies may also have reported spurious associations due to uncontrolled confounding by lifestyle or genetic factors. Alternatively, observational and intervention studies may not be entirely comparable. Observational studies show an association between higher vitamin D status, which is predominantly derived from sun exposure, and decreased incidence of T2DM. Trials intervene with vitamin D supplementation, and therefore may be missing alternate causes of the effect of sun exposure, as seen in observational studies. We propose that sun exposure may be the driving force behind the associations seen in observational studies; sun exposure may have additional benefits beyond increasing serum 25-hydroxyvitamin D (25OHD) levels. We performed an electronic literature search to identify articles that examined associations between sun exposure and T2DM and/or glucose metabolism. A best evidence synthesis was then conducted using outcomes from analyses deemed to have high methodological quality. Ten eligible full-text articles were identified, yielding 19 T2DM-related outcomes. The best evidence analysis considered 11 outcomes which were grouped into six outcome types: T2DM, fasting glucose, glucose tolerance, fasting insulin, insulin secretion and insulin sensitivity. There was moderate evidence to support a role of recreational sun exposure in reducing odds of T2DM incidence. High-level evidence was lacking; evidence presented for other outcomes was of low or insufficient level. This review highlights significant gaps in research pertaining to sun exposure and T2DM-related outcomes. Further research is encouraged as we aim to identify novel preventative strategies for T2DM.
dc.identifier.issn0300-0664
dc.identifier.urihttp://hdl.handle.net/1885/76126
dc.publisherBlackwell Publishing Inc.
dc.sourceClinical Endocrinology
dc.titleShining the Light on Sunshine: A systematic review of the influence of sun exposure on type 2 diabetes mellitus-related outcomes
dc.typeJournal article
local.bibliographicCitation.issue6
local.bibliographicCitation.lastpage811
local.bibliographicCitation.startpage799
local.contributor.affiliationShore-Lorenti, Catherine, University of Melbourne
local.contributor.affiliationBrennan, Sharon, University of Melbourne
local.contributor.affiliationSanders, Kerrie, University of Melbourne
local.contributor.affiliationNeale, Rachel, Queensland Institute of Medical Research
local.contributor.affiliationLucas, Robyn, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationEbeling, Peter, University of Melbourne
local.contributor.authoremailu4002313@anu.edu.au
local.contributor.authoruidLucas, Robyn, u4002313
local.description.embargo2037-12-31
local.description.notesImported from ARIES
local.identifier.absfor110300 - CLINICAL SCIENCES
local.identifier.ariespublicationU3488905xPUB5014
local.identifier.citationvolume81
local.identifier.doi10.1111/cen.12567
local.identifier.scopusID2-s2.0-84912076306
local.identifier.thomsonID000345326500002
local.identifier.uidSubmittedByU3488905
local.type.statusPublished Version

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