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A new pooled data analysis, published in the open-access journal BMJ Nutrition Prevention & Health, has revealed that micronutrient deficiencies are widespread among individuals with type 2 diabetes. The analysis highlights the crucial role that vitamins and minerals play in maintaining healthy bodily function, noting that a lack of essential micronutrients can contribute to the development and complications of the disease.
The study found that micronutrient deficiencies, a condition often referred to as “hidden hunger,” are common in people with type 2 diabetes. Among the most commonly deficient micronutrients is vitamin D, which is lacking in a significant portion of the population. Women, in particular, are at a greater risk of these deficiencies compared to men, according to the findings.
The researchers point to several factors that increase the risk of type 2 diabetes, including genetic predisposition, environmental influences, sedentary lifestyles, poor diets, and obesity. Previous studies have suggested that micronutrients could play a pivotal role in the development of the disease by influencing glucose metabolism and insulin signaling.
To estimate the global prevalence of micronutrient deficiencies in people with type 2 diabetes, the researchers conducted a comprehensive review of existing studies, analyzing data from 132 research papers published between 1998 and 2023. These studies involved a total of 52,501 participants, with most being hospital-based.
The pooled data analysis revealed that micronutrient deficiencies are prevalent in 40–45% of individuals with type 2 diabetes who also have complications associated with the condition. The most common deficiency identified was vitamin D, which affected 60.5% of participants. Magnesium deficiency followed closely, impacting 42% of individuals, while iron and B12 deficiencies were also significant, affecting 28% and 29% of people, respectively. B12 deficiency was notably higher in patients taking the diabetes medication metformin.
Further analysis showed that women with type 2 diabetes had a higher prevalence of micronutrient deficiencies, with rates approaching 49%. The highest rates of deficiencies were found in the Americas, where more than 54% of patients were affected.
However, the study has limitations. Most of the included studies were cross-sectional, meaning they could not establish a cause-and-effect relationship between poor glycemic control and micronutrient deficiencies. Additionally, without population-based studies comparing individuals with type 2 diabetes to the general population, it is impossible to make direct comparisons.
“This systematic review exemplifies the double burden of malnutrition in action, where nutritional deficiencies and diet-related non-communicable diseases, such as type 2 diabetes, coexist,” noted Shane McAuliffe, Visiting Senior Academic Associate at the NNEdPro Global Institute for Food, Nutrition and Health. He emphasized the importance of optimizing overall nutrition and urged that the findings focus attention on further research and policy development aimed at understanding and addressing these deficiencies.
The study underscores the need for greater focus on micronutrient health in the management of type 2 diabetes, complementing existing approaches that mainly target energy metabolism and macronutrient intake.
Disclaimer: This article is based on the findings from the study Burden of micronutrient deficiency among patients with type 2 diabetes: systematic review and meta-analysis, published in BMJ Nutrition Prevention & Health (2025). The study is limited by the cross-sectional nature of most included research and a lack of population-based studies comparing patients with type 2 diabetes to the general population.
