Diabetic peripheral neuropathy is more painful if vitamin D is low

Correlation of vitamin D and diabetic peripheral neuropathic pain: A cross-sectional study - June 2026

J Int Med Res 2026 Jun;54(6): 10.1177/03000605261463663

Caixia Yao 1, Li Wang 2, Hongman Zhang 3, Wenping Yang 4, Ying Zhong 1, Wenli Han 1, Ji Xu 1, Yan Chen 1, Ping Wang 1, Shoucheng Zhang 5

Objective: Although ample evidence exists on the association between vitamin D deficiency and diabetic peripheral neuropathy, only a few studies have distinguished between painful and painless forms. This study compared serum vitamin D levels in type 2 diabetes patients with and without painful neuropathy.

Methods: We enrolled 46 patients with diabetes (painless diabetic peripheral neuropathy, n = 15; painful diabetic peripheral neuropathy, n = 16; non-neuropathy, n = 15) and 15 healthy controls. Assessments included neurologic exams, Michigan Neuropathy Screening Instrument, electrophysiology, skin biopsy, and serum 25(OH)D measurements.

Results: The level of 25(OH)D was significantly lower in painful diabetic peripheral neuropathy (23.00 ± 7.97) patients versus controls (44.48 ± 6.77), non- diabetic peripheral neuropathy (31.22 ± 6.14) patients, and painless diabetic peripheral neuropathy patients (36.91 ± 6.22; P < 0.01). Multivariate analysis identified vitamin D as an independent factor for painful diabetic peripheral neuropathy (P = 0.007). The 25(OH)D level was significantly correlated with sural amplitude (r = 0.377), peroneal amplitude (r = 0.434), vibration threshold (r = -0.393), and Michigan Neuropathy Screening Instrument score (r = -0.456).

Conclusions: Serum 25(OH)D levels were significantly lower in painful diabetic peripheral neuropathy, suggesting the potential role of vitamin D deficiency in the pathogenesis of diabetic peripheral neuropathy.

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