{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:47:42Z","timestamp":1789080462590,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Painful diabetic neuropathy (\n PDN<\/jats:styled-content>\n ) is a common complication of type 1 and type 2 diabetes, causing substantial morbidity. Current treatments, including antidepressants and analgesics, are often only partially effective and may have significant side effects. Vitamin D deficiency affects around 60% of people with diabetes, making supplementation a low\u2010toxicity, biologically plausible intervention. Observational studies suggest potential benefit, but robust evidence from randomised controlled trials (\n RCTs<\/jats:styled-content>\n ) is lacking.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To systematically review and synthesise\n RCT<\/jats:styled-content>\n evidence on the effect of vitamin D supplementation on pain outcomes in\n PDN.<\/jats:styled-content>\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic search was conducted in Medline,\n EMBASE<\/jats:styled-content>\n , Web of Science, Cochrane Library,\n CINAHL<\/jats:styled-content>\n ,\n EBSCO<\/jats:styled-content>\n and Google Scholar up to September 2025. Eligible studies were\n RCTs<\/jats:styled-content>\n comparing vitamin D supplementation with placebo in adults with diabetes and\n PDN<\/jats:styled-content>\n . The primary outcome was pain intensity measured with validated tools. A fixed\u2010effects meta\u2010analysis was performed, with results expressed as standardised mean differences (\n SMD<\/jats:styled-content>\n ). Risk of bias was assessed using the Cochrane\n RoB<\/jats:styled-content>\n tool, and publication bias examined via Egger's funnel plot.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Five studies met inclusion criteria; four (\n n<\/jats:italic>\n \u2009=\u2009320) were included in the meta\u2010analysis. Pooled results showed a significant short\u2010term reduction in pain with vitamin D versus placebo (\n SMD<\/jats:styled-content>\n \u2009=\u2009\u22120.85; 95%\n CI:<\/jats:styled-content>\n \u22121.07 to \u22120.62), with moderate heterogeneity (\n \n I<\/jats:italic>\n 2<\/jats:sup>\n <\/jats:styled-content>\n \u2009=\u200961.4%), equivalent to ~11 points on common pain scales. No studies reported medium\u2010 or long\u2010term outcomes. Study quality varied, with concerns regarding allocation concealment and selective outcome reporting. Four trials were prospectively registered.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Vitamin D supplementation may reduce short\u2010term pain in PDN, but evidence is limited by small sample sizes and methodological quality. Larger, rigorously designed RCTs with longer follow\u2010up are needed before routine vitamin D testing or supplementation can be recommended for PDN in clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/edm2.70118","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:22:28Z","timestamp":1761538948000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Vitamin D for Painful Diabetic Neuropathy: A Systematic Review and Meta\u2010Analysis of Randomised Controlled Trials"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0245-6938","authenticated-orcid":false,"given":"Abraham","family":"Gilbody","sequence":"first","affiliation":[{"name":"North Bristol NHS Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4603-8253","authenticated-orcid":false,"given":"Joseph","family":"Gilbody","sequence":"additional","affiliation":[{"name":"MRC Integrative Epidemiology Unit University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v6.i3.432"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.10.013"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/2091960"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112099"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-53480-4.00005-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2007.00347.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.04.031"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040622314552071"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-009-0070-1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-020-02145-7"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.08.008"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03510.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13798"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3361"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2015-000148"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2022.03.012"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2013.05.023"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-2760(01)00547-1"},{"key":"e_1_2_9_22_1","unstructured":"\u201c!!! 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